Assessment of the Implementation of the International Health Regulations during the COVID-19 Pandemic: Portugal as a Case Study

Authors

  • Guilherme Queiroz National School of Public Health. Universidade NOVA de Lisboa. Lisboa; Agrupamento de Centros de Saúde do Baixo Vouga. Administração Regional de Saúde do Centro. Coimbra.
  • Joana Maia National School of Public Health. Universidade NOVA de Lisboa. Lisboa; Agrupamento de Centros de Saúde do Estuário do Tejo. Administração Regional de Saúde de Lisboa e Vale do Tejo. Lisboa. 
  • Filipa Gomes National School of Public Health. Universidade NOVA de Lisboa. Lisboa; Agrupamento de Centros de Saúde de Loures-Odivelas. Administração Regional de Saúde de Lisboa e Vale do Tejo. Lisboa.
  • José Chen-Xu National School of Public Health. Universidade NOVA de Lisboa. Lisboa; Agrupamento de Centros de Saúde do Baixo Mondego. Administração Regional de Saúde do Centro. Coimbra. 
  • Joana China National School of Public Health. Universidade NOVA de Lisboa. Lisboa; Agrupamento de Centros de Saúde Arrábida. Administração Regional de Saúde Lisboa e Vale do Tejo. Lisboa.
  • Sofia Carmezim Pereira National School of Public Health. Universidade NOVA de Lisboa. Lisboa; Agrupamento de Centros de Saúde Amadora. Administração Regional de Saúde Lisboa e Vale do Tejo. Lisboa. 
  • Patrícia Pita Ferreira National School of Public Health. Universidade NOVA de Lisboa. Lisboa; Agrupamento de Centros de Saúde Oeste Norte. Administração Regional de Saúde Lisboa e Vale do Tejo. Lisboa.
  • José Ramalho National School of Public Health. Universidade NOVA de Lisboa. Lisboa; Agrupamento de Centros de Saúde Lisboa Ocidental e Oeiras. Administração Regional de Saúde Lisboa e Vale do Tejo. Lisboa.
  • Joana Roque National School of Public Health. Universidade NOVA de Lisboa. Lisboa; Agrupamento de Centros de Saúde Oeste Sul. Administração Regional de Saúde Lisboa e Vale do Tejo. Lisboa.
  • José Pedro Teixeira National School of Public Health. Universidade NOVA de Lisboa. Lisboa; Agrupamento de Centros de Saúde Sintra. Administração Regional de Saúde Lisboa e Vale do Tejo. Lisboa.
  • Constança Carvalho National School of Public Health. Universidade NOVA de Lisboa. Lisboa; Unidade Local de Saúde do Litoral Alentejano. Administração Regional de Saúde do Alentejo. Alentejo.
  • Luís Oliveira National School of Public Health. Universidade NOVA de Lisboa. Lisboa; Agrupamento de Centros de Saúde do Baixo Mondego. Administração Regional de Saúde do Centro. Coimbra. 
  • Diogo Simões National School of Public Health. Universidade NOVA de Lisboa. Lisboa; Agrupamento de Centros de Saúde Almada – Seixal. Administração Regional de Saúde Lisboa e Vale do Tejo. Lisboa. 
  • João Gomes National School of Public Health. Universidade NOVA de Lisboa. Lisboa; Agrupamento de Centros de Saúde de Pinhal Interior Norte. Administração Regional de Saúde do Centro. Coimbra.
  • Carla Lopes National School of Public Health. Universidade NOVA de Lisboa. Lisboa; Agrupamento de Centros de Saúde Cascais. Administração Regional de Saúde Lisboa e Vale do Tejo. Lisboa.
  • Tiago Correia Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL. Instituto de Higiene e Medicina Tropical. Universidade NOVA de Lisboa. Lisboa.

DOI:

https://doi.org/10.20344/amp.19887

Keywords:

COVID-19, Decision Making, Health Policy, International Health Regulations, Pandemics, Preparedness

Abstract

Introduction: The International Health Regulations (IHR) were developed to prepare countries to deal with public health emergencies. The spread of SARS-CoV-2 underlined the need for international coordination, although few attempts were made to evaluate the integrated implementation of the IHR’s core capacities in response to the COVID-19 pandemic. The aim of this study was to evaluate whether IHR shortcomings stem from non-compliance or regulatory issues, using Portugal as a European case study due to its size, organization, and previous discrepancies between self-reporting and peer assessment of the IHR’s core capacities.
Methods: Fifteen public health medical residents involved in contact tracing in mainland Portugal interpreted the effectiveness of the IHR’s core capabilities by reviewing the publicly available evidence and reflecting on their own field experience, then grading each core capability according to the IHR Monitoring Framework. The assessment of IHR enforcement considered efforts made before and after the onset of the pandemic, covering the period up to July 2021.
Results: Four out of nine core IHR capacities (surveillance; response; risk communication; and human resource capacity) were classified as level 1, the lowest. Only two were graded level 3 (preparedness; and laboratory), the highest. The remaining three) (national legislation, policy & financing; coordination and national focal point communication; and points of entry) were classified as level 2.
Conclusion: Portugal exemplifies the extent to which implementation of the IHR was not fully achieved, which has resulted in the underperformance of several core capacities. There is a need to improve preparedness and international cooperation in order to harmonize and strengthen the global response to public health emergencies, with better political, institutional, and financial support.

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Published

2023-10-11

How to Cite

1.
Queiroz G, Maia J, Gomes F, Chen-Xu J, China J, Carmezim Pereira S, Pita Ferreira P, Ramalho J, Roque J, Teixeira JP, Carvalho C, Oliveira L, Simões D, Gomes J, Lopes C, Correia T. Assessment of the Implementation of the International Health Regulations during the COVID-19 Pandemic: Portugal as a Case Study. Acta Med Port [Internet]. 2023 Oct. 11 [cited 2024 May 28];36(12):819-25. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19887

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