To help draw lessons from the COVID-19 pandemic and be better prepared for the next health crisis, the IPU and the World Health Organization (WHO) have jointly published Strengthening health security preparedness: The International Health Regulations (2005). This is the 34th handbook for parliamentarians published by the IPU. The handbook is designed to be an essential tool for parliamentarians and parliaments on bolstering emergency preparedness and health security.
Ongoing health risk
Since the 1918 Spanish influenza pandemic, there have been at least six pandemics, including COVID-19. Each of these has been a zoonosis (a disease caused by germs that spread from animals to people), and each underscores how a public-health crisis can lead to significant health and economic losses and deprive people of opportunities. Climate change, the wildlife trade and damage to natural ecosystems all increase the potential for viruses that infect animals to make the jump to people. Such virus-related health emergencies, large and small, will keep occurring in the future.
WHO Director-General Dr. Tedros Adhanom Ghebreyesus said: “Global health crises impact all segments of society, and no community in our world is fully protected against them. Resilient health systems are vital for preparing for and responding to emergencies, and for maintaining essential health services during a crisis.”
The IPU Secretary General Martin Chungong said: “Parliaments and parliamentarians play a unique and powerful role in achieving health preparedness through their various responsibilities: law-making, oversight, budgetary allocation and citizen representation…. Parliaments and parliamentarians are extremely well positioned to help build and strengthen all three.”
The International Health Regulations (2005) (IHR)
The handbook uses the framework of the International Health Regulations (2005), which are an instrument of international law conferring rights and obligations on individual countries. They are designed to prevent the spread of disease internationally and to guide the public-health response when risks arise. The response must be proportional to the risk and avoid unnecessary interference with international traffic and trade.
The COVID-19 pandemic has demonstrated that the world remains at high risk, and that strong levels of national preparedness across all relevant sectors are crucial to ensuring the effective management of health emergencies. The pandemic has also shown the need to scale up the implementation of the International Health Regulations, under which countries are required to build and maintain strong and resilient health systems to prevent, detect and rapidly respond to and recover from public health crises.
Health security preparedness
At the global level, the IHR provide an overarching legal framework that is legally binding for all countries. They facilitate the regular monitoring and evaluation of health-security capacities through their inclusion in the annual self-assessment and reporting that is mandatory for all UN members.
Another monitoring and evaluation mechanism is the joint external evaluation (JEE), a voluntary, collaborative, multisectoral process to assess country capacities to prevent, detect and rapidly respond to public-health risks, whether occurring naturally or due to deliberate or accidental events.
The role of parliaments
Parliaments and parliamentary staff have a crucial role to play in the preparedness process, including the support to cross-sector capacity-building efforts and by providing legislative oversight. Without parliamentary oversight over legislation designed to enable emergency health or budget measures, parliaments are stripped of an important function which then weakens democratic governance. Hasty lawmaking can also lead to unintended consequences when insufficient consideration is given to all aspects of a proposed new law.
COVID-19 exposed the lack of preparedness on the parliamentary level. Owing to imposed restrictions, some parliaments met less frequently while others stopped meeting entirely for a period. One consequence for some parliaments was that their lawmaking and oversight functions were bypassed, replaced by subordinate legislation or executive orders that did not go to parliament for consideration.
A balance should be struck between the need to move quickly in an emergency and parliament’s role in the passage of new principal legislation and budget approval, which should generally not be managed via executive order. Part of preparedness is ensuring that the rules and arrangements that support a swift response are matched by appropriate, flexible arrangements that enable parliament to exercise oversight in an appropriately streamlined process.
The time is now
The time to examine and recalibrate the rules is well ahead of any health emergency. Preparedness implies creating the necessary legal and administrative frameworks for flexibility in a potential emergency. Parliamentarians using the handbook Strengthening health security preparedness: The International Health Regulations (2005) which includes a checklist to ascertain what needs to be done, can make sure they are preparing now for the next health emergency.