International Health Regulations

The IHR build upon national and international collaborations for early detection and limitation of the spread of communicable diseases and substances that pose an international threat to human health, both in Sweden and across borders. The IHR cover all serious threats to public health – whether they are spread by accident or intentionally. These threats include everything from chemical, biological, radiological and nuclear (CBRN) threats to health threats of an environmental or unknown origin.

Sweden’s roles and responsibilities as per the IHR

The International Health Regulations have been implemented into Swedish law through the Swedish Protection Against International Threats to Public Health Act (2006:1570). The Act tasks the Public Health Agency of Sweden with coordinating preparedness against serious international health threats. The Agency is also the Government’s designated national focal point and has a duty to report to the WHO as stipulated in the IHR.

The Agency evaluates whether there is an international threat to human health and then reports any identified threats to the WHO within 24 hours. Furthermore, the Agency must continually inform the relevant public authorities, municipalities and regions about the measures being taken.

Existing national structures and resources need to be used in order to meet the requirements the IHR set for monitoring, reporting, notifying and managing serious health threats. The IHR is therefore part of the Swedish crisis management system, and should be approached within the framework for each authority’s area of responsibility. Additionally, the three fundamental principles of the crisis management system should be followed. These are: responsibility, equality, and proximity.

Several authorities are responsible for preventing and managing incidents involving hazardous substances in their respective sector. The IHR-related threats extend across all these areas. Those who have the general responsibility for one area do so both during a national crisis and an IHR-related event.

The following requirements are in place in addition to the creation of a national point of contact:

• duty to inform and assess threats (in Swedish)
• designated ports and airports in Sweden (in Swedish)
• health declaration forms in the event of threats to people’s health on board ships and aircrafts (in Swedish)
• ship sanitation certificates (in Swedish)

European Union (EU) Health threat legislation

EU member states cooperate to protect against cross-border health threats. The implementation of the IHR in the European Union is regulated by Decision No. 1082/2013/EU on serious cross-border threats to health. This legislation includes guidelines on epidemiological monitoring and responses to serious cross-border threats to human health, including preparedness and planning courses of action in conjunction with these events. It also aims to promote collaboration and coordination between member states.

The Public Health Agency of Sweden is the national point of contact for the European Early Warning and Response System (EWRS).The system enables member states to rapidly inform each other and the EU Commission about outbreaks of communicable diseases that risk being spread to other EU countries.

Current regulations

• The Protection Against International Threats to Public Health Act (2006:1570) (riksdagen.se) (in Swedish)
• The Protection Against International Threats to Public Health Ordinance (2007:156) (riksdagen.se) (in Swedish)
• Regulations and general guidelines on protecting against international threats to human health HSLF-FS 2015:8
• Regulations and general guidelines on the duty to inform about international threats to human health HSLF-FS 2015:9

Further reading

• International Health Regulations (who.int)
• Declaration of a public health emergency of international concern (PHEIC) (in Swedish))
• Decision No 1082/2013/EU of the European Parliament and of the Council of 22 October 2013 on serious cross-border threats to health (eur-lex.europa.eu)