A negociação do novo Regulamento Sanitário Internacional (RSI) foi um processo complexo que durou dez anos e envolveu preocupações que extrapolam o campo da saúde pública. Este artigo, resultado final da pesquisa de Mestrado desenvolvida no âmbito do Programa de Pós-Graduação do Instituto de Relações Internacionais da Universidade de São Paulo (IRI/USP), busca demonstrar, por meio de vasta pesquisa documental, revisão de literatura e entrevistas com atores, que a agenda de segurança internacional influenciou as negociações do RSI em vigor, contribuindo para o avanço do processo de securitização da saúde pública. Temas de segurança internacional, notadamente o uso intencional ou acidental de agentes químicos, biológicos, radio-nucleares e a potencial ameaça de bioterrorismo foram determinantes tanto do avanço das negociações como da natureza do documento final aprovado, que promoveu mudanças substanciais na regulação internacional da saúde pública. / The negotiation of the new International Health Regulations (IHR) was a complex 10-year-long process and involved concerns which go beyond the public health field. This article, the final result of the Master\'s program at the Institute of International Relations of the University of Sao Paulo (IRI/USP), aims to demonstrate, through vast documental research, literature review and interview with actors, how the international security agenda influenced the IHR negotiations, advancing the securitization process of public health. International security issues, specially the intentional or accidental use of biological, chemical or radio-nuclear agents and the potential threat of bioterrorism were determinant both for the negotiation advancement and the character of the approved final document, which promoted substantial changes in the international public health regulation.

A negociação do novo Regulamento Sanitário Internacional (RSI) foi um processo complexo que durou dez anos e envolveu preocupações que extrapolam o campo da saúde pública. Este artigo, resultado final da pesquisa de Mestrado desenvolvida no âmbito do Programa de Pós-Graduação do Instituto de Relações Internacionais da Universidade de São Paulo (IRI/USP), busca demonstrar, por meio de vasta pesquisa documental, revisão de literatura e entrevistas com atores, que a agenda de segurança internacional influenciou as negociações do RSI em vigor, contribuindo para o avanço do processo de securitização da saúde pública. Temas de segurança internacional, notadamente o uso intencional ou acidental de agentes químicos, biológicos, radio-nucleares e a potencial ameaça de bioterrorismo foram determinantes tanto do avanço das negociações como da natureza do documento final aprovado, que promoveu mudanças substanciais na regulação internacional da saúde pública. / The negotiation of the new International Health Regulations (IHR) was a complex 10-year-long process and involved concerns which go beyond the public health field. This article, the final result of the Master\'s program at the Institute of International Relations of the University of Sao Paulo (IRI/USP), aims to demonstrate, through vast documental research, literature review and interview with actors, how the international security agenda influenced the IHR negotiations, advancing the securitization process of public health. International security issues, specially the intentional or accidental use of biological, chemical or radio-nuclear agents and the potential threat of bioterrorism were determinant both for the negotiation advancement and the character of the approved final document, which promoted substantial changes in the international public health regulation.

This thesis investigates the impact of international organizations on the making of international law by applying insights on how international organizations work—or fail to work—to the process of institutionalized treaty making. Specifically, I probe the relationship between the World Health Organization (“WHO”) and international infectious disease law, focusing in particular on the 2005 International Health Regulations (“2005 IHR”), which was negotiated, adopted, and is now being implemented under WHO’s auspices. The 2005 IHR is the most recent development in international infectious disease law, the history of which extends back to the beginning of international health cooperation in the mid-nineteenth century, before any international health organization was formed. Relying on secondary sources, WHO documents, archival materials, and personal interviews, I chronologically trace the evolution of international infectious disease law across changing institutional settings. I first examine the incremental growth of the older “barrier” approach to infectious disease regulation, initially developed in the absence of any international health organization and then with the aid of one of WHO’s predecessor organizations. I then analyze the decline of the barrier approach and the rise of the new “epidemiological” approach embodied by the 2005 IHR, with the aid of WHO. Based on my empirical analysis, I conclude that WHO has radically changed the process of making international infectious disease law as well as its content. On its own initiative and without member state demand, WHO’s permanent staff experimented with novel practices that subsequently became the basis for the 2005 IHR. WHO’s work reduced the length of formal negotiation needed to arrive at a new agreement and the uncertainty associated with adopting a novel regulatory system. Its influence also raises normative questions about the proper role of international organizations in making international law—questions that require further exploration.

Šiame darbe yra analizuojamos Tarptautinės sveikatos priežiūros taisyklės, aptariant jų istoriją, pagrindinius principus bei įtaką šiuolaikiniu globalizacijos periodu. Tarptautinės sveikatos taisyklės yra neatsiejama dalis, siekiant išvengti tarptautinio infekcinių ligų plitimo tarptautiniu mastu, netrukdant tarptautinei prekybai bei susisiekimui. Norint išlikti visaverte partnere tarptautinėje erdvėje vystant ekonominę, socialinę padėtį, privalu taisykles įgyvendinti. Lietuva, būdama Pasaulio sveikatos organizacijos, Europos Sąjungos narė, ratifikavo taisykles bei įsipareigojo jas įgyvendinti Lietuvos Respublikos Vyriausybės nutarime iki 2012 metų. Pagrindiniai uždaviniai – suderinti atitinkamus teisės aktus su Taisyklių reikalavimais, užtikrinti tinkamą pasirengimą ir reagavimą į ekstremalias visuomenės sveikatai situacijas, keliančias tarptautinį susirūpinimą, taip pat efektyviai ir laiku koordinuoti tokias situacijas, sustiprinti administracinius gebėjimus, kurių reikia reaguojant į ekstremalias visuomenės sveikatai situacijas, keliančias tarptautinį susirūpinimą. Teisinė bazė yra rengiama pakeičiant/priderinant jau egzistuojančias bei kuriant naujas teisės normas. Lietuvos Respublikos Vyriausybė įsipareigoja teisinę bazę galutinai parengti 2009 metais. / This work is an analysis of the International Health Regulations, discussing their history, basic principles and the impact of globalization in the contemporary period. International Health Regulations are an integral part, to prevent the international spread of infectious diseases internationally, impeding international trade and travel. To remain full–fledged partner in international space development in economic, social situation, the regulations must be implemented. Lithuania as the member of World Health Organization and European Union has ratified the regulations, and undertook implement by the resolution of the Goverment Republic of Lithuania until 2012. The main tasks of harmonizing the legislation with the regulations, are to ensure adequate preparedness and response to emergency public health situations which pose an international concern, as well as an efficient and timely coordination of such situations, to reinforce the administrative capacity needed to respond to emergency public health situations which pose an international concern. The legal framework is being prepared modyfing / adjusting existing and the developing new legal norms. The Government of the Republic of Lithuania commited to finalise legal framework in 2009.

Face aux pandémies, le droit international s'organise-t-il sous la forme d'un « système de sécurité sanitaire collective» (abandon des mesures unilatérales excessives - garantie offerte par la collectivité par le biais d'une action commune - sauvegarde du droit des États d'adopter les mesures individuelles nécessaires) ? L'étude des instruments adoptés au sein de l'OMS (Règlement sanitaire international et Cadre de préparation en cas de grippe pandémique), des actes unilatéraux de l'ONU (résolutions de l'Assemblée générale, du Conseil de sécurité et du Conseil économique et social), de la coopération entre organisations intergouvernementales et des accords de l'OMC (GATT, Accord SPS et Accord sur les ADPIC) révèle que chaque segment de la question reçoit une réponse positive. Pourtant, on ne peut ignorer le caractère largement imparfait du résultat de la lutte contre les pandémies. S'il existe indéniablement des indices en faveur de la thèse selon laquelle un système de sécurité sanitaire collective serait en formation, le droit international face aux pandémies se caractérise par un agglomérat de fragments aux antipodes d'un édifice juridique cohérent. / In the face of pandemics, is international law organized as a "system of collective health security" (foregoing excessive unilateral measures - guaranteed by the community through joint action - upholding State rights to adopt necessary individual measures)? The study of instruments adopted by the WHO (International Health Regulations, Pandemic Influenza Preparedness Framework), of unilateral acts of the UN (resolutions of the General Assembly, the Security Council and the Economic and Social Council), of cooperation between international organizations and of the WTO's Agreements (GATT, SPS Agreement and TRIPS Agreement) reveals that the answer to each segment of the question is positive. However, one cannot ignore the highly imperfect result of the fight against pandemics. If there are undeniable indices which illustrate the existence of a nascent system of collective health security, international law in the face of pandemics is nevertheless thus far characterized by an agglomerate of fragments at odds with a coherent legal edifice.

This diploma thesis on the theme:"The implementation of the International Health Regulations, 2005 in Czech Republic.", is divided into theoretical and practical part.The theoretical part focuses on the International Health Regulations 2005 capacity required, and the measures proposed in the Czech Republic. It describes the history of the International Health Regulations and the implementation of International Health Regulations 2005, in Czech Republic.I also deal, in this part of thesis, about highly contagious diseases.Data processing research for this study was collected in the district of Český Krumlov. The research was conducted by a qualitative method.The sample consisted of 8 respondents.The aim of the study was to determine whether practitioners know how to proceed in case of a patient with a highly contagious disease in their office.This diploma thesis could serve as a source of information, whether the Czech Republic meet the requirements formulated by the World Health Organization in the International Health Regulations 2005.

Rift Valley fever (RVF) is an emerging viral zoonosis that causes frequent outbreaks in east Africa and on the Arabian Peninsula. The likelihood of RVF global expansion due to climate change and human anthropogenic factors is an important issue. The causative agent, RVF virus, is an arbovirus that is transmitted by several mosquito species and is able to infect a wide range of livestock as well as people. The infection leads to mass abortions and death in livestock and a potentially deadly hemorrhagic fever in humans. RVF has severe socio-economic consequences such as animal trade bans between countries, disruption of food security, and economic disaster for farmers and pastoralists as well as for countries. Human behavior such as direct contact with infected animals or their fluids and exposure to mosquito bites increases the risk for contracting the disease. To better understand the challenges associated with RVF outbreaks and to explore prevention and control strategies, we used the One Health approach. The local community had to be involved to understand the interaction between the environment, animals, and humans. We focused on Sudan, Saudi Arabia, and Kenya. First, we systematically reviewed the literature and then we performed cross sectional community-based studies using a special One Health questionnaire. Climatic and remote sensing data were used in combination with statistics to develop a sub-region predictive model for RVF. For both Saudi Arabia and Sudan, the ecology and environment of the affected areas were similar. These areas included irrigation canals and excessive rains that provide an attractive habitat for mosquito vectors to multiply. The surveillance systems were unable to detect the virus in livestock before it spread to humans. Ideally, livestock should serve as sentinels to prevent loss of human lives, but the situation here was reversed. Differences between countries regarding further spread of RVF was mainly determined by better economic and infrastructure resources. In Sudan, there was a lack of knowledge and appropriate practices at the studied community regarding RVF disease symptoms and risk factors for both animals and humans. The community was hesitant in notifying the authorities about RVF suspicion in livestock due to the lack of a compensation system. The perceived role of the community in controlling RVF was fragmented, increasing the probability of RVF transmission and disease. In Kenya, our study found that better knowledge about RVF does not always translate to more appropriate practices that avoid exposure to the disease. However, the combination of good knowledge, attitudes, and practices may explain why certain communities were less affected. Strategies to combat RVF should consider socio-cultural and behavioral differences among communities. We also noticed that RVF outbreaks in Kenya occurred in regions with high livestock density exposed to heavy rains and wet soil fluxes, which could be measured by evapotranspiration and vegetation seasonality variables. We developed a RVF risk map on a sub-regional scale. Future outbreaks could be better managed if such relevant RVF variables are integrated into early warning systems. To confront RVF outbreaks, a policy is needed that better incorporates ecological factors and human interactions with livestock and environment that help the RVF pathogen spread. Early detection and notification of RVF is essential because a delay will threaten the core of International Health Regulations (IHR), which emphasizes the share of information during a transboundary disease outbreak to avoid unnecessary geographical expansion.