By IPS Correspondents
NAIROBI, Apr 7 2007 (IPS)

Just two months remain before the international community is scheduled to take a critical step forward in addressing global health threats, marked by the entry into force of the updated ‘International Health Regulations’.

Described by the World Health Organisation (WHO) as a “key milestone in public health”, the beefed up rules will give both the WHO and states party to the regulations greater responsibilities for monitoring and responding to national health threats that have the potential to become global emergencies. The ‘International Health Regulations (2005)’ – or ‘IHR(2005)’ – revises the 1969 version of the IHR, and is the first legally binding agreement of its kind.

But while IHR(2005) looks good on paper, can it realistically be implemented in countries such as Kenya, which are already struggling to meet public health needs?

Health experts interviewed by IPS agreed that the limited resources and facilities of the East African country would present a challenge concerning the new regulations.

“We are required to report cases of diseases immediately (but) we do not have adequate laboratories. When there is a real need to get results out quickly, we cannot,” said Ahmed Ogwell, head of international health relations at the Ministry of Health.

“But that does not mean that we do not strive to meet the stipulations of IHR(2005), because the cost of not doing it is a lot higher than our cost of stretching resources. So we are stretching our resources to meet the regulations, which Kenya has signed up to.”

Information from the WHO country office in Kenya shows government has increased the national health budget from about 217 million dollars in 2001/2 to some 333 million dollars in 2006/7.

Nonetheless, certain departments that are considered critical for controlling the spread of illnesses remain underfunded, noted Ogwell. These include the port health authority, which lacks sufficient facilities to place in isolation people who have contracted infectious diseases, upon their entry into Kenya. “We have not adequately funded port health; we need three times what we have,” Ogwell said.

Shortages of staff for both public and veterinary health departments – and constraints on employing more personnel – aggravate matters.

“We have skilled personnel who are well trained. The problem is that they are old and are soon retiring and…we have not recruited any new persons for over ten years,” said Simon Kimani, chief veterinary field officer at the Department of Veterinary Services in the Ministry of Livestock and Fisheries Development.

The dangers of this situation have been highlighted by the outbreak of avian influenza that began in south-east Asia four years ago, showing anew the need for governments to maintain their ability to monitor health threats.

Millions of chickens have been culled in an attempt to contain the H5N1 virus that is responsible for this epidemic – and which has also claimed a number of human lives. There are fears that the virus could mutate into a form that is very infectious for humans.

Kenyan authorities have responded by training farmers to be on the look out for signs of avian influenza.

“We have encouraged farmers to report any dead bird or unusual happenings on farms, for example an unusual number of birds dying en masse. Farmers have also been told how to handle dead birds,” Kimani said.

To date, no cases of avian influenza have been reported in Kenya. Hundreds of birds were found dead in Kasarani on the outskirts of the capital, Nairobi, last year; however, the birds were later diagnosed as having died from Newcastle disease, a highly contagious illness that is also fatal.

The African country currently in the front lines of the avian influenza epidemic is Egypt, where the number of people testing positive for the virus reportedly stood at 33 this week. Thirteen Egyptians are said to have died from bird flu since it was first detected in the country last year. The North African state reportedly also has the highest number of confirmed bird flu cases amongst humans outside of Asia.

The cross-border health threats that Kenya is grappling with also include polio, this after the country’s northern neighbour – Somalia – became re-infected with the virus in 2005.

Three cases of polio were reported recently in Eastleigh, a suburb of eastern Nairobi that is home to thousands of Somalis, many of whom remain in contact with relatives in their homeland. Each of the cases was traced back to Somalia, according to government.

Renewed conflict in Somalia has undermined efforts to halt the march of polio. A transitional government for the Horn of Africa state was inaugurated in 2004 in a bid to end more than a decade of lawlessness sparked by the toppling of dictator Mohamed Siad Barre; however, this administration has since become embroiled in a power struggle with an Islamic grouping.

“Every time war breaks out in Somalia, we have to conduct a polio campaign to ensure that children below the age of five are immunised to keep them safe,” said Ogwell. But, the “conflict in Somalia complicates our ability to respond”.

The particular risk posed by global health threats is in the spotlight this week with World Health Day (Apr. 7), which is focusing on the need for international cooperation to deal with these threats under the theme ‘Invest in health, build a safer future’.

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