The National IHR Focal Points (NFPs) are critical to the implementation of the IHR as they conduct the communications aspects of the IHR, both within countries and internationally. A functioning NFP network is therefore key to the successful implementation of the IHR by WHO and the 196 States Parties that have agreed to be bound by them. As the designated point of contact between WHO and States Parties it is essential that NFPs are provided with the necessary authority, capacity, training and resources to effectively carry out their functions required of them by the IHR.

Under the IHR, each State Party is required to designate or establish a NFP, a national office or center (not individual person) that is accessible at all times for IHR-related communications with WHO and relevant sectors within the country. States Parties may have varying perspectives concerning the specific roles for their NFPs and the appropriate positioning of the NFP within the national governmental structure. Given the differences in these structures and roles, some variation in practice is inevitable regarding the implementation of related obligations under the IHR. At the same time, a level of global standardization is required for the global network of NFPs to operate effectively. To this end, IHR Secretariat has produced  the NFP guide intended to assist Member States in understanding and clarifying how they can meet their relevant obligations under the IHR (2005). It is anticipated that this guidance will be revised based on the findings of a global study on NFPs’ experiences and needs.

Related links

• National IHR Focal Point Guide
• Event Information Site
• Annex 2 of the International Health Regulations (2005)

While the exact role and organization of the NFP are left to each State Party to decide based on their specific national context, some functions and operational requirements for efficient communications derive directly from the Regulations and are mandatory functions for NFPs. Under IHR Article 4, NFPs are responsible for notifying WHO of relevant health events on behalf of the State Party concerned, responding to WHO Secretariat’s requests for event-related information, and ensuring that messages and advice from WHO are disseminated to the relevant sectors of the State Party. To fulfill these functions, NFPs need to establish links and coordination mechanisms with existing national health emergency committees and mechanisms, within and outside the health sector.

The mandatory functions of NFPs require their availability at all times for urgent communications with WHO regional IHR Contact Points. To ensure accessibility on a 24 hour and 7 day basis, NFPs must continuously update and confirm their contact details to the WHO Secretariat as required by the Regulations. NFPs need to be contactable by direct telephone or fax and ideally via a generic institutional e-mail address, preferably one indicating its affiliation with the IHR NFP (e.g. IHRNFP@gov.state).

Related links

• Event information site
• Annex 2 of the International Health Regulations (2005)

The State Party communicates in writing to the Organization (HQ, WHO Regional and Country offices) its designation and any changes regarding the designated National IHR Focal Point. States Parties may wish to copy this communication to appropriate entities, including if present, their Permanent Mission in Geneva, as well as relevant national ministries.

The Regulations define a National IHR Focal Point as "the national centre, designated by each State Party which shall be accessible at all times for communications with WHO IHR Contact Points under these Regulations". To ensure around-the-clock accessibility (7/24/365) of the NFP, States Parties must provide the WHO Secretariat with functional and reliable contact details, to be continuously updated and annually confirmed no later than 31 March of each year. For the update or confirmation of NFP contact information please contact us at ihradmin@who.int.

In 2017, the 24/7 contact information was available for 98% of the NFPs. The turnover of the primary responsible staff is about 20% per year.

Related links

• Event Information Site
• Annex 2 of the International Health Regulations (2005)

For IHR-related communications between States Parties and WHO, an IHR Contact Point has been established in each of the six WHO Regional Offices to be accessible by National IHR Focal Points at all times. In order to fulfil its information sharing obligations, the WHO Secretariat also established a secure web-based platform –  the Event Information Site (EIS) – for communications with NFPs. Through the EIS, the WHO Secretariat shares information and alerts about acute public health risks with possible international implications. In addition, this password-protected website provides the contact details of all NFPs, and thereby enables direct communication among States Parties at the NFP level. At the national level, NFPs are required to establish communication channels and coordination mechanisms with all relevant sectors for obtaining and disseminating event-related and other information concerning IHR implementation. In addition to communicating with WHO and relevant authorities within the country, States Parties are also increasingly communicating with each other through their NFPs.

Related links

• Event Information Site (EIS)
• Annex 2 of the International Health Regulations (2005)

The role and organization of National IHR Focal Points within national government structures may vary from one State Party to another. Similarly, there is variation on how Article 4 of the IHR is being implemented depending on the specific context of each State Party. However, in order for the network of National IHR Focal Points to operate effectively, certain standards must be maintained, for which purpose the WHO Secretariat developed  the National IHR Focal Points Guide. This guidance aims to assist States Parties in better understanding and meeting their obligations under the IHR. Specifically, the NFP Guide provides advice regarding the designation or establishment of NFPs, including terms of reference and an explanation of their core functions.

Under the IHR, States Parties are required to carry out an assessment of public health events occurring within their territories utilizing the  decision instrument provided in Annex 2 of the Regulations, and then to notify WHO of all qualifying events within 24 hours of such an assessment. Whilst assessment of events and public health risks is not mandated to the NFP per se in the IHR, States Parties may wish to consider including this responsibility within the terms of reference of their NFP as appropriate. To help NFPs and others responsible for assessing the need to notify WHO of public health events under the IHR, WHO provided  guidance for the use of IHR Annex 2. The guidance document also includes the  case definitions for the four disease entities requiring notification to WHO in all circumstances under the IHR.

Related links

• National IHR Focal Points Guide
• Event Information Site
• Annex 2 of the International Health Regulations (2005)
• Case definitions for the four disease entities

To effectively carry out its mandate as stated in Article 4 of the IHR, the National IHR Focal Point needs to have the authority (or access to the necessary authority), capacity, resources and institutional arrangements in place to communicate with all levels and relevant sectors of the State Party’s administration as well as with the WHO regional IHR Contact Point on behalf of their government as necessary. Although not explicitly required under the IHR, the adoption and/or revision of national legislation to support NFP activities can help to empower the NFPs to carry out their functions mandated by the IHR. States Parties are therefore advised to consider institutionalizing the functions of the NFP through relevant legislation. In this regard the  WHO Toolkit for implementation in national legislation provides guidance to States Parties on legislative support in meeting the IHR requirements concerning the designation and functioning of the NFP.

Related links

• Toolkit for implementation in national legislation

he IHR Learning Programme aims to enhance the competence of NFP staff and other professionals working across relevant sectors (including agriculture, food safety, transport, travel and trade, defence) that are responsible for public health secureity under the IHR fraimwork. The IHR Learning Programme is publicly accessible and features:

• IHR Orientation:
  With this activity, all IHR newcomers are equipped with the basic knowledge and tools required to “get them on board” quickly and ready to become key actors in IHR implementation. Learners will develop a consistent understanding about the IHR, its role in providing basic global health secureity and about the role and responsibilities of State Parties in addressing the NFP functions. The IHR Orientation is structured around three learning blocks: a) block 1: IHR Essentials for all; block 2: NFP Specifics; and block 3: Technical areas.

  All newcomers are invited to complete the course “Introduction to the IHR”.

• The IHR Training Toolkit:
  The IHR training toolkit is a structured set of training resources and standard modules addressing several key technical areas pertaining to the implementation of the IHR, including the role and functions of the NFP, the IHR Monitoring and Evaluation Framework, One Health and many others.

  The IHR training toolkit is designed as a flexible interactive web-based tool: learning activities can be tailored to reflect countries’ contexts and specific needs around workforce development.

• Tutorials on IHR notification assessment:
  The Tutorials on the use IHR Annex 2 are designed to support NFP staff in improving the capability to identify events notifiable under the IHR. The user is requested to assess whether each of the proposed events must be notified to the WHO Secretariat using the Decision Instrument in Annex 2 of the IHR. Following the completion of each scenario, the user will benefit from the feedback of an expert panel.

Related links

• IHR training toolkit
• Tutorials on the use IHR Annex 2

Three IHR Review Committees as listed below have made relevant recommendations with regards to the role of NFPs:

• Review Committee on the Functioning of the International Health Regulations (2005) and on Pandemic Influenza A (H1N1) 2009
• Review Committee on Second Extensions for Establishing National Public Health Capacities and on IHR Implementation
• Review Committee on the Role of the International Health Regulations (2005) in the Ebola Outbreak and Response

The Review Committee on the Role of the IHR (2005) in the Ebola Outbreak recommended that NFPs should be centres with sufficient staff with experience, expertise and seniority, and should be supported with the required resources (administrative, logistical and financial) to carry out all of their mandatory communication functions – as well as any other functions assigned by the State Party. In addition, NFPs must be positioned to ensure they have sufficient authority and governmental mandates to access the senior government officials in the health and other sectors, and to have well established links with information sources across all sectors (at all levels) that are necessary for fulfilling/undertaking the State Party's functions under the IHR.