The International Health Regulations (IHR), the legally binding set of rules providing a framework to prevent the spread of public health events across borders, have a long and illustrious history that goes back over 170 years. Under its Country Cooperation Strategy 2023-2026, WHO Mauritius is committed to scaling up IHR capacity and public health emergency preparedness . As part of this priority, it recently organized a weeklong interactive training on IHR targeting a wide range of stakeholders who all have a role to play in Mauritius’ compliance to IHR as a first line of defense against epidemics and other potential public health threats.

The Ministry of Health and Wellness (MOHW) is instrumental in ensuring compliance with the IHR. A National Focal Point (NFP) was established following a Joint External Evaluation  in 2018 and the country regularly conducts the States Parties Self-Assessment Annual Reporting (SPAR) Tool which aims to assess progresses in strengthening IHR core capacities. 

In addition, the country has developed a National Action Plan for Health Security, as well as action plans for antimicrobial resistance and infection prevention and control. The Ministry is also working on the setting up of a Public Health Emergency Operations Centre. WHO and the MOHW have developed an operational plan to accelerate Integrated Disease Surveillance and Reporting coverage from a baseline of 25% of health facilities reporting on all priority diseases on a timely (daily or weekly) basis in 2022 to a rate of 100% by the end of 2024. 

The COVID-19 pandemic amplified the recognition of the importance of IHR, providing additional impetus to accelerate implementation. “The country’s tourism industry and business attractiveness involve the high movement of people and goods. These must be safeguarded to support its socio-economic growth,” noted Dr Anne Ancia at the closing ceremony. Indeed, at their core, the IHR were developed with the dual objective of saving lives and maintaining travel and trade. “This is why it is crucial for Mauritius to adhere to these regulations and to continuously enhance its preparedness and response to public health emergencies.” 

Emphasizing the need for preparedness, Dr Fazil Khodabocus, acting director of Public Health at the MOHW, referred to previous outbreaks of infectious diseases between 2006 and 2010, such as chikungunya, dengue and Influenza A (H1N1). These events led to the creation of the Communicable Diseases Control Unit to better coordinate the response to public health emergencies. Dr Khodabocus also stressed “the importance of transparency” when dealing with such outbreaks. 

For Soobdial Rajkoomaree, acting manager of the neonatal ICU of Dr AG Jeetoo Hospital, the workshop was her first exposure to IHR. “Although this was the first time I was hearing about IHR, it will be come in very useful, be it now at ward level or later on in my career if I come to be involved in policy making,” she explains. “Now that I know about IHR, how we should proceed, how to put an emphasis on the core IHR capacities at ward level and how to allocate resources efficiently, such as nursing staff. The gameplay in particular was very useful.”

Indeed, the WHO consultants, Amarachi Abianuru and Joel Gandar, used gameplay techniques, including scenario planning, to help participants grasp the way that IHR function by getting them to react to realistic situations. The workshop was also the opportunity to introduce some participants to the One Health approach whilst refreshing the knowledge of others. 

Manisha Curpen Mahadoo, senior scientific officer at laboratories division of the Ministry of Blue Economy, Marine Resources and Shipping, explains that the training introduced her to core capacities involving Surveillance, Laboratory, Food Safety and Risk Communication. “I understand how IHR must be integrated into our approach. The next step will be to set up a committee at the level of each ministry to facilitate multisectoral engagement under the One Health approach.”

For his part, Zaheed Jhummun, community pharmacist and secretary of the Pharmaceutical Association of Mauritius, says that he had a notion of IHR and One Health previously, but that the learning country package had greatly enriched his understanding. He is now keen to disseminate what he’s learned as part of the association’s monthly continuous professional development sessions. “There are around 400 pharmacies in Mauritius, which form a useful network. We can play an important role in contributing to the IHR core capacities and surveillance, in particular, as we are present at community level in every corner of the country.”

Scaling up IHR core capacities and improving the country’s emergency preparedness is an ongoing undertaking. The IHR training marked an important step in introducing, in some cases, and reinforcing, in others, vital awareness of the regulations and the One Health approach among key stakeholders who now look forward to putting this knowledge to good use in their respective roles.