Achieving compliance with the International Health Regulations by overseas territories of the United Kingdom of Great Britain and Northern Ireland.

The 2005 International Health Regulations (IHR) came into force for all Member States of the World Health Organization (WHO) in June 2007 and the deadline for achieving compliance was June 2012. The purpose of the IHR is to prevent, protect against, control - and provide a public health response to - international spread of disease. The territory of the United Kingdom of Great Britain and Northern Ireland and that of several other Member States, such as China, Denmark, France, the Netherlands and the United States of America, include overseas territories, which cover a total population of approximately 15 million people. Member States have a responsibility to ensure that all parts of their territory comply with the IHR. Since WHO has not provided specific guidance on compliance in the special circumstances of the overseas territories of Member States, compliance by these territories is an issue for self-assessment by Member States themselves. To date, no reports have been published on the assessment of IHR compliance in countries with overseas territories. We describe a gap analysis done in the United Kingdom to assess IHR compliance of its overseas territories. The findings and conclusions are broadly applicable to other countries with overseas territories which may have yet to assess their compliance with the IHR. Such assessments are needed to ensure compliance across all parts of a Member States' territory and to increase global health security.

Le Règlement sanitaire international de 2005 (RSI) est entré en vigueur pour tous les États membres de l'Organisation mondiale de la Santé en juin 2007, et la date limite pour sa mise en conformité était juin 2012. L'objectif du RSI est de prévenir, de protéger, de contrôler ­ et d'apporter une réponse de santé publique ­ à la propagation internationale des maladies. Le territoire du Royaume-Uni de Grande-Bretagne et d'Irlande du Nord et celui d'autres États membres, comme la Chine, le Danemark, la France, les Pays-Bas et les États-Unis d'Amérique, se composent de territoires d'outre-mer, lesquels couvrent une population totale d'environ 15 millions d'habitants. Les États membres ont la responsabilité de veiller à ce que toutes les parties de leur territoire se conforment au RSI. Étant donné que l'OMS ne fournit pas d'orientation spécifique concernant la conformité dans les circonstances spéciales des territoires d'outre-mer des États membres, leur conformité est une question d'auto-évaluation par les États membres eux-mêmes. À ce jour, aucun rapport n'a été publié sur l'évaluation de la conformité au RSI dans les pays possédant des territoires d'outre-mer. Nous décrivons une analyse des lacunes effectuée au Royaume-Uni pour évaluer la conformité au RSI de ses territoires d'outre-mer. Les résultats et les conclusions sont largement applicables aux autres pays possédant des territoires d'outre-mer, qui peuvent cependant évaluer leur propre conformité au RSI. Ces évaluations sont nécessaires pour veiller à la conformité dans toutes les parties du territoire d'un État membre et pour augmenter la sécurité sanitaire mondiale.

El Reglamento Sanitario Internacional 2005 (RSI) entró en vigor para todos los Estados miembros de la Organización Mundial de la Salud (OMS) en junio de 2007 con junio de 2012 como fecha límite para lograr el cumplimiento. El objetivo del RSI es prevenir, proteger, controlar y proporcionar una respuesta de salud pública a la propagación internacional de enfermedades. El territorio del Reino Unido de Gran Bretaña e Irlanda del Norte y otros Estados miembros como China, Dinamarca, Francia, los Países Bajos y los Estados Unidos de América cuentan con territorios de ultramar que abarcan una población total de aproximadamente 15 millones de personas. Los Estados miembros tienen la responsabilidad de garantizar que todos sus territorios cumplan con el RSI. Puesto que la OMS no ha proporcionado orientación específica sobre el cumplimiento para las circunstancias especiales de los territorios de ultramar de los Estados miembros, el cumplimiento por parte de estos territorios es un problema que los propios Estados miembros tienen que evaluar. Hasta la fecha no se han publicado informes sobre la evaluación del cumplimiento del RSI en los países con territorios de ultramar. Describimos un análisis de las deficiencias realizado en el Reino Unido con objeto de evaluar el cumplimiento del RSI de sus territorios de ultramar. Los resultados y conclusiones son ampliamente aplicables a otros países con territorios de ultramar que quizá aún tengan que evaluar su cumplimiento con el RSI. Dichas evaluaciones son necesarias para asegurar el cumplimiento en todos los territorios de los Estados miembros y para aumentar la seguridad sanitaria mundial.

Incidence and patterns of detection and management of childhood-onset hereditary retinal disorders in the UK.

BACKGROUND: A prospective, national population-based cross-sectional study to enable understanding of the burden and management in the UK of hereditary retinal disorders presenting in childhood. METHODS: Children aged <16 years with a new diagnosis of an inherited retinal disorder made between September 2006 and February 2008 in the UK were identified through two national active surveillance schemes. Clinical and socio-demographic information was collected on each child at diagnosis and 9 months later using standardised questionnaires. RESULTS: 241 patients were reported with 24 distinct diagnoses. 14% had additional systemic disorders and 13% had dual sensory impairment. Annual incidence was 1.4/100,000 children (aged 0-15 years) and the cumulative incidence by age 16 years was 22.3/100,000 children. The most common mode of inheritance was autosomal recessive. A significantly higher rate was seen in males than females (relative rate (RR) 1.53), in children of Asian compared with White ethnicity (RR 7.12) and in those in the worst quintile of socio-economic deprivation compared with those in the best (RR 1.43). Parents most commonly detected a problem with their child's vision. Up to seven different health professionals were involved in a child's early management, and variations were noted in the proportion of eligible children having assessments for low vision aids, statement of educational needs and certification as sight-impaired. CONCLUSIONS: These findings illustrate the highly heterogeneous nature of childhood retinal dystrophies and provide previously unavailable data on disease incidence, distributions and management, which are important for service provision and for planning future treatment programmes, particularly as novel therapies become available.