The pneumonia that caused the death of an employee at a Russian laboratory researching the plague has exposed shortcomings in the international regulations intended to prevent pandemics and threats to public health, reports Politico.At the center of the discussion are the International Health Regulations (IHR), which outline the rights and obligations of countries in situations where a health threat could spread beyond national borders. These regulations have been signed by 196 countries, including Russia, China, and the United States. However, questions have now arisen as to whether Russia properly adhered to these rules—specifically regarding the timely and transparent communication of information concerning potential threats.This incident has not only sparked international concern regarding Russia’s policy on transparency but has also raised doubts about the effectiveness of the existing system in detecting and responding to threats, including those that could lead to pandemics. Lawrence Gostin, a professor at Georgetown University and director of the World Health Organization Collaborating Center on National and International Health Law, pointed out that when countries fail to act in accordance with the IHR, there is a risk that new infectious diseases could spread unchecked, creating the threat of a new pandemic. Roojin Habibi, a professor at the University of Ottawa, added that if countries lack full knowledge of the facts, this can also trigger fear-based responses, such as the closure of borders. She noted that the IHR become less effective when countries do not play by the rules.Last week, European Union politicians expressed concerns regarding a lack of transparency during a meeting of the European Parliament’s Committee on Health. Independent Member of Parliament Ondřej Dostál pointed out that weak diplomatic ties with countries such as Russia pose a risk to public health. He argued that, at the very least when serious health threats are involved, the EU should maintain a minimum level of diplomatic contact with all nations.In early October, a 28-year-old laboratory worker at the Irkutsk Research Institute for Plague Control died after contracting pneumonia of unknown origin. Concerns were raised by the possibility that the woman had contracted the illness at work following exposure to the plague bacterium. The WHO noted that it first learned of the laboratory worker’s death through the media, rather than from Russian health authorities. On the 3rd of October, the WHO requested further information to assess the scale of the potential threat. Under international law, countries are required to respond to a WHO request within 24 hours; in Russia’s case, it took three days.Moscow reported that no cases of plague had been recorded in the Irkutsk region recently, confirmed that an epidemiological investigation had been conducted, and stated that the woman’s death was caused by pneumonia of unknown origin. From the Russian perspective, the matter was closed, and there is no risk of an epidemic in the region. The WHO, however, pointed out that several questions remained unanswered—including what caused the pneumonia and how the woman contracted it.Article 6 of the IHR stipulates that countries must assess public health threats and notify the WHO within 24 hours regarding any events that could constitute an international public health emergency. For certain diseases—such as SARS and smallpox—information must be reported to the WHO immediately. In other instances, countries make the decision themselves—for example, when a disease outbreak is unusual or unexpected, or when there is a possibility that the disease might spread internationally.Habibi noted that in the Irkutsk case, had no one else fallen ill, Moscow could have decided that notifying the WHO was unnecessary. However, the IHR encourage countries to report public health threats to the WHO—particularly when the situation is unclear—a point emphasized in Article 8. Habibi explained that, in legal terms, there is a distinction between “must” (mandatory) and “should” (advisory); Article 8 stipulates that countries “should” report, rather than that they are strictly “obliged” to do so. While countries are encouraged to report—as this constitutes good practice and is the morally correct course of action—one could debate whether a mandatory obligation exists. Nevertheless, the professor stressed that, in light of the experience with COVID-19, it is clear that this was a lapse in judgment.Even if Russia has deliberately violated the rules, there is little the WHO can do. Abdirahman Mahamud, Director of the WHO’s Health Emergency Alert and Response department, told MEPs that the organization functions as a secretariat for its member states and merely carries out their wishes. He stated that the IHR relies on the actions of member states.Gostin noted that the WHO can publicly address countries that fail to act as agreed—something the organization has already done by highlighting outstanding issues and missed deadlines in its statements.Another option is pressure from other member states. Gostin suggested that countries like the United States should exert political pressure to ensure compliance with the rules. Over the past two weeks, the EU and the US have called on Russia to provide more detailed information regarding the case.
Pneumonia in Russia highlights weaknesses in International Health Regulations
