Guidance

International Health Regulations 2005: UK National Focal Point communications protocol

Updated 19 September 2025

Scope

1. This protocol deals with the communications of the National Focal Point (NFP) in relation to the International Health Regulations (IHR) 2005:

• for specific IHR purposes only, including Freedom of Information requests about those IHR purposes – it does not deal with communications with health bodies, the media or the public more generally, or with case or event management
• between certain bodies (for example the UK Heath Security Agency (UKHSA), the Department of Health and Social Care (DHSC), the devolved administrations (DAs), the UK Overseas Territories (OTs) and Crown Dependencies (CDs), and the World Health Organization (WHO)), not within those bodies.

Communications with the NFPs of other countries are covered on a separate page: International Health Regulations National Focal Point: international communications for contact tracing and other public health responses

Introduction

2. The IHR are a legally binding international instrument designed to “prevent, protect against, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade”. The UK Government have accepted the amendments to the IHR, which were agreed by countries at the World Health Assembly on 1 June 2024. The amendments are reflected in this protocol.

3. The IHR define a list of diseases that must always be notified to WHO. These are:

• smallpox
• poliomyelitis due to polioviruses
• human influenza caused by a new subtype
• severe acute respiratory syndrome (SARS)

4. In addition, other events occurring within a State Party’s territory must be assessed using the decision instrument in Annex 2 and to notified to WHO if they may constitute a Public Health Emergency of International Concern (PHEIC). This includes non-infectious events (chemical or radiological). The IHR lists diseases that should always lead to the use of the decision instrument. These are:

• cholera
• pneumonic plague
• yellow fever
• viral haemorrhagic fevers (Ebola, Lassa, Marburg)
• West Nile fever
• other diseases that are of special national or regional concern

5. Diseases of particular relevance to the UK territories may be included in the category “other diseases that are of special national or regional concern” in consultation between UKHSA, other public health authorities for relevant UK territories and DHSC as necessary.

6. The decision instrument should be used for the assessment of any other event of potential international public health concern, including those of unknown causes or sources, in particular clusters of cases of severe acute respiratory disease of unknown or new cause, and those involving other events or diseases than those listed above.

7. Under the IHR, State Parties are also required to inform WHO if they believe that an event with international implications is occurring outside their territory.

National Focal Point function

8. There is a requirement outlined in Article 4^{[footnote 1]} of the IHR that each State Party shall designate or establish a National Focal Point (NFP) that “shall be accessible at all times for communications with the WHO IHR Contact Points” and whose functions “shall include:

• sending to WHO IHR Contact Points, on behalf of the State Party concerned, urgent communications concerning the implementation of these Regulations, in particular under Articles 6 to 12
• disseminating information to, and consolidating input from, relevant sectors of the administration of the State Party concerned, including those responsible for surveillance and reporting, points of entry, public health services, clinics and other government departments”

9. The UK governments (including the devolved administrations) have designated UKHSA to act as the NFP for all of the UK territory (including England, Wales, Northern Ireland, Scotland, the Overseas Territories (OTs) and the Crown Dependencies (CDs)). Communications on IHR NFP matters should not be sent directly to WHO from any other body than the NFP.

10. The Travel Health and IHR team, within TARZET (Tuberculosis, Acute Respiratory Infections, Zoonosis, Emerging Infections and Travel Health) at UKHSA, leads on the UKHSA role as the NFP, with oversight from the Chief Medical Advisor.

11. The IHR envisages that the NFP, in addition to having the authority to communicate IHR related information to WHO, should also provide support for and, if so decided by the State Party, participate in collaborative risk assessment with WHO. The UK government expects that UKHSA as the NFP will take the lead on assessing events for the UK under IHR but that this will be done in conjunction with the relevant public health authorities in the part of the UK territory affected.

12. Under the IHR, State Parties are only obliged to notify incidents that may constitute a potential PHEIC. However, in practice, dialogue and discussion with WHO regarding other events that are of international public health significance is encouraged.

Communicating with the National Focal Point

13. The UK NFP can be contacted 24 hours a day, 7 days a week at:

Email: ihrnfp@ukhsa.gov.uk Telephone: + 44 (0)208 327 6260

14. Urgent matters should be directed to the NFP by phone. When calling, you will be asked to send a follow up email providing written details.

15. Any incident that occurs in any part of UK territory that might have implications for international public health, trade or traffic should be discussed by the lead public health agency for that territory with the NFP. Furthermore, any part of UK territory that becomes aware of an incident that may be relevant under the IHR occuring outside its territory should also discuss their concerns with the NFP. Advice on the international implications of an incident can be sought at any time from the NFP and those seeking advice or reporting must ensure that they provide all the available information to the NFP to enable a judgement to be made.

Sending information to WHO

16. The communications protocol for the UK NFP to provide information to WHO varies according to the type of incident.

a) Case of disease on the defined list of diseases that must always be notified to WHO

Where a case of disease on the defined list of diseases has been confirmed in any part of UK territory, the NFP will seek sign off from DHSC and will notify the case to WHO within 24 hours of confirmation. Where a case is strongly suspected but microbiological confirmation is awaited or not possible, the NFP may discuss with WHO in the absence of such confirmation.

b) Any other event assessed using the decision instrument in Annexe 2 of the IHR

For any other event occurring in the UK territory that may have implications for international public health, traffic or trade, the NFP will make an initial judgement as to the likely international impact of the event, in collaboration with UKHSA disease expert leads. Where the event has occurred in any part of UK territory other than England, the judgement will be determined in conjunction with public health authorities for the relevant UK territories.

The subsequent actions will depend upon the nature of the event and are not covered in detail by this protocol. The underlying principles are:

• for events assessed as requiring notification to WHO under the IHR, the NFP, in collaboration with UKHSA disease expert leads and public health authorities for the relevant UK territories, will prepare a formal written notification for WHO including the rationale for the assessment – notification to WHO should take place within 24 hours of assessment and following DHSC sign off
• for events assessed as not requiring notification to WHO under the IHR, the NFP may still informally communicate with WHO, following DHSC sign off

c) WHO requests information about an incident from the UK

Where an incident in UK territory or involving UK nationals in another member state is suspected, WHO may request information from the UK. The NFP must send an initial response or acknowledgement to a request for information from WHO within 24 hours. The NFP, in collaboration with UKHSA disease expert leads and public health authorities for the relevant UK territories, will conduct an initial assessment to determine whether the incident is verified and what the international implications might be for public health, trade and traffic.

If the event is verified and assessed as a potential PHEIC, the NFP will share a formal written notification with WHO including the rationale for the assessment. If the event is either not verifiable or is not a potential PHEIC, then the NFP will share this information WHO and inform DHSC and the relevant UK territory public health authorities about the communication.

Disseminating information from WHO

17. WHO communicates with the UK NFP about a variety of global incidents of public health importance that may have relevance for UK territory. The Event Information Site, a secure web-based platform, is used by WHO for less urgent communication with State Party NFPs. Where information needs to be passed on to the UK urgently, WHO would be expected to contact the UK NFP by phone or email.

18. UKHSA has an internal protocol for assessing and disseminating event information that comes to the NFP from WHO to public health and government leads for all parts of the UK territory.

19. Where WHO is advising significant actions by the UK, the NFP will inform relevant colleagues in UKHSA, DHSC and other parts of the UK as appropriate, to allow intra- and inter-governmental discussion and response to the advice.

1. The amendments to the IHR, agreed at the WHA on 1 June 2024, also require states to designate or establish a National IHR Authority, responsible for coordinating the implementation of the IHR within the jurisdiction of the State Party. The UK National IHR Authority sits within UKHSA. ↩