The U.S. delegation included field representatives from the Department of State, the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Agency for International Development (USAID).

Conference objectives, Ziemer said during a June 17 keynote address, “are to gain an understanding of the revised International Health Regulations [IHR] as they apply to the Lower Mekong Initiative countries, and to look at case presentations, discuss the successes and challenges of implementing the [IHR] in the Lower Mekong Initiative countries, and identify gaps and lessons learned that could be addressed through regional health collaboration.”

INTERNATIONAL HEALTH REGULATIONS

The IHR, revised in 2005 and in force starting June 15, 2007, are legally binding rules adopted country by country to contain disease threats that could spread quickly around the world.

Such diseases include emerging infections like the H1N1 pandemic virus, which the World Health Organization says has infected people in more than 214 countries and killed at least 18,172. Such lethal threats also could come from nuclear accidents or chemical spills, leaks and illegal dumping.

The IHR offers a legal framework that defines rights, obligations and procedures to ensure international health security without unnecessary interference in international traffic and trade. The revised regulations require all member states to strengthen their capacity for disease surveillance and response. Some of the Lower Mekong countries have adopted the new regulations.

At the meeting, Lawrence Gumbiner, deputy assistant secretary in the U.S. State Department’s Bureau of Oceans, Environment and Science, told America.gov that participants said greater communication is needed in the region.

“With globalization, with rapid transboundary transport that’s available with goods and services and people moving across borders, we need rapid and efficient communication on health issues,” he added. “Work is needed on language [barriers] and on computer systems that will allow health and other authorities to share information quickly.”

Better sectoral coordination within governments was also discussed.

“This can’t just involve ministries of health,” Gumbiner said. “Customs officials, immigration officials, law enforcement and representatives from the ministries of finance and foreign affairs must be involved. There has to be more of a whole-of-government approach.”

A coordinated approached is also needed to fight the sale of counterfeit medications. According to the Association of Southeast Asian Nations, the most counterfeited drugs in developing countries are high-volume medications such as anti-malarial drugs, vaccines and paracetamol, a mild painkiller called acetaminophen in the United States.

“Everybody recognized that counterfeit pharmaceuticals are a huge public health hazard and that a coordinated approach is required to confront it,” Gumbiner said. “That involves health, law enforcement and trade. No organization can do it on its own.”

Meeting participants also discussed adopting the health regulations and communicating the requirements from the national level to authorities at the local and regional levels, and holding more regular meetings of the Lower Mekong health authorities.

“Our people in the field — from the State Department, CDC and USAID,” Gumbiner said, “stand ready to help them get together with greater frequency.”

REGIONAL HEALTH ASSISTANCE

The conference was a component of Secretary of State Hillary Rodham Clinton’s Lower Mekong Initiative. On July 23, 2009, Clinton and the foreign ministers of Cambodia, Laos, Thailand and Vietnam met in Phuket, Thailand, to explore ways to expand cooperation between the United States and the Lower Mekong countries in the areas of environment, health, education and infrastructure.

“Total 2009 U.S. health assistance in the region was over $135 million,” Ziemer told conference attendees, “with the focus on HIV/AIDS, pandemic influenza preparedness, malaria, tuberculosis, maternal and child health, and family planning and reproductive health.”

The U.S. government and bilateral partners pool their resources to accomplish health goals and achieve sustainable public health activities in all LMI countries, he added.