The potential effectiveness of the WHO International Health Regulations capacity requirements on control of the COVID-19 pandemic: a cross-sectional study of 114 countries

OBJECTIVES

We examined if the WHO International Health Regulations (IHR) capacities were associated with better COVID-19 pandemic control.

DESIGN

Observational study.

SETTING

Population-based study of 114 countries.

PARTICIPANTS

General population.

MAIN OUTCOME MEASURES

For each country, we extracted: (1) the maximum rate of COVID-19 incidence increase per 100,000 population over any 5-day moving average period since the first 100 confirmed cases; (2) the maximum 14-day cumulative incidence rate since the first case; (3) the incidence and mortality within 30 days since the first case and first COVID-19-related death, respectively. We retrieved the 13 country-specific International Health Regulations capacities and constructed linear regression models to examine whether these capacities were associated with COVID-19 incidence and mortality, controlling for the Human Development Index, Gross Domestic Product, the population density, the Global Health Security index, prior exposure to SARS/MERS and Stringency Index.

RESULTS

Countries with higher International Health Regulations score were significantly more likely to have lower incidence (β coefficient -24, 95% CI -35 to -13) and mortality (β coefficient -1.7, 95% CI -2.5 to -1.0) per 100,000 population within 30 days since the first COVID-19 diagnosis. A similar association was found for the other incidence outcomes. Analysis using different regression models controlling for various confounders showed a similarly significant association.

CONCLUSIONS

The International Health Regulations score was significantly associated with reduction in rate of incidence and mortality of COVID-19. These findings inform design of pandemic control strategies, and validated the International Health Regulations capacities as important metrics for countries that warrant evaluation and improvement of their health security capabilities.

[THE STATE OF INTERNATIONAL LEGAL REGULATION OF CADAVERIC DONATION: ON THE PATH TO UNIFICATION (REVIEW)]

The purpose of this study is to assess the current state of international legal regulation of cadaveric donation and determine the possibility of its further unification. Therefore, the subject of the study was the legal regulation of cadaveric donation as a certain part of medicine. In particular, the work examined the norms of international law, as well as the separate provisions of the national legislation of different countries, aimed at regulating relations in the field of cadaveric donation. Also analyzed the results of scientific research on this subject. During the study, different methods of cognition were used. In particular, the historical method allowed to establish trends in the development of legal regulation of cadaveric donation. The comparative-legal method has given an opportunity to highlight the peculiarities of national regulation of relations associated with cadaveric retrieval of organs in some individual countries and correlated them to international legal experience. The statistical method has given an opportunity to establish the effectiveness of the application of a legal construct, its ability to overcome the "deficit" of the bodies and a fair distribution between the recipients. On the basis of the dialectical method, the conclusion was drawn about the possibility of developing common standards for the legal regulation of relations in the area of cadaveric donation. Other methods were used in this work, including: formal-logical, dogmatic, modeling, analysis and synthesis. The result of the study was the conclusion about the need and the possibility of forming a single international standards for the legal regulation of cadaveric donation, and in the context of globalization, there is an urgent need to create a universal Model code on donation and transplantation.