CM18.1-3 | International Health — Graded Quiz

Correct. SDG 3.1 specifies reducing global maternal mortality ratio to less than 70 per 100,000 live births by 2030. This is a measurable, time-bound global target.

SDG 3 key targets: MMR <70 (3.1); U5MR ≤25, NMR ≤12 (3.2); end AIDS/TB/malaria epidemics (3.3); reduce NCD premature mortality by 1/3 (3.4); UHC (3.8); reduce road traffic deaths (3.6). SDG 3 replaced MDGs 4, 5, 6.

Incorrect. SDG 3 targets include reducing MMR (<70/100,000), ending preventable newborn/child deaths, fighting communicable diseases (AIDS, TB, malaria), reducing NCD premature mortality by one-third, UHC, and reducing road traffic deaths — not cholera elimination or country-specific insurance mandates.

Correct. UNDP's health contribution is indirect — through poverty reduction, good governance, gender equality, and sustainable development that create conditions for health. It also co-leads the Global Fund, Gavi, and Stop TB Partnership.

UNDP headquarters: New York. Its health role is upstream: addressing social determinants (income, education, governance). It publishes the Human Development Index (HDI), which incorporates life expectancy as a key metric.

Incorrect. Direct clinical care is MSF's role; drug approval is WHO/national agencies; reference labs are managed by WHO Collaborating Centres. UNDP works on development conditions that determine health.

Correct. India belongs to WHO's South-East Asia Regional Office (SEARO), headquartered in New Delhi. SEARO has 11 member states including Bangladesh, Bhutan, DPR Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand, and Timor-Leste.

WHO has 6 regional offices: AFRO (Brazzaville), AMRO/PAHO (Washington DC), SEARO (New Delhi), EURO (Copenhagen), EMRO (Cairo), WPRO (Manila). SEARO has only 11 member states — one of the smallest regions but includes over 25% of the world's population.

Incorrect. WPRO covers Western Pacific (Manila); EMRO covers Eastern Mediterranean (Cairo); EURO covers European region (Copenhagen). India is in SEARO, New Delhi.

Correct. WHO Director-General Tedros Adhanom Ghebreyesus declared COVID-19 a PHEIC on 30 January 2020. (The pandemic declaration followed on 11 March 2020.) Some sources round to 31 January — the announcement was made on 30 January 2020.

Timeline: 31 Dec 2019 — China notifies WHO → 30 Jan 2020 — PHEIC declared → 11 Mar 2020 — Pandemic declared. Key distinction: PHEIC is an IHR instrument; 'pandemic' is an epidemiological descriptor WHO used informally. COVID-19 PHEIC was ended on 5 May 2023.

Incorrect. The PHEIC was declared on 30/31 January 2020, well before the pandemic declaration (11 March 2020). China first notified WHO on 31 December 2019, but the PHEIC came a month later.

Correct. Re-emerging infectious diseases are those that previously declined to insignificance but have re-appeared as a public health problem (e.g., dengue, cholera, tuberculosis). Emerging diseases are those newly appearing in a population or rapidly increasing.

Examples of re-emerging diseases: dengue (global expansion), cholera (periodic pandemics), plague (resurgence in Madagascar), drug-resistant TB, yellow fever. Drivers: antimicrobial resistance, climate change, urbanisation, breakdown in public health infrastructure.

Incorrect. 'Emerging' refers to newly appearing diseases; 'imported' refers to diseases brought in from outside; 'endemic' describes a disease constantly present in a region. The key feature here — previous decline followed by re-appearance — defines re-emerging.

Correct. Gavi (formerly Global Alliance for Vaccines and Immunisation), established in 2000 and headquartered in Geneva, co-finances vaccine procurement and delivery for the world's poorest nations, using market shaping to reduce vaccine prices.

Gavi's model: donor governments + BMGF fund Gavi → Gavi co-finances vaccines for lower-income countries → countries graduate as incomes rise. As of 2024, Gavi has reached >1 billion children with vaccines. It is a public-private partnership, not a UN agency.

Incorrect. Vaccine quality regulation is WHO's prequalification programme; clinical trials are conducted by vaccine manufacturers and academic institutions; post-conflict reconstruction is funded by the World Bank and bilateral donors.

Correct. NCDC serves as India's designated National IHR Focal Point under IHR 2005 and operationally manages the Integrated Disease Surveillance Programme (IDSP) — the backbone of disease outbreak detection and response in India.

NCDC key functions: (1) National IHR Focal Point — 24/7 WHO contact point; (2) IDSP — weekly surveillance data from all states; (3) Laboratory network for outbreak investigation; (4) Epidemic intelligence and rapid response. Established originally as the National Institute of Communicable Diseases (NICD).

Incorrect. Vaccine approval is CDSCO's function; WHO financial contributions are negotiated by the Ministry of External Affairs/Ministry of Finance; district health officers are under state government jurisdiction. NCDC's role is surveillance and IHR compliance.

Correct. One Health surveillance at the animal-human-environment interface — monitoring livestock, wildlife reservoirs, and environmental samples — enables early detection of zoonotic spillover events before they amplify in human populations (the moment of greatest preventive opportunity).

One Health is championed by WHO, FAO, UNEP, and WOAH (World Organisation for Animal Health). About 70% of emerging infectious diseases are zoonotic. Key examples: SARS (civet cats → humans), Ebola (bats), Nipah (pigs/bats), H5N1 (poultry). India's One Health framework: NCDC + ICAR + MoEFCC joint platform.

Incorrect. Hospital-based virology detects disease after human transmission is established; trade restriction alone cannot prevent emergence; a pathogen database is a reference tool, not a surveillance system. One Health is specifically about integrating the three domains at their interface.