By Rob Stein
Washington Post Staff Writer
Wednesday, May 28, 2003; Page A15

The World Health Organization, fending off an attempt by the United States to derail the measure, won broad new authority yesterday to fight international health threats such as severe acute respiratory syndrome.

The U.N. agency's governing body unanimously approved a resolution to allow WHO to intervene even when countries refuse to admit they are facing a health crisis, and to send teams to independently investigate whether national authorities are responding effectively.

The changes, aimed at correcting the weaknesses exposed by the SARS epidemic, mark the first significant expansion of WHO's power in more than three decades.

The action frees WHO from having to wait until a country officially reports an international health threat before beginning countermeasures, establishes the first global emergency epidemic alert network and gives the agency the authority to begin ground inspections without a formal invitation.

"This allows, within a country, for WHO to do what needs to be done to help the rest of the world," Gro Harlem Brundtland, WHO's outgoing director general, told the World Health Assembly, which approved the measure by consensus.

The U.S. delegation surprised WHO officials by asking for a postponement of action on the proposals until they could be considered as part of a broader set of negotiations. The Bush administration, which generally has been wary of granting U.N. agencies more authority, dropped the request after it did not garner support, and the original proposal was endorsed by speaker after speaker.

"We're pleased," said David L. Heymann, director of WHO's communicable diseases program, said afterward. "It's giving WHO a much more relevant role."

Until now, the International Health Regulations that outline WHO's authority and the responsibilities of its 192 member states required nations to report only three diseases -- yellow fever, cholera and plague. WHO also could only respond to official federal government reports, and had no power to independently verify whether containment efforts were adequate.

WHO officials were hoping the alarm and momentum generated by SARS would enable them to speed up revisions to the regulations, which date to 1969 and have long been considered antiquated. Changes have been in the works for years but were not due to be completed until 2005.

In the case of SARS, China denied for months that the epidemic was raging in the southern province of Guangdong, allowing the dangerous new lung infection to spread around the world. WHO also complained that it was not receiving timely and complete information from the United States and Canada.

Under the resolution approved yesterday, WHO can act on many other sources of information, including news accounts, reports from nongovernmental organizations such as the Red Cross, and WHO-affiliated scientific laboratories. After validating whether the reports are reliable, WHO can then "alert the international community, when necessary and after informing the government concerned, to the presence of a public health threat that may constitute a serious threat to neighboring countries or international health."

In addition, WHO is now authorized to evaluate the severity of the threat and whether countermeasures are adequate. If necessary, "and after informing the government concerned," WHO can "conduct on-the-spot studies . . . with the purpose of ensuring that appropriate control measures are being employed."

WHO has no power to punish a noncompliant nation and does not gain any with the changes. But nations will be obligated to be more responsive. The SARS epidemic demonstrated that the agency can use international pressure to gain cooperation and that its alerts and travel advisories can have a devastating economic impact.

The revision also requires member nations to designate contacts that WHO could notify in a health emergency. Because there was no formal emergency notification system, the only way WHO could alert the world to SARS was to hold a news conference.

The assembly also adopted a separate SARS resolution that specifically requires nations to "promptly and transparently report cases and to provide requested information."

Informally, WHO already gathers information from a variety of sources to search for early signs of new epidemics. But WHO officials wanted official authorization to give them more clout.

"This was a way to see whether countries continue to accept this role for WHO," Heymann said. "That way we know that next time we can do what we're doing now. It's a more active rather than passive way of operating."

WHO first proposed that the new powers be written into the International Health Regulations immediately. But, fearing that might be rejected, the final measure gave the agency new powers while the revision process continues on its original schedule.

William Pierce, a spokesman for the U.S. Department of Health and Human Services, described the U.S. move earlier in the day as a "negotiating tactic" designed to avoid locking the nation into any particular position in the ongoing negotiations. "We wanted to make sure we didn't prejudice the negotiating process. We wanted to make sure the steps we took today didn't lock negotiations into any particular direction, lock us into any preordained actions," Pierce said.

HHS Secretary Tommy G. Thompson, while saying he generally supports the concept of giving WHO more power, has said he is concerned that any increased WHO authority not interfere with the U.S. Centers for Disease Control and Prevention.

Said Pierce: "We understand the principle behind wanting to give WHO more authority to take action. At the same time, we don't want to in any way crimp, impinge or limit the ability of the CDC to take action as well. It's a delicate balance."