# Disaster Management and International Health for NEET PG PSM: Disaster Cycle, Triage Tags, IHR 2024 and Pandemic Emergency Source: https://tracknation.in/story/disaster-management-and-international-health-for-neet-pg-psm-disaster-cycle-triage-tags-ihr-2024-and-pandemic-emergency (TrackNation — free UPSC notes with PYQs) > NEET PG Community Medicine: the disaster management cycle, NDMA and its state and district bodies, the 2025 amendment, triage colours, Sendai priorities, and international health: WHO, the International Health Regulations, PHEIC versus the new 'pandemic emergency', 24-hour notification and yellow fever certificates, from official documents, with a diagram, hooks, MCQs and cards. ## Start Here 🎯 **Exam priority: Medium.** *Expect triage colours, who heads which disaster body, what a PHEIC is, and yellow fever certificate timing. IHR changed in 2025.* CBME mapping: **CM 13.1–13.4, CM 18.1–18.3**. ## The Disaster Cycle *Most of the cycle happens before and after the event. India's plan moved from relief alone to reducing risk.* - **Pre-disaster**: prevention, mitigation and risk reduction, then preparedness. - **Disaster**: response. - **Post-disaster**: recovery, aiming to **Build Back Better**. India's approach has shifted from a **relief-centric** model to a proactive one. The National Disaster Management Plan follows the **Sendai Framework (2015–2030)**, whose four priorities are: - Understanding disaster risk - Strengthening disaster risk governance - Investing in disaster risk reduction for resilience - Enhancing preparedness for effective response and to Build Back Better ## Who Runs Disaster Management in India | **Level** | **Body** | **Headed by** | | National | National Disaster Management Authority (NDMA) | Prime Minister | | National | National Crisis Management Committee | Cabinet Secretary | | State | State Disaster Management Authority | Chief Minister | | District | District Disaster Management Authority | District Collector or Magistrate, co-chaired by the head of the local body | The **National Disaster Response Force** is the specialist national response force. On the ground, the **Incident Response System** sets roles and sites such as the incident command post and relief camp. **Disaster Management (Amendment) Act 2025**: - Gives legal status to the **National Crisis Management Committee** and a **High Level Committee**. - Lets a state constitute a **State Disaster Response Force**. - Adds **Urban Disaster Management Authorities** and a **disaster database**. - Clarifies that "man-made causes" do not include law and order situations. ## Triage Triage sorts casualties so that limited resources help the greatest number. The START method uses four tags: | **Tag** | **Category** | **Meaning** | | **Red** | Immediate | Severe or life-threatening injury with a high chance of survival: treat now | | **Yellow** | Delayed | Serious but not immediately life-threatening; can wait | | **Green** | Minor | Minor injuries; can often help themselves and can wait | | **Black** | Expectant | Dead or unlikely to survive given injuries and resources | START assesses five things: ability to walk, spontaneous breathing, respiratory rate, a radial pulse or capillary refill under 2 seconds, and ability to obey commands. **The counter-intuitive point**: red goes to those who are badly hurt but can be saved. Those beyond saving, given the resources, are tagged black. ## WHO and the International Health Regulations **WHO**'s constitution came into force on **7 April 1948**, marked each year as World Health Day. Member States are grouped into **six regions**. The **International Health Regulations (2005)** aim to prevent, protect against, control and respond to the international spread of disease, while avoiding unnecessary interference with traffic and trade. | **Term** | **Means** | | **PHEIC** | An extraordinary event that risks spreading internationally and may need a coordinated international response | | **Pandemic emergency** | A PHEIC caused by a communicable disease with wide spread across states, exceeding health system capacity, and causing substantial social or economic disruption | | **National IHR Focal Point** | The national centre reachable at all times for communication with WHO | | **National IHR Authority** | The body that coordinates implementation within the country (added in 2024) | - **Timing**: a country assesses urgent events within **48 hours** and notifies WHO within **24 hours** of assessment. - **2024 amendments** took effect on **19 September 2025**, adding "pandemic emergency" as the highest alert. 11 of 196 States Parties rejected them, so earlier versions still apply to those states. - WHO's role is as secretariat: it has no authority to compel countries to act. - Members also adopted the **WHO Pandemic Agreement**, a separate instrument. **Yellow fever** is the one vaccination named in the IHR as a condition of entry: - Incubation period: **6 days**. - Protection and certificate validity start **10 days after** vaccination. - The certificate is valid for the **life** of the person vaccinated. ## Traps the Examiner Sets - NDMA is chaired by the Prime Minister; the National Crisis Management Committee by the Cabinet Secretary. - Red, not black, is the first priority for treatment. - Assess in 48 hours, notify in 24 hours after that. - Pandemic emergency applies only to communicable disease and sits above a PHEIC. - Yellow fever certificates are lifelong, starting on day 10. Annex 7 was amended in 2014, in force from 11 July 2016, so older notes saying 10 years are out of date. ## Memory Hooks & Shortcuts *Shortcuts to lock in this article's numbers and lists. Each one only re-packages facts proven above.* - 🧠 **PM, CM, DM** — NDMA, SDMA, DDMA heads: Prime Minister, Chief Minister, District Magistrate - 🧠 **Red = rescue now** — immediate, salvageable - 🧠 **48 then 24** — IHR: assess, then notify - 🧠 **Yellow fever: 6, 10, for life** — incubation 6 days, valid from day 10, lifelong certificate - 🧠 **April 7 is WHO** — constitution in force 1948, World Health Day - 🧠 **Sendai 15 to 30** — the framework runs 2015–2030 ## Rapid-Revision Cards - Prevention and mitigation, preparedness, response, recovery. - 2015–2030; four priorities. - Understand risk, governance, invest in risk reduction, preparedness and Build Back Better. - Prime Minister. - Chief Minister. - Collector or District Magistrate, co-chaired by the local body head. - Cabinet Secretary. - NCMC and High Level Committee given legal status; SDRF; Urban Authorities; disaster database. - Exclude law and order situations. - Immediate: life-threatening but salvageable. - Delayed: serious, not immediately life-threatening. - Minor. - Expectant: dead or unlikely to survive. - Walking, breathing, respiratory rate, perfusion, obeying commands. - 7 April 1948; six regions. - Extraordinary event with international spread risk needing coordinated response. - Highest alert: communicable PHEIC, wide spread, health systems exceeded, major disruption. - Assess within 48 hours; notify WHO within 24 hours of assessment. - 19 September 2025. - Valid from day 10, for life. - 6 days. ## Sources *Facts in this article were checked against these documents.* - National Disaster Management Plan — NDMA, 2019 (link) - The Disaster Management (Amendment) Act, 2025 — Gazette of India, 29 March 2025 (link) - START Adult Triage — CHEMM, US Department of Health and Human Services, accessed November 2026 (link) - International Health Regulations (2005), as amended in 2014, 2022 and 2024 — WHO, 2025 (link) - Amended International Health Regulations enter into force — WHO, 19 September 2025 (link) - History of WHO; WHO regional offices — WHO, accessed November 2026 (link) ## Test Yourself: Practice Questions Twenty-one questions in NEET PG style. ## Practice Questions (NEET PG pattern) *Original questions written in the style of the exam: +4 for a correct answer, −1 for a wrong one. Every answer was checked against the sources listed above. NEET PG papers are not published by NBEMS, so these are not past-paper questions.* **Q1.** After a bus crash, a man has heavy bleeding and is breathing fast but can be saved with prompt care. His triage tag is - (a) red - (b) yellow - (c) green - (d) black **Answer: (a)** — Immediate: severe or life-threatening injuries with a high potential for survival. **Q2.** A victim has a closed fracture of the femur, stable vitals and is not expected to deteriorate over several hours. The tag is - (a) yellow - (b) red - (c) black - (d) green **Answer: (a)** — Delayed: serious, but not immediately life-threatening. **Q3.** A person with cuts and bruises walks to the triage area. The tag is - (a) green - (b) red - (c) black - (d) yellow **Answer: (a)** — Minor: relatively minor injuries, can wait. **Q4.** A black triage tag means the casualty is - (a) the first to be transported - (b) dead or unlikely to survive given injuries and resources - (c) uninjured - (d) contaminated by chemicals **Answer: (b)** — Expectant: deceased or unlikely to survive. Palliative care if resources allow. **Q5.** Which is assessed in START triage? - (a) Glasgow Coma Scale total - (b) Blood group - (c) Blood pressure by cuff - (d) Ability to obey commands **Answer: (d)** — Walking, breathing, respiratory rate, radial pulse or capillary refill, and obeying commands. **Q6.** The National Disaster Management Authority is headed by the - (a) Prime Minister - (b) Home Minister - (c) Cabinet Secretary - (d) Health Minister **Answer: (a)** — NDMA: Prime Minister; State: Chief Minister; District: Collector or Magistrate. **Q7.** The National Crisis Management Committee is chaired by the - (a) Chief Justice of India - (b) Prime Minister - (c) President - (d) Cabinet Secretary **Answer: (d)** — Given statutory status by the 2025 amendment, with the Cabinet Secretary as Chairperson. **Q8.** The District Disaster Management Authority is headed by the - (a) Member of Parliament - (b) Superintendent of Police - (c) District Collector or Magistrate - (d) Chief Medical Officer **Answer: (c)** — It is headed by the Collector or District Magistrate and co-chaired by the local body chairperson. **Q9.** Under the Disaster Management (Amendment) Act 2025, 'man-made causes' of a disaster do not include - (a) nuclear accidents - (b) law and order situations - (c) chemical spills - (d) industrial accidents **Answer: (b)** — The amendment excludes law and order related matters. **Q10.** Stocking supplies, running drills and setting up warning systems belong to which phase? - (a) Response - (b) Rehabilitation - (c) Preparedness - (d) Recovery **Answer: (c)** — Preparedness is pre-disaster, alongside prevention and mitigation. **Q11.** 'Build Back Better' relates to which phase of disaster management? - (a) Preparedness - (b) Recovery - (c) Prevention - (d) Mitigation **Answer: (b)** — Sendai priority four links preparedness to building back better in recovery, rehabilitation and reconstruction. **Q12.** The Sendai Framework for Disaster Risk Reduction covers - (a) 2020–2035 - (b) 2000–2015 - (c) 2015–2030 - (d) 2005–2015 **Answer: (c)** — SFDRR (2015–2030). **Q13.** The first priority of the Sendai Framework is - (a) funding insurance - (b) understanding disaster risk - (c) building shelters - (d) investing in relief **Answer: (b)** — Understanding risk, governance, investing in risk reduction, and preparedness. **Q14.** WHO's constitution came into force on - (a) 10 December 1948 - (b) 24 October 1945 - (c) 7 April 1948 - (d) 1 January 1950 **Answer: (c)** — 7 April 1948, now World Health Day. **Q15.** Under the IHR, a country must notify WHO of a potential PHEIC within - (a) 14 days - (b) 24 hours of assessment - (c) 48 hours of the first case - (d) 7 days **Answer: (b)** — Within 24 hours of assessment of public health information, after assessing within 48 hours. **Q16.** Under IHR core capacities, urgent events must be assessed within - (a) 7 days - (b) 24 hours - (c) 72 hours - (d) 48 hours **Answer: (d)** — Assess all reports of urgent events within 48 hours. **Q17.** Which is true of a 'pandemic emergency' under the amended IHR? - (a) It is declared by each country - (b) It can be declared for any non-communicable disease - (c) It replaces PHEIC entirely - (d) It is a PHEIC caused by a communicable disease with wide spread and overwhelmed health systems **Answer: (d)** — It is a PHEIC with added criteria, caused by a communicable disease. **Q18.** The 2024 IHR amendments came into force on - (a) 1 June 2024 - (b) 1 January 2026 - (c) 7 April 2025 - (d) 19 September 2025 **Answer: (d)** — 19 September 2025; 11 of 196 States Parties rejected them. **Q19.** A traveller is vaccinated against yellow fever. The certificate becomes valid - (a) after 30 days, for life - (b) after 6 days, for 5 years - (c) at once, for 10 years - (d) 10 days after vaccination, for life **Answer: (d)** — Valid for the life of the person vaccinated, beginning 10 days after vaccination. **Q20.** The incubation period of yellow fever under the IHR is - (a) 21 days - (b) 6 days - (c) 10 days - (d) 14 days **Answer: (b)** — Annex 7 states six days. **Q21.** The centre in each country reachable at all times for communication with WHO is the - (a) National Crisis Management Committee - (b) National Disaster Response Force - (c) Regional Office - (d) National IHR Focal Point **Answer: (d)** — Each State Party designates a National IHR Focal Point. ### Active Recall From memory: draw the disaster cycle; name who heads each disaster body; give the four triage tags; state the Sendai priorities; define PHEIC and pandemic emergency; and give the IHR notification timings and the yellow fever rules.