Amended International Health Regulations enter into force

• The amendments to the International Health Regulations (IHR) entered into force on September 19, which marks a milestone in global health governance. 

• This reflects a renewed global commitment to cooperation in the face of public health emergencies, shaped by hard-earned lessons of the COVID-19 pandemic.

International Health Regulations

• While disease outbreaks and other acute public health risks and events are often unpredictable and require a range of responses, the International Health Regulations  (IHR) provide an overarching legal framework that defines States Parties’ rights and obligations in managing public health risks, events and emergencies that have the potential to cross borders.

• The International Health Regulations are an instrument of international law  that is legally-binding on 196 countries, including the 194 WHO Member States. 

• It recognises that infectious diseases and other public health risks do not respect borders, and that coordinated global action is critical.

• The origins of the IHR can be traced back to the 19th century, when the expansion of travel and trade accelerated the spread of disease from port to port, prompting the introduction of quarantine measures. 

• Initially governed by bilateral and regional treaties, these efforts were made global under the International Sanitary Regulations in 1951 following the founding of WHO. 

• These regulations were later renamed the IHR and have since evolved to meet the changing landscape of global health.

• The purpose and scope of the IHR are to prevent, prepare for, protect against, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risk and which avoid unnecessary interference with international traffic and trade.

• The responsibility for implementing the IHR rests upon all States Parties, across government sectors, and on WHO.

They establish rights and obligations for countries such as: 

i) Establish and maintain core capacities for surveillance and response, as well as at points of entry.

ii) Notify WHO public health risks and events with actual or potential international public health implications, regardless of their origin or source.

iii) Verify information of public health risk and events of which WHO has become aware through informal and unofficial sources.

Amendments to IHR

• The WHO Member States adopted amendments by consensus at the 77th World Health Assembly held in Geneva, Switzerland from May 27 to June 1, 2024. 

The new amendments to the IHR include:

i) A new level of global alert – a “pandemic emergency” – to trigger stronger international collaboration when a health risk escalates beyond a public health emergency of international concern (PHEIC) and poses the risk of becoming, or has already become, a pandemic, with widespread impact on the health system and disruption to societies. 

ii) A commitment to solidarity and equity on strengthening access to medical products and financing. This includes establishing a Coordinating Financial Mechanism to support identification of, and access to, financing required to “equitably address the needs and priorities of developing countries, including for developing, strengthening and maintaining core capacities,” and other pandemic emergency prevention, preparedness and response-related capacities.

iii) Establishment of the States Parties Committee to facilitate the effective implementation of the amended Regulations. The Committee will promote and support cooperation among States Parties for the effective implementation of the IHR.

iv) Creation of National IHR Authorities to improve coordination of implementation of the Regulations within and among countries.

• These changes were driven by lessons learned during the COVID-19 pandemic. 

• The last major revisions were adopted in 2005 following the SARS outbreak.