Governments agreed on a way forward for updating the WHO International Health Regulations 2005 (IHR), holding the first round of intensive discussions on more than 300 amendments proposed by countries to this globally agreed instrument. The IHR set out agreed approaches and obligations for countries to prepare for, and respond to, disease outbreaks and other acute public health risks. The proposed amendments come in response to the challenges posed by the COVID-19 pandemic, according to a press release issued by the World Health Organization.

The Second meeting of the Working Group on Amendments to the International Health Regulations (2005) took place from 20-24 February, during which the proposed amendments were discussed for the first time. The Group heard the intent behind the 307 amendments proposed by governments and shared views on each. They also agreed on next steps to tackle more in-depth negotiations on the proposed amendments, and plans for its next meeting on 17-20 April. 

Co-Chair of the IHR Working Group, Dr Ashley Bloomfield, said in discussing amendments to the Regulations, governments focused on making their countries, and the international community, better prepared for future emergencies.

“COVID-19 showed us that having a good, strong set of International Health Regulations is essential, and showed where the current Regulations need to be improved,” said Dr Bloomfield, former Director-General of Health, New Zealand. “The ongoing pandemic has underscored the importance of countries working together collaboratively, and supporting WHO in its vital work, to make the world safer. The tone of the discussions and progress made during this week’s meeting clearly show that countries understand the responsibility they have to ensure this process is successful.”

Throughout the week-long meeting, the 194 Member States of WHO, who are also State Parties to the IHR, stressed the importance of enhancing capacity building, especially in low-income countries; access to benefits arising from sharing pathogens; equitable access to medical countermeasures; and enhanced cooperation and information sharing.

Fellow IHR Working Group Co-Chair, Dr Abdullah M. Assiri, Deputy Minister of health, Kingdom of Saudi Arabia, said governments were committed to leading the process to strengthening the IHR to, in turn, make the world safer and healthier. 

“Countries are in the driving seat of this process as they need to implement the International Health Regulations, deliver on the obligations, and make the key decisions needed to respond to public health threats,” said Dr Assiri. “During the pandemic, the world faced the urgent need for functioning international instruments, and placed increasing importance in international organizations, such as WHO. Updated Regulations will enable the world to better detect outbreaks early, and prevent them from developing into public health emergencies of international concern. This is about strengthening our collective ability to do that and to better protect everybody.” 

In the lead-up to the meeting, an independent and diverse team of experts prepared a technical assessment of the proposed amendments to assist countries in their negotiations.

In parallel with the IHR amendments process, governments are also negotiating the drafting of an WHO instrument on pandemic prevention, preparedness and response, also referred to as a pandemic accord. Governments will meet from 27 February-3 March 2023 to consider the zero draft of the accord.

Dr Bloomfield said the two processes are complementary, as they are both guided by the imperative of making the world safer from communicable diseases and ensuring equitable responses to public health threats. “The efforts to update the International Health Regulations and draft a pandemic accord share a number of common themes, including the importance of equity in access to health, collaboration and capacity building,” he said. “It is important that there is consistency and alignment across the two processes.”

WHO Member States issued the International Sanitary Regulations in 1951, the precursor to the IHR, which came into being in 2005. The IHR are an instrument of international law that is legally-binding on 196 State Parties, including the 194 WHO Member States. The IHR create rights and obligations for countries, including the requirement to report to WHO public health events with risk of international spread. They also outline the criteria to determine if a particular event constitutes a public health emergency of international concern, WHO’s highest level of alarm under the IHR, which in turn triggers specific response actions for countries to prevent the further spread of the epidemics and reduce their impact on population health and societies at large.