When the World Health Assembly (WHA) meets next week, it will create a historic milestone for global public health. A package of amendments, based on 300 proposals made by member countries after the pandemic, will be the star of the agenda. These amendments to the International Health Regulations will target improving the ability of countries to respond to public health emergencies of international concern.
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The International Health Regulations (IHR), first adopted by the WHA in 1969 and last revised in 2005, were conceived to maximise collective efforts to manage public health events while minimising disruption to travel and trade. There are 196 State Parties to the IHR, comprising all 194 WHO Member States plus Liechtenstein and the Holy See.
The IHR provides an overarching legal framework that defines countries’ rights and obligations in handling public health events and emergencies that have the potential to cross borders. They also introduce important safeguards to protect the rights of travellers and other persons in relation to the treatment of personal data, informed consent and non-discrimination in the application of health measures under the Regulations. Therefore, the IHR is an instrument of international law that is legally binding on 196 countries.
Surveillance systems
The IHR requires that all countries have surveillance systems capable of detecting acute public health events in a timely manner, assessing these events, reporting to the WHO those that may constitute a public health emergency of international concern, and responding to public health risks and emergencies. The goal of country implementation is to limit the spread of health risks to neighbouring countries and to prevent unwarranted travel and trade restrictions.
World Health Organization Director General Tedros Adhanom Ghebreyesus said: “The IHR has served the world well for nearly 20 years, but our collective experience in using this vital tool for the management of multiple public health emergencies, including the COVID-19 pandemic, has demonstrated important areas in which they could be strengthened for the benefit of all 196 State parties.” Of the amendments, he added: “This is historic. Countries have come together around improved international mechanisms to protect every person in the world and future generations from the impact of epidemics and pandemics, with a commitment to equity and solidarity.”
IHR Working Group co-chair Ashley Bloomfield expressed the hope that the amendments hold out. “It has been a long but very productive and gratifying process to achieve consensus on the majority of the proposed amendments. This shows the importance the world places on being able to prepare effectively for and respond better to epidemic and pandemic threats, and that there is strong international consensus on how to go about international public health protection.”
This process has been running in parallel with an intergovernmental process to develop an international agreement on pandemic prevention, preparedness, and response. The draft pandemic agreement, with its own member State-led negotiating process that resumes on May 20, is also due to go to the World Health Assembly.
Building capacities
A potential new pandemic agreement and the amended IHRs would be complementary international instruments designed and negotiated by Member States to help countries protect their peoples better from future pandemic threats. The IHR focuses on building countries’ capacities to detect and respond to public health events, which could take on international dimensions, while the draft pandemic accord focuses on a coordinated international response to pandemics, with equitable access to vaccines, therapeutics, and diagnostics at the centre.
As another WGIHR co-chair, Abdullah Assiri, of the Kingdom of Saudi Arabia, said, this reflects the critical need to bolster collective defences against current and future public health risks while firmly adhering to the principle of national sovereignty and respecting equity. “Today, we have coalesced around a robust set of amendments that will make international cooperation more effective and easier to implement.”
As the WHA gets underway on Monday, and continues through the week, it is likely that at the end of it, the world will be richer with consensual agreements to handle future outbreaks early and prevent crises, as it recently witnessed with the COVID pandemic.
