Today marks a significant milestone in global health governance as the amended International Health Regulations (IHR) officially enter into force, reflecting renewed international commitment to cooperation during public health emergencies. These amendments are shaped by lessons learned from the COVID-19 pandemic and aim to strengthen preparedness, coordination, and equity in response to global health risks.
The IHR provide a legal framework guiding 196 States Parties, including all 194 WHO Member States, on their rights and obligations regarding public health risks. Recognizing that diseases and other health threats do not respect borders, the IHR emphasize coordinated global action. The regulations trace their origins to the 19th century, when the spread of disease through international travel and trade prompted the introduction of quarantine measures. Initially governed by bilateral and regional treaties, these efforts became global under the International Sanitary Regulations in 1951 and were later renamed the IHR, evolving over decades to meet new public health challenges.
In 2024, WHO Member States adopted the latest amendments by consensus at the Seventy-seventh World Health Assembly in Geneva. Key changes include the introduction of a new global alert level – a “pandemic emergency” – which triggers stronger international collaboration when a health threat escalates beyond a public health emergency of international concern (PHEIC) and poses widespread risks to health systems and societies. The amendments also require the establishment of National IHR Authorities to coordinate IHR implementation and include provisions to strengthen equitable access to medical products and financing.
These updates build on lessons from the COVID-19 pandemic, while the previous major revisions were adopted in 2005 following the SARS outbreak. WHO Director-General Dr. Tedros Adhanom Ghebreyesus emphasized, “The strengthening of the International Health Regulations represents a historic commitment to protect future generations from the devastating impact of epidemics and pandemics. We know that no one is safe until everyone is safe. The IHR amendments reaffirm our shared responsibility and solidarity in the face of global health risks.”
Alongside the IHR amendments, Member States also adopted the WHO Pandemic Agreement and are negotiating an annex on Pathogen Access and Benefit Sharing. While States retain sovereign rights over national health legislation, WHO serves as the Secretariat, providing support and guidance without authority to compel action. Eleven of the 196 States Parties rejected the 2024 amendments, meaning the previous version continues to apply for them, though rejection can be withdrawn at any time. WHO will support all States Parties in integrating the amendments into national legal frameworks and building institutional capacity to strengthen global health security.
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