Today marks a milestone in global health governance as the amendments to the International Health Regulations (IHR) enter into force. 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.
The IHR are global regulations that guide 196 States Parties, including all 194 WHO Member States, on their rights and obligations concerning public health risks. They recognize 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.
In 2024, WHO Member States adopted amendments by consensus at the Seventy-seventh World Health Assembly in Geneva. One of the changes is the introduction of 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. The amendments also introduce the establishment of National IHR Authorities by governments to coordinate IHR implementation, and include provisions to strengthen access to medical products and financing based on equity and solidarity.
These changes were driven by lessons learned during the COVID-19 pandemic. The last major revisions were adopted in 2005 following the SARS outbreak.
"The strengthening of the International Health Regulations represents a historic commitment to protect future generations from the devastating impact of epidemics and pandemics," said WHO Director-General Dr Tedros Adhanom Ghebreyesus. "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 amended IHR, Member States also adopted the WHO Pandemic Agreement at this year's World Health Assembly and are actively negotiating an annex to the agreement on Pathogen Access and Benefit Sharing.
States have the sovereign right to implement legislations related to health policies. Under the IHR, WHO serves as the Secretariat, without authority to compel action by countries.
Eleven of the 196 IHR States Parties rejected the 2024 amendments. For them, previous versions of IHR continue to apply, though rejections may be withdrawn at any time. WHO will support IHR States Parties, as requested, in integrating the amendments to the regulations into national legal frameworks and strengthening institutional capacities to work together to build a safer, healthier future for all.
