Amendments to the International Health Regulations and their implications

On 1 June 2024, the 77th World Health Assembly (WHA) adopted the International Health Regulations (IHR) by consensus without a vote. The IHR were criticised during COVID-19 for failing to provide as a legal framework for international coordination of the pandemic response. This article aims to assess the main amendments and implications of the new IHR. It does so by first analysing the context in which the revision was initiated, assessing the response of the IHR in the wake of the COVID-19 pandemic, and providing an overview of the negotiation process in order to better understand the main amendments (Ⅱ). It then examines the key provisions of the amendments to assess their practical value in terms of the evolution of the IHR (Ⅲ). Although the new IHR introduce a definition of 'pandemic emergency', the declaration of a pandemic emergency does not change the actions of WHO and States Parties. The existing provisions for the determination of a public health emergency of international concern (PHEIC) and the measures to be taken under such determinations shall apply equally to the declaration of a pandemic emergency. However, the declaration of a pandemic emergency is expected to facilitate a more rapid and coordinated global response. The the new IHR recognise the importance of equitable access and make the IHR more inclusive by introducing a definition of “relevant health products” and obligations to cooperate in ensuring access to and financing of “relevant health products” during a public health emergency. The establishment of a “Coordinating Financial Mechanism” to support the implementation of the new IHR, particularly in developing countries, will enable the mobilisation of core capacities and resources in low-and middle-income countries, thus embodying the principles of equity and solidarity that are essential for the prevention, control, management and response to international disease outbreaks. Other bodies, such as the Implementing Committee of States Parties and National IHR Authorities have also been established to strengthen compliance with and implementation of the new IHR.