The International Health Regulations (2005; IHR) is a legally binding instrument with a purpose of “preventing, protecting against, controlling and providing a public health response to the international spread of diseases in ways that are commensurate with and restricted to public health risks.1 The IHR Review Committee on Second Extension recommended to transition from self-evaluations to approaches that combine self-evaluation, peer review, and voluntary external evaluation, thus the IHR Monitoring and Evaluation Framework was developed, with the Joint External Evaluation (JEE) being one of its components.
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Kandel et al. (2017) studied this question.