A strengthened set of International Health Regulations (IHR) officially entered into force, marking a significant milestone in the effort to bolster global defenses against future pandemics. The legally binding amendments, adopted by the World Health Assembly in 2024, introduce new mechanisms and obligations for the 196 States Parties, reflecting key lessons learned from the failures and inequities of the global response to the COVID-19 pandemic.
A central innovation of the amended IHR is the creation of a new, higher-tier global alert: the "pandemic emergency." This new designation can be declared by the WHO Director-General for communicable diseases that pose a significant threat of becoming a pandemic, triggering stronger and more coordinated international collaboration than the existing "public health emergency of international concern" (PHEIC). The amendments also place a new emphasis on equity and solidarity. Revised Article 13 now includes provisions to strengthen access to essential medical products, such as vaccines and diagnostics, during health emergencies. This is complemented by the establishment of a Coordinating Financial Mechanism to help resource pandemic responses, particularly in lower-income countries, though contributions are voluntary. Structurally, the new regulations require each member state to designate a National IHR Authority to oversee and coordinate the implementation of the regulations at the domestic level. This is intended to address long-standing challenges of fragmented authority and poor inter-sectoral coordination that have historically hindered effective IHR implementation. The entry into force of the amendments was hailed by WHO Director-General Dr. Tedros Adhanom Ghebreyesus as a "historic commitment to protect future generations."
However, the new framework faces significant challenges. Eleven of the 196 States Parties, most notably the United States, have formally rejected the 2024 amendments. For these countries, previous versions of the IHR will continue to apply, creating a fractured global health governance landscape. The U.S. rejection was based on claims that the amendments infringed on national sovereignty, an assertion the WHO has described as based on "inaccuracies." The WHO has consistently maintained that the IHR are non-binding recommendations and that sovereign states retain full authority over their domestic health policies. The success of the amended IHR will now depend on how effectively the remaining 185 States Parties translate these new international obligations into their national legal frameworks and whether the new mechanisms can foster a more collaborative and equitable response when the next global health crisis emerges.
Source: WHO