For two years, the 196 State Parties to the 2005 International Health Regulations (IHR) – composed of 194 Member States of the World Health Organization (WHO), and Liechtenstein and the Vatican – have been submitting and discussing proposed amendments to update this agreement. Introduced in the 1960s, the IHR are intended to strengthen national capacities and improve coordination among countries in the event of a health emergency. Though a legally binding agreement under international law (i.e. a treaty), most of the provisions have always been voluntary.
The draft of the IHR amendments and an accompanying draft Pandemic Agreement are both still under negotiation a month short of the intended vote at the World Health Assembly (WHA) in late May. Together, they reflect a sea change in international public health over the past two decades. They aim to further centralize control of public health policy within the WHO and base response to disease outbreaks on a heavily commoditized approach, rather than the WHO’s prior emphasis of building resilience to disease through nutrition, sanitation, and strengthened community-based health care.