Lockdown during the Covid-19 epidemic.
Next week's World Health Assembly (WHA) will be a historic milestone for global public health. At the center of the agenda will be a series of proposed changes to the International Health Regulations, based on 300 proposals made by Member States in the wake of the pandemic. These proposed changes to the International Health Regulations aim to improve countries' ability to respond to public health emergencies of international concern.
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The International Health Regulations (IHR), first adopted by the World Health Assembly in 1969 and last revised in 2005, were designed to maximise collective efforts to manage public health events while minimising disruptions to travel and trade. There are 196 countries that are parties to the IHR, including all 194 WHO Member States as well as Liechtenstein and the Holy See.
The IHR provide a comprehensive legal framework that defines the rights and obligations of countries in responding to public health events and emergencies that may cross borders. They also introduce important safeguards to protect the rights of travelers and other people with regard to the processing of personal data, informed consent, and non-discrimination in the application of health measures under the rules. The IHR are therefore an instrument of international law that is legally binding on 196 countries.
Monitoring system
The IHR require that all countries have surveillance systems in place to detect acute public health events in a timely manner, assess these events, report to WHO those that may constitute a public health emergency of international concern, and respond to public health risks or emergencies. Countries' implementation goals are to limit the spread of health risks to neighboring countries and prevent unjustified travel and trade restrictions.
“The IHR have served the world for nearly two decades, but our collective experience using this vital tool to manage multiple public health emergencies, including the COVID-19 pandemic, has shown key areas where it can be strengthened for the benefit of all 196 States Parties,” said World Health Organization Director-General Tedros Adhanom Ghebreyesus. Commenting on the amendments, he added, “This is historic. Countries have come together behind an improved international mechanism, committed to equity and solidarity, to protect all people and future generations around the world from the impacts of epidemics and pandemics.”
IHR Working Group Co-Chair Ashley Bloomfield expressed hope that the amendments will survive: “The process of reaching agreement on most of the amendments has been long, but very productive and satisfying. It demonstrates the importance the world places on being able to effectively prepare for and better respond to epidemic and pandemic threats, and that there is strong international agreement on how to advance international public health protection.”
This process is running in parallel with an intergovernmental process to develop an international agreement on pandemic prevention, preparedness and response. A draft pandemic agreement, with a Member State-led negotiating process resuming on 20 May, will also be presented to the World Health Assembly.
Building capacity
The potential new pandemic agreement and revised IHR would be complementary international instruments designed and negotiated to help member states better protect their populations from future pandemic threats. While the IHR focuses on building national capacities to detect and respond to public health events that may take on international dimensions, the draft pandemic agreement focuses on a coordinated international response to pandemics, with equitable access to vaccines, therapeutics, and diagnostics at its core.
Abdullah Asiri of the Kingdom of Saudi Arabia, the other co-chair of the WGIHR, said this reflects the vital importance of strengthening collective defense against current and future public health risks, while upholding the principle of national sovereignty and respecting impartiality. “Today, we have finalized a powerful set of amendments that will make international cooperation more effective and easier to implement.”
The WHA began on Monday and will continue through this week, but at its end the world is likely to be better off with a consensus-based agreement to address future outbreaks early and prevent crises, as witnessed recently with the COVID pandemic.
