In tense final hours of the World Health Assembly in Geneva on June 1, countries agreed to strong amendments to the World Health Organization's 2005 International Health Regulations.
For more than a century, countries have sought to develop international rules to combat the threat of infectious diseases while protecting their national interests. Building on that history, these rules are the world's only international legal agreement focused exclusively on preventing and responding to cross-border infectious disease outbreaks.
The last time regulations were significantly overhauled was when the world barely survived the SARS epidemic in 2003. The old rules simply didn't work against a new pathogen. Countries, recognizing their shared vulnerability to new diseases, moved to update regulations.
Like SARS, the COVID-19 pandemic has exposed the flaws in this global health legal framework. But unlike SARS, the long-term human, social, economic and political toll of COVID-19 has been felt in almost every part of the world. The pandemic has exposed deeper, more systemic flaws. It has called into question the world's ability to confront the pandemic threat with fairness, solidarity and trust.
Upcoming regulatory reforms aim to fill some of these gaps. Once these changes come into effect, the world may be better able to work together to avert the next pandemic.
Fairness and solidarity
First, the new regulations will increase the transparency and timeliness of information about important public health events. They also introduce new “pandemic emergency” alerts, aiming to help countries prepare for imminent threats before it is too late to contain them. Importantly, they will require countries to work together to better ensure that medicines, diagnostics and vaccines reach those who need them most, wherever they are.
A shipment of COVID-19 vaccines distributed by the U.N.-backed COVAX initiative arrives in Abidjan, Côte d'Ivoire, in February 2021 amid the COVID-19 pandemic. COVAX was part of a global collaboration calling for equitable access to COVID treatments and vaccines. (AP Photo/Diomande Blé Blonde)
These are laudable changes. But the reform’s most significant impact may be symbolic. For the first time in history, more than 190 countries have agreed to go beyond narrow, “technical” interpretations of the regulations and bridge the North-South divide on a key issue. The new rules state that implementation of the regulations must be guided by principles of fairness and solidarity, along with fundamental human rights.
As a former member of the WHO Expert Committee that first considered proposed changes to the regulations, I am particularly encouraged to see this part of the Committee's recommendations being taken up in country negotiations.
Affirming fairness and solidarity as fundamental to regulatory application does not address deep-rooted global health inequities, nor does it gloss over egregious failures of solidarity, such as the squandered opportunity to temporarily waive intellectual property barriers that prevented life-saving vaccines from being distributed to places that need them most.
Read more: Vaccine patent exemptions are still needed, but not like those proposed at World Trade Organization meeting
But it will help ensure that all future actions under the regulations are guided by these ideals and enable civil society to hold governments to account. We must not repeat the gross injustices of vaccine hoarding and price gouging that have prolonged the COVID-19 pandemic and disproportionately affected the Global South.
Challenges and Implementation
The opening ceremony of the 77th World Health Assembly (WHA77) at the United Nations European Headquarters in Geneva, Switzerland, on May 27, 2024. The World Health Organization's annual meeting aimed to strengthen global preparedness and response to the next pandemic in the wake of COVID-19. (Salvatore Di Nolfi/Keystone via The Associated Press)
To be sure, hard work lies ahead to make the new regulations a reality. Implementation is a perennial challenge in international law. There is no guarantee that what countries agree to today will match their actions tomorrow. The regulations also give governments up to one year to decide whether to comply with the new rules.
But for now, in a world of geopolitical tensions, misinformation, disinformation and populism, the restrictions are a rare victory for multilateralism and global health diplomacy, and all parties involved in negotiating the agreement should be applauded.
And we should channel the celebration of this achievement into the important work ahead of us: developing new pandemic-specific legal instruments under the WHO. From the transfer of technology and know-how to the licensing of pandemic-related products, the Pandemics Convention offers countries an opportunity to go beyond words and put fairness and solidarity into practice through concrete actions and evidence-based law.
Canada's role
That's where Canada comes in. Wealthy countries like Canada often disagree with developing nations on how to achieve equity in pandemic preparedness and response, but successful regulatory reform should motivate countries to work harder to reach a pandemic treaty agreement.
Read more: Canada's 'me first' COVID-19 vaccine strategy could come at the expense of global health
Canada, as a “middle power” in global health diplomacy, has an especially important role to play in facilitating this consensus. Regardless of its past negotiating positions, Canada should view the restrictions as a reset button and permission to rethink how to constructively move forward with the final stages of negotiations.
The recent changes to the International Health Regulations show what can be achieved through constructive dialogue and diplomacy, even in a world as perilous as ours. We must use this momentum to build a global health law system that prioritizes fairness and equity, so that no one is left behind when the next crisis strikes. The risks are too great to settle for anything less.
