Governments Hold Fourth Round of Discussions on Proposed Amendments to International Health Regulations (2005)

Governments last week continued their detailed examination of a significant number of the over 300 proposed amendments to the WHO International Health Regulations 2005 (IHR). In this fourth round of intensive discussions, taking place under the aegis of the Working Group on Amendments to the IHR (WGIHR), the 196 State Parties to the IHR – which include WHO’s 194 Member States(1) - discussed proposed amendments related to the following topics:

• Responsible authorities - Article 4
• Notification, verification, and provision of information - Article 5 (paragraph 4 and new paragraphs 5). Articles 6-11, Annex 2 and new Annex 2
• Determination of public health emergency of international concern - Article 12
• The Emergency Committee - Articles 48, 49
• Temporary and standing recommendations - Articles 15, 16, 17, 18

The Working Group agreed that efforts should continue during the intersessional period as follows:

• discussions between proponents of various proposed amendments, with a view to presenting any outcomes to the drafting group for consideration; and
• intersessional briefings and facilitated informal consultations, in a hybrid format, open to all drafting group members, as well as joint intersessional work with the INB at dates and times to be announced, covering Articles and Annexes discussed during the fourth meeting of the WGIHR, including those that have been the subject of intersessional work. The outcomes of facilitated informal consultations are understood not to constitute agreed text, and will be translated and made available in advance of the next WGIHR meeting in October 2023.

The IHR were originally adopted to set out agreed approaches and obligations for countries to prepare for, and respond to, disease outbreaks and other acute public health events with risk of international spread. The original International Sanitary Regulations were revised three times – in 1969 (when they became International Health Regulations), in 1981, and in 2005. The IHR, in their version adopted in2005, have been amended twice – in 2014 and 2022 (the most-recent amendments have not yet come into force). The newest proposed amendments come in response to the challenges posed by the COVID-19 pandemic.

“We made excellent progress this week on important and substantive areas of the IHR which the States Parties had identified as key areas for revision in the wake of the experience with COVID-19,” said Dr Ashley Bloomfield, former Director-General of Health, New Zealand and Co-Chair of the IHR Working Group.

“COVID showed the world how vulnerable we all are and what needed fixing in the global public health architecture if we are to be better prepared for the next big event and the tone of the discussions during last week’s meeting clearly shows that everyone wants to ensure that this process is successful.”

Throughout the 5-day meeting from 24-28 July, the WGIHR stressed the importance of thoroughly considering the proposed amendments on their merits of filling critical gaps in the implementation of the IHR, while being mindful of the importance of the principles of equity, sovereignty, and solidarity.

Fellow IHR Working Group Co-Chair, Dr Abdullah M. Assiri, Deputy Minister of Health, Kingdom of Saudi Arabia, said governments were committed to strengthening the IHR for the benefit of every country and every citizen.

“Countries are in the driver's position for this process, as they propose essential amendments to the IHR and make decisions necessary to address threats to public health. This week, we have witnessed how their positive attitude and efficient work have enabled us to make substantial progress. Between now and the Working Group's upcoming meeting in October, a great deal of diligence and effort will be required,” added Dr Assiri.

In parallel with the IHR amendments process, governments are also negotiating the drafting of a WHO instrument on pandemic prevention, preparedness and response, also referred to as a pandemic accord. The INB and WGIHR held a joint Plenary meeting on 21 and 24 July to discuss the relationship between the processes and instruments of the INB and WGIHR and topics of common interest to both processes.

WHO Member States issued the International Sanitary Regulations in 1951, the precursor to the IHR, which came into being in 2005. The IHR are an instrument of international law that is legally-binding on 196 State Parties, including the 194 WHO Member States.

(1) Liechtenstein and the Holy See are State Parties to the IHR but not Member States of WHO.