The Amended International Health Regulations And INB

• Urgent implementation of the amended International Health Regulations can improve outbreak prevention, alert and response including with the new focus on equity and finance
• WHO Member States must now maintain the momentum and adopt an effective pandemic agreement as soon as possible

1 June 2024

The former Co-Chairs, active members and advisors to The Independent Panel for Pandemic Preparedness and Response applaud WHO Member States on the adoption of amended International Health Regulations (IHRs).

“These amended International Health Regulations, if fully implemented, can result in a system that can better detect health threats and stop them before they become international emergencies,” said the Right Honourable Helen Clark, former Co-Chair of The Independent Panel for Pandemic Preparedness and Response.

“I congratulate WHO Member States for agreeing to regulations intended to improve information-sharing about outbreaks, and action to ensure that countries have access to health products to contain outbreaks, including to the financing required.”

The amended regulations define pandemic emergencies; place new emphasis on preparedness; say that WHO should share information even where a country is not collaborating – while encouraging the State Party to accept the WHO’s offer of collaboration; have new language on timely and equitable access to health products; offer more potential for international funding to ensure that countries are prepared and can access health products; and have introduced a new implementation committee.

“It’s excellent that a pandemic emergency is now defined in the IHR,” Helen Clark said. The world must now urgently make the investments needed to implement the revised IHRs, including in low- and middle-income countries, with the objective of stopping pandemic threats in their tracks.”

The Independent Panel, in its main report COVID-19: Make it the Last Pandemic, found that the 2005 IHRs had served ‘to constrain rather than facilitate rapid action’ and that ‘the precautionary principle was not applied to the early alert evidence when it should have been.’

The Panel also noted that a Public Health Emergency of International Concern (PHEIC) was the loudest alarm bell which WHO had the authority to ring under the 2005 IHR, and that many countries had essentially not acted on the PHEIC designation on 30 January 2020 for COVID-19. In many cases therefore, action was taken only belatedly after WHO used the term ‘pandemic’ on 11 March to describe the state of the spread and impact of COVID-19. At that time, the term pandemic was not included in the IHRs.

The IHR amendments now agreed by the World Health Assembly include some promising language which should help to speed detection of health threats, their verification, alerts, and actions. These include:

A specific reference to an obligation to report ‘clusters of severe acute respiratory disease of unknown or novel cause.’ This encourages countries to take a precautionary approach and alert such events more rapidly.

WHO should share information about a health threat with potential for international spread, even where the originating country does not accept WHO’s offer to collaborate.

Countries should keep WHO up-to-date on information concerning a health event of concern not requiring notification, even if full information is not available.

In its report, the Panel had also recommended that there should be incentives for countries to comply with the IHRs. The revised IHR contain new incentives to report health events and also to stop outbreaks and protect people. They include new commitments to equity, including WHO obligations to help countries access health products. There are new financing commitments as well, including for countries to invest domestically, and to provide additional financing globally.

One Panel recommendation that has not been implemented was for WHO to be given full authority to investigate the site of an outbreak without restrictions. WHO must therefore fully use its authority to provide Member States information about a health event if the country where the outbreak originates is not cooperating.

Now an effective pandemic agreement must be negotiated and adopted

An effective pandemic agreement should complement the amended International Health Regulations. WHO Member States have given themselves an additional year to negotiate and adopt an agreement.

“Political commitment at the highest levels is now required to ensure that a pandemic agreement can be both concluded and effective,” said Helen Clark. “Full implementation of the International Health Regulations brings the world closer to being safer from pandemic threats. A new pandemic agreement with equity at its heart, would further strengthen the rules around and guide international collaboration.”

“When the Intergovernmental Negotiating Body for a pandemic agreement meets in July, it is strongly encouraged to review its ways of working, including by forming structured working groups and inviting independent experts, including from civil society, to take part in the process,” said Helen Clark.

© Scoop Media