Implementation of the International Health Regulations: Evolving Reforms to Address Historical Limitations

Abstract

This chapter examines the implementation of the IHR in addressing public health emergencies. Framing these implementation obligations, Part II outlines WHO’s constitutional authority to develop regulations to address the international spread of disease, highlighting the interplay between international legal commitments and state implementation under the IHR. Part III chronicles the implementation of the IHR since the establishment of WHO, with early implementation efforts proving largely incommensurate to the emerging disease threats of a globalizing world. Following sweeping IHR reforms in 2005, Part IV examines how the revised IHR (2005) was implemented in addressing a rapid succession of public health emergencies of international concern.

 

Despite legal advancements under IHR (2005), the COVID-19 pandemic overwhelmed the world, and Part V examines the continuing limitations of the IHR in meeting this cataclysmic threat, raising an imperative for further reforms. Part V analyzes these 2024 amendments promulgated by WHO Member States, establishing new mechanisms to support national and global IHR implementation. As these amendments arose alongside reforms across the global health governance landscape, including the adoption of a new WHO Pandemic Agreement, this chapter concludes in Part VI that IHR implementation must be considered as part of an interconnected and mutually reinforcing landscape of global health law obligations, recommending additional studies on evolving implementation processes to inform the evidence-based development of law and policy to protect and advance public health.

Note:
Funding Information: None to declare.

Conflict of Interests: None to declare.

Keywords: International Health Regulations, World Health Organization, COVID-19