GENEVA – There were claps and cheers from inside Room XXVI of the UN’s Palais des Nations as World Health Organization (WHO) member states finally agreed on amendments to the International Health Regulations (IHR) after over two years of negotiations.

After failing to reach an agreement on the amendments before Monday’s start of the World Health Assembly (WHA), member states agreed to try to race to the finish during this week.

A drafting committee has been in intensive talks ever since, and its co-chair, Dr Ashley Bloomfield, told Health Policy Watch on Saturday that he had barely slept for the past few  days.

The IHR is a legally binding international instrument aimed at preventing the international spread of disease, and require countries to conduct surveillance for potential international health threats of all kinds and report those to WHO.

The COVID-19 pandemic showed weaknesses in the IHR, including that it did not mention “pandemic”. Member states submitted over 300 proposed amendments to the Working Group on Amendments to the IHR (WGIHR), chaired by New Zealand’s Bloomfield and Dr Abdullah Asiri of Saudi Arabia.

When parallel negotiations on a new pandemic agreement sailed into heavy water, there was a risk that the IHR amendments might become a casualty in the bargaining process – particularly from African member states pursuing equitable access to health products in the pandemic agreement.

They fear that the powerful Western countries pushing for the IHR to be passed – the US, European Union, Japan and the UK – will be less inclined to continue negotiating in good faith on the pandemic agreement once the IHR amendments have been passed. 

It is much harder for wealthy nations to buy into an agreement that involves compelling pharmaceutical companies to share their products – and the know-how about to make these – with companies and countries in the global south.

At the time of publication, the WHO still had to outline the process to conclude the pandemic agreement negotiations, but this is expected before the WHA closes at midnight on Saturday.