‘Excellent Progress’ in IHR Negotiations – But Still a Long Road Ahead
The working group on amending the IHR met in Geneva last week (20-24 Februar 2023).

Negotiations to tighten up the World Health Organization’s (WHO) International Health Regulations (IHR) to make them pandemic-ready made “excellent progress” – but it still faces enormous obstacles.

WHO member states spent four days last week addressing 100 of the 300 proposed amendments to the IHR, dealing particularly with compliance, implementation, and public health response. 

In describing the “excellent progress”, co-chair of the Working Group of the IHR (WGIHR), New Zealand’s Dr Ashley Bloomfield, said that discussions also “considered critical areas such as core capacities for surveillance and response, collaboration and assistance”. 

In addition, six newly proposed articles and one new annex were put on the table.

Fellow Co-Chair, Saudi Arabia’s Dr Abdullah Assiri described the tone of the meeting as positive and constructive.

“Countries are in the driving seat of this process as they need to implement the IHR, deliver on the obligations, and make the key decisions needed to respond to public health threats,” said Assiri.

Pandemic weaknesses

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. 

However, they proved inadequate during the COVID-19 pandemic, as pointed out by WHO Director-General Dr Tedros Adhanom Ghebreyesus.

“During the COVID-19 pandemic, the international community has learned a great deal about how the IHR functions in a public health emergency of international concern. But the pandemic also revealed deep inequalities in the global health architecture at the national and global levels,” said Tedros.

“It’s important to note that currently, the IHR are the only universal instrument for global health security that the world has,” added Tedros.“That’s why bold but well-targeted amendments are so vital.” 

“The IHR rely on the worldwide application of obligations for international cooperation and assistance in respect of human rights and the underlying principles of solidarity,” said Tedros.

“The process of amending the IHR offers an opportunity to strengthen and extend these principles, but these adjustments to the IHR also have practical implications, as we have learned from many outbreaks in recent years, especially during the early stages of a potential public health emergency.”

Incentives for pathogen sharing

Tedros said that the IHR’s incentive structures are not well-aligned, as some states that quickly notified WHO were “sometimes penalised by travel and trade restrictions”. He added they should be amended to encourage rather than punish transparency and IHR compliance.

Huge challenges remain to be resolved, however, particularly around pathogen sharing. The Africa group wants the WHO to establish a repository for cell lines to accelerate the production and regulation of generic products and vaccines.

Meanwhile, Bangladesh also wants the WHO to set up a database of the ‘recipes’ of vaccines and medicines needed during public health emergencies of international concern, as well as know-how related to their manufacturing.

Image Credits: WHO.

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