The United States’ decision last Friday to reject amendments to the International Health Regulations (IHR) – aimed at improving the global response to disease outbreaks – is based on “inaccuracies”, according to the Director General of the World Health Organisation (WHO).

“We regret the US decision to reject the amendments adopted by consensus by the World Health Assembly in 2024 – including by the US, as the US played an active role in developing and negotiating those amendments together with other countries,” said Dr Tedros Adhanom Ghebreyesus.

Member states “have the right to decide whether or not to adopt and, subsequently, implement amendments to the IHR”, added Tedros.

US Health Secretary Robert F Kennedy Jr and US Secretary of State Marco Rubio claimed in a statement that the amendments “significantly expand” the WHO’s “authority over international public health responses” and will “have undue influence on our domestic health responses”.

This criticism of the IHR Amendments is part of the narrative of Project2025, the Trump administration’s governing blueprint published by conservative think-tank the Heritage Foundation before the 2024 US elections.

Learnings from COVID-19

In response, Tedros said he wished to “correct inaccuracies stated by Secretary Kennedy and Secretary Rubio”.

Tedros noted that the 2024 amendments “were proposed, negotiated and adopted by member states, based on the learnings from the COVID-19 pandemic” and “are not about empowering WHO, but about improving cooperation among member states in the next pandemic.

In addition, said Tedros, the “amendments are clear about member states’ sovereignty” and that the WHO “has never had the power to mandate lockdowns, travel restrictions or other such measures”, but “member states have the power to do so if they see the need”. 

The US officials also claimed that the amendments “create additional authorities for the WHO for shaping pandemic declarations, and promote WHO’s ability to facilitate “equitable access” of health commodities”, and “fail to adequately address the WHO’s susceptibility to the political influence and censorship – most notably from China – during outbreaks”.

However, Tedros said that “risk communication is an essential part of any emergency response, as populations need to be informed in a timely way”. 

“Using disease outbreaks for propaganda would be destructive and disastrous,” stressed Tedros, adding that the WHO “is impartial and works with all countries to improve people’s health”.

Georgetown University’s Professor Lawrence Gostin, who assisted the WHO to draft the IHR, said that Kennedy’s claim that amendments “ open the door to the kind of narrative management, propaganda, and censorship that we saw during the COVID pandemic” was untrue.

“The IHR facilitates rapid detection and response. It actually promotes accurate information and protects civil liberties. And it certainly does not affect US sovereignty. These are all falsehoods,” said Gostin, who is the O’Neill Chair in Global Health Law at Georgetown University.

As someone who helped @WHO to draft the IHR, nothing RFK says here is true. The IHR facilitates rapid detection & response. It actually promotes accurate info & protects civil liberties. And it certainly does not affect US sovereignty. These are all falsehoods. https://t.co/OW2RqSUd6N

— Lawrence Gostin (@LawrenceGostin) July 18, 2025

What are the IHR amendments?

The IHR were amended after the SARS cotbreak in 2005, but widespread criticism of the WHO’s slow response to COVID-19 prompted member states to resolve to amend the regulations again to enable speedier and more sophisticated responses to health emergencies.

The new amendments to the IHR include introducing the definition of a “pandemic emergency” to trigger more effective international collaboration in response to events that are at risk of becoming a pandemic. 

There is also a new commitment to solidarity and equity, based on strengthening all countries’ access to medical products and financing. This includes establishing a “Coordinating Financial Mechanism” to help raise funds to enhance developing countries’ pandemic emergency prevention, preparedness and response-related capacities.

While the IHR does propose the establishment of a “States Parties Committee” to facilitate the implementation of the amended regulations, this is to be “non-punitive” and based on supporting inter-country cooperation and support.

The US was a vice-chair of the working group that negotiated to amendments to the IHR under the Biden administration, and the US delegation stressed that they would not accept an agreement that undermined US sovereignty.

“The experience of epidemics and pandemics, from Ebola and Zika to COVID-19 and mpox, showed us where we needed better public health surveillance, response and preparedness mechanisms around the world,” said Dr Ashley Bloomfield of New Zealand, Co-Chair of the Working Group on Amendments to the IHR, at the conclusion of the negotiations on the amendments.

His co-chair Dr Abdullah Assiri of Saudi Arabia, added that the amendments  “strengthen mechanisms for our collective protections and preparedness against outbreak and pandemic emergency risks”.

Image Credits: WHO.