WHO shared in June 2024 that at the annual meeting of its 194 member countries, the World Health Assembly (WHA), a “historic” agreement was reached on “critical amendments” to the International Health Regulations (2005) (IHR) and negotiations on the global pandemic agreement. These decisions were announced on the final day of the 77th WHA and “build on lessons” from several global health emergencies, including the COVID-19 pandemic.
“These critical actions have been taken to protect the health and safety of all people everywhere from the risk of future outbreaks and pandemics.”
Amendments to the IHR
The latest amendments to the IHR include:
- The introduction of a definition of a pandemic emergency to ensure more effective international collaboration in response to events that are at risk of becoming, or have become, a pandemic. This represents a higher level alarm that builds on the existing mechanisms of the IHR, including the determination of a public health emergency of international concern. The definition determines that a pandemic emergency is a communicable disease that has, or is at high risk of having, wide geographical spread to and within multiple States, exceeds or is at high risk of exceeding the capacity of health systems to respond in those States, causes, or is at high risk of causing, substantial social and/or economic disruption, including disruption to international traffic and trade, and requires rapid, equitable, and enhanced coordinated international action, with whole-of-government and whole-of-society approaches.
- A commitment to solidarity and equity on strengthening access to medical products and financing. This includes establishing a Coordinating Financial Mechanism to support the identification of, and access to, financing required to “equitably address the needs and priorities of developing countries, including for developing, strengthening, and maintaining core capacities”, and other pandemic emergency prevention, preparedness, and response-related capacities.
- Establishment of the State Parties Committee to facilitate the effective implementation of the amended Regulations. The Committee is to promote and support cooperation among State Parties for the effective implementation of the IHR.
- Creation of National IHR Authorities to improve coordination of the Regulations within and among countries.
WHO’s Director-General Dr Tedros Adhanom Ghebreyesus identified a “common desire by Member States to protect their own people, and the world’s, from the shared risk of public health emergencies and future pandemics.
“The amendments to the International Health Regulations will bolster countries’ ability to detect and respond to future outbreaks and pandemics by strengthening their own national capacities, and coordination between fellow States, on disease surveillance, information sharing, and response. This is built on commitment to equity, an understanding that health threats do not recognise national borders, and that preparedness is a collective endeavour.”
The Director-General hopes that this IHR progress will provide “powerful momentum to complete the Pandemic Agreement”. Dr Ashley Bloomfield of New Zealand, Co-Chair of the Working Group on Amendments to the IHR (WGIHR), is “so proud to be a part of this”.
“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. Countries knew what had to be done and we did it.”
Fellow Co-Chair of WGIHR, Dr Abdullah Assiri of the Kingdom of Saudi Arabia, agreed that the amendments “strengthen mechanisms for our collective protections and preparedness against outbreak and pandemic emergency risks”.
“Today’s powerful show of global support for stronger Regulations also provides a great boost for the process to negotiate a much-needed international Pandemic Agreement.”
The Pandemic Agreement
WHO Member States also agreed to extend the mandate of the Intergovernmental Negotiating Body to continue negotiations on a Pandemic Agreement as soon as possible. Precious Matsoso of South Africa, Co-Chair of the Pandemic Accord Intergovernmental Negotiating Body (INB) and the Drafting Group on the INB and IHR agenda items at the WHA, suggested that there was a “clear consensus” among the Member States on the “need for a further instrument to help the world better fight a full-blown pandemic”. Fellow INB Co-Chair Roland Driece of the Netherlands celebrated the “great result”.
“We clearly have the will, the purpose, and now the time needed to complete this generational agreement.”
CEPI calls for more effort
Also in June, CEPI issued a statement welcoming the news that WHO Member States will keep up momentum on negotiations and calling on governments to “make every effort” to reach an agreement “at the earliest possible opportunity”. The statement highlighted a need for efforts on several commitments in the process:
- Sustained preparedness investments in R&D and ensuring that government R&D funding agreements include contractual requirements to support equitable access, such as licensing, affordable pricing, technology transfer, information sharing, and equitable allocation.
- Establishment of a network of partnerships for end-to-end collaboration on medical countermeasures development and response and promotion of strategic investments in economically sustainable, geographically distributed vaccine manufacturing facilities with capability for rapid response.
- Establishment of a multilateral system that supports rapid and efficient sharing of samples and data on pathogens with pandemic potential to expedite R&D for medical countermeasures, at all times, as well as equitable access to the outputs of such R&D. CEPI reiterated that real-time access to 20% of pandemic vaccines should be a minimum requirement for equitable access.
CEPI believes that an agreement that “strengthens accountability, transparency, and international collaboration” will be possible. It hopes for an agreement that “combats structural inequity” and drives the “system-wide change needed to respond more quickly and more fairly” to a future pandemic.
“The world was too slow in its response to COVID-19. This cost the lives of millions of people. We cannot afford to repeat the same mistakes.”
For more on the importance of this agreement in pandemic preparedness and response, join us at the Congress in Barcelona later this year, and don’t forget to subscribe to our newsletters here.
