Global Health Rules Amended: New International Regulations Enter Into Force

The amended International Health Regulations (IHR) officially entered into force today, signaling a renewed global commitment to cooperation in tackling health emergencies, a move shaped by the hard lessons of the COVID-19 pandemic.

The IHR provide a legal framework guiding 196 States Parties, including all 194 WHO Member States, on their rights and obligations in responding to public health risks that cross borders. First established in 1951 as the International Sanitary Regulations and later renamed the IHR, the framework has evolved over decades to reflect the realities of global travel, trade, and emerging diseases.

In May 2024, the Seventy-seventh World Health Assembly in Geneva adopted the latest amendments by consensus. Among the most notable changes is the creation of a new global alert level, a “pandemic emergency,” which activates stronger international collaboration when a health risk escalates beyond a Public Health Emergency of International Concern (PHEIC).

The amendments also require governments to establish National IHR Authorities to coordinate implementation, while strengthening provisions for equitable access to medical products and financing. These reforms, WHO officials say, are rooted in shortcomings exposed during the COVID-19 crisis, when fragmented responses and unequal access to vaccines highlighted deep gaps in preparedness and solidarity.

“The strengthening of the International Health Regulations represents a historic commitment to protect future generations from the devastating impact of epidemics and pandemics,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus. “We know that no one is safe until everyone is safe. The IHR amendments reaffirm our shared responsibility and solidarity in the face of global health risks.”

The IHR amendments come alongside the adoption of the WHO Pandemic Agreement earlier this year, which is still under negotiation regarding pathogen access and benefit-sharing. While WHO acts as Secretariat under the IHR, the organization does not have authority to compel countries to act, as states retain sovereign rights over their health policies.

Not all countries have accepted the reforms. Eleven of the 196 States Parties rejected the 2024 amendments, meaning previous versions of the IHR will continue to apply for them. However, those states may withdraw their rejections at any time.

WHO has pledged to support countries in integrating the new provisions into national laws and strengthening institutional capacities. Global health experts view the amendments as a critical step toward a more unified response to future outbreaks, a safeguard against repeating the costly mistakes of the recent past.