Context: World Health Assembly has agreed to a historic decision of introducing critical amendments to International Health Regulations, 2005 (IHR) aiming to strengthen international community's ability to detect and respond to pandemic threats. Alongside, members of World Health Assembly fixed timelines on the global pandemic agreement and agreed to bring the Global Pandemic Agreement in to effect within a year.
Following the COVID-19 Pandemic, WHO started a twin-track process to. The first track saw the formation of Intergovernmental Negotiating Body for the development of Pandemic Prevention, Preparedness and Response Accord (Popularly known as the Pandemic Treaty) and the second track focused on constitution of a working group for amending the International Health Regulations, 2005 based on the lessons learnt for COVID-19 pandemic aiming to strengthen global preparedness, surveillance and response to public health emergencies, including pandemics.
International Health Regulations 2005
- The IHR Regulations aim to prevent, prepare for, protect against, control and provide a public health response to the international spread of disease that are commensurate with and restricted to public health risk and avoid unnecessary interference with international traffic and trade.
- IHR 2005 provides for an overarching legal framework that defines rights and obligations of countries in handling public health events and emergencies that have the potential to cross borders.
- IHR 2005 is a successor of International Sanitary Regulations 1951.
- IHR 2005 were conceived to maximize to collective efforts to manage public health events while at the same time minimising their disruption to travel and trade.
- IHR regulations are an instrument of international law. Currently, there are 196 State Parties to IHR which comprises 194 WHO Member States plus Liechtenstein and Holy See.
- IHR Regulations also outline the criteria to determine whether a particular event constitutes a “public health emergency of international concern”.
- However, to make the IHR 2005 relevant for pandemics, further strengthening of these regulations was required.
- The amendments to 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 recognize national borders, and that preparedness is a collective endeavour.
Salient features of Amendments to International Health Regulations 2005
- Determination of a public health emergency of international concern, including a pandemic emergency: The Director General of WHO will determine if an event constitutes a public health emergency of international concern or pandemic emergency based on:
- Information provided by State Party/Parties
- Decision Instrument contained in Annex 2
- Advise of the Emergency Committee
- Scientific principles and available scientific evidence and other relevant information.
- An assessment to risk to human health, risk of international spread of disease and risk of interference with international traffic.
- Emergency Committee: Director General of WHO shall establish an Emergency Committee that will provide the Director General with views on:
- Whether an event constitutes a public health emergency of international concern, including a pandemic emergency.
- Termination of a public health emergency of international concern, including a pandemic emergency.
- Definition of Pandemic Emergency:
- The clear definition of Pandemic will trigger more effective international collaboration in response to events that are at the risk of becoming a pandemic. The Pandemic emergency definition represents a higher level of alarm that builds on existing mechanisms of IHR such as Public Health Emergency of International Concern.
- A Pandemic Emergency has been defined as a public health emergency of international concern that is caused by communicable disease, and
- Has, or is at high risk of having, wide geographical spread to and within multiple States.
- In exceeding, or is at high risk of exceeding, the capacity of health systems to respond in those States.
- In causing, or is at high risk of causing, substantial social and/or economic disruption, including disruption to international traffic and trade.
- Requires rapid, equitable and enhanced coordinated international action, with whole of government and whole of society approaches.
- Constitutes National IHR Authority in all state parties to International Health Regulations:
- National IHR Authority is an entity designated or established by State Party at national level to coordinate the implementation of IHR regulations within the jurisdiction of the State Party.
- The Committee will promote and support cooperation among State Parties for effective implementation of IHR.
- Equitable access to relevant health products:
- WHO shall support State Parties and coordinate international response activities during public health emergencies of international concern, including pandemic emergencies.
- WHO shall facilitate and remove barriers to timely and equitable access to State Parties to relevant health products during a public health emergency of international concern, including a pandemic emergency based on public health risks and needs.
- Relevant health products are those health products needed to respond to public health emergencies of international concern, including pandemic emergencies such as medicines, vaccines, diagnostics, medical devices, vector control products, personal protective equipment, decontamination products, assistive products, anti-dotes, cell and gene-based therapies and other health technologies.
- Towards the Director General shall:
- Conduct, review and update, assessments of public health needs, availability and accessibility including relevant health products for public health response, publish such assessments
- Make use of WHO coordinated mechanisms, or facilitate their establishment as needed
Coordinating Financial Mechanism for financial collaboration
State Parties shall maintain or increase domestic funding and collaborate through international cooperation and assistance to strengthen financing to support the implementations of these regulations.
State Parties shall undertake to collaborate, to the extent possible:
- Encourage governance and operating models of existing financial entities and funding mechanisms to be regionally representative and responsive to the needs and national priorities of developing countries.
- Identify and enable access to financial resources, including through Coordinating Financial Mechanism, necessary to equitably address the needs and priorities of developing countries, including for developing, strengthening and maintaining core capacities.
- Amendments establish Coordinating Financial Mechanism establish to:
- Promote provision of timely, predictable and sustainable financing for implementation of these regulations to develop, strengthen and maintain core capacities, including those relevant for pandemic emergencies.
- Seek to maximize the availability of financing for implementation needs and priorities of State Parties, of developing countries.
- Work to mobilise new and additional financial resources and increase the efficient utilisation of existing financial instruments.
- For these the Coordinating Financial Mechanism will:
- Use or conduct relevant needs and funding gap analyses.
- Promote harmonisation, coherence and coordination of existing financial instruments.
- Identify all sources of financing that are available for implementation support and make the information available to State Parties.
- Provide advice and support to State Parties in identifying and applying for financial resources for strengthening core capacities, including those relevant for pandemic emergencies.
- Leverage voluntary monetary contributions for organisations and other entities supporting State Parties to develop, strengthen and maintain their core capacities, including those relevant for pandemic emergencies.