World Health Assembly agreement reached on wide-ranging, decisive package of amendments to improve the International Health Regulations

In an historic development, the World Health Assembly, the annual meeting of its 194 member countries, today agreed a package of critical amendments to the International Health Regulations (2005) (IHR), and made concrete commitments to completing negotiations on a global pandemic agreement within a year, at the latest. These critical actions have been taken in order to ensure comprehensive, robust systems are in place in all countries to protect the health and safety of all people everywhere from the risk of future outbreaks and pandemics.

These decisions represent two important steps by countries, taken in tandem with one another on the final day of the Seventy-seventh World Health Assembly, to build on lessons learned from several global health emergencies, including the COVID-19 pandemic. The package of amendments to the Regulations will strengthen global preparedness, surveillance and responses to public health emergencies, including pandemics.

The historic decisions taken today demonstrate 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,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “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 recognize national borders, and that preparedness is a collective endeavor."

Dr Tedros added: The decision to conclude the Pandemic Agreement within the next year demonstrates how strongly and urgently countries want it, because the next pandemic is a matter of when, not if. Today’s strengthening of the IHR provides powerful momentum to complete the Pandemic Agreement, which, once finalized, can help to prevent a repeat of the devastation to health, societies and economies caused by COVID-19.

The new amendments to the IHR include:

• introducing a definition of a pandemic emergency to trigger more effective international collaboration in response to events that are at risk of becoming, or have become, a pandemic. The pandemic emergency definition represents a higher level of alarm that builds on the existing mechanisms of the IHR, including the determination of  public health emergency of international concern. According to the definition, 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 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 States Parties Committee to facilitate the effective implementation of the amended Regulations. The Committee will promote and support cooperation among States Parties for the effective implementation of the IHR; and


• creation of National IHR Authorities to improve coordination of implementation of the Regulations within and among countries.

“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 (WGIHR), and of the Drafting Group that guided the negotiations of the package of amendments during the WHA. “Countries knew what had to be done and we did it. I am so proud to be a part of this.”

Fellow WGIHR Co-Chair Dr Abdullah Assiri, of the Kingdom of Saudi Arabia, added: “The amendments to the International Health Regulations 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 provide a great boost for the process to negotiate a much-needed international Pandemic Agreement.”

Plan agreed for finalizing negotiations on a Pandemic Agreement

Countries agreed to continue negotiating the proposed Pandemic Agreement to improve international coordination, collaboration and equity to prevent, prepare for and respond to future pandemics.

WHO’s Member States decided to extend the mandate of the Intergovernmental Negotiating Body, established in December 2021, to finish its work to negotiate a Pandemic Agreement within a year, by the World Health Assembly in 2025, or earlier if possible at a special session of the Health Assembly in 2024.

“There was a clear consensus amongst all Member States on the need for a further instrument to help the world better fight a full-blown pandemic,” said Ms Precious Matsoso of South Africa, Co-Chair of both the Pandemic Accord Intergovernmental Negotiating Body (INB) and the Drafting Group on the INB and IHR agenda items at the WHA.

Fellow INB Co-Chair Roland Driece, from the Netherlands, said: “Today’s great result in approving amendments to the International Health Regulations will provide the momentum we need to finalize the Pandemic Agreement. We clearly have the will, the purpose and now the time needed to complete this generational agreement.”

Notes to editors:

The IHR (2005), the successors of the 1951 International Sanitary Regulations, were conceived to maximize collective efforts to manage public health events while at the same time minimizing their disruption to travel and trade. They have 196 States Parties, comprising all 194 WHO Member States plus Liechtenstein and the Holy See.

WHO Member States launched the process to develop the world’s first pandemic accord, to prevent a repeat of the global health, economic and social impacts of the COVID-19 pandemic, at a Special Session of the World Health Assembly in December 2021.