Hi,

The amended International Health Regulations have now come into force. These targeted amendments were adopted last year by WHO member states in June 2024.

In this edition we bring you, a guest essay by Ashley Bloomfield, who along with his colleagues at the Working Group set up to amend the IHR, led the negotiations.

Today’s piece serves as a useful reminder on the challenges in complex multilateral negotiations in a period of shifting geopolitics and commercial considerations.

(In case you missed it, please see our reportage on the negotiations on the amendments to the IHR compiled into a single volume that we published earlier in the year. Details below.)

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More soon!

Best,

Priti

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I. UPDATE:

The Entry into Force of the Amended International Health Regulations (2005)

Last week, the amended International Health Regulations entered into force. See Appendix 4 here with a series of countries who have variously reserved, rejected the amendments. “Eleven of the 196 IHR States Parties rejected the 2024 amendments. For them, previous versions of IHR continue to apply, though rejections may be withdrawn at any time,” WHO said.

Rejections: Argentina, Austria, Brazil, Canada, Czech Republic, Germany, Israel, Italy, The Netherlands, Philippines, the U.S.

Reservations: Holy See, Switzerland.

Declarations under Article 59 (Para 3) IHR (2005): Croatia, Cyprus, France, Hungary, Ireland, Latvia, Malta, South Africa submitted declarations, in accordance with Article 59 of the IHR, indicating that, due to the need for domestic legal and administrative arrangements, they will be able to implement the 2024 amendments by 19 September 2026, WHO said.

II. GUEST ESSAY

Amending the 2005 International Health Regulations: Looking Back & Looking Forward

By Ashley Bloomfield

Bloomfield was Co-Chair of the Working Group for Amendments to the IHR (2005) and is now the Interim Chief Executive at Environmental Science and Research in New Zealand and a Professor at the University of Auckland.

This piece was written in March 2025 and features as a contribution in the book published by Geneva Health Files: Negotiating Equity: The Amendments to the International Health Regulations (2005): A multilateral effort to strengthen the rules to govern international health emergencies [ISBN: 9782970162742, May 2025]

On 1 June 2024, a package of amendments to the 2005 International Health Regulations (IHR (2005)) was adopted by consensus at the 77th World Health Assembly. This milestone was the culmination of some 18 months of work, including over 40 days - and some nights - of face-to-face negotiations.

At the time, it was clear that getting agreement on the amendments was not guaranteed. There was always the possibility that either a consensus would not be reached, or that the agreed amendments would be only minor and not address the underlying problems highlighted by the COVID-19 pandemic, including addressing equity.

We have previously outlined the factors that we consider lay behind the successful conclusion of the process, and expressed our view that the agreed amendments are not trivial.[i] In summary, we consider the key success factors to be:

• the Bureau working and leading as a team with the WHO secretariat, solving problems inside the room and speaking with one voice outside it;

• a strong focus on listening to and reflecting back all positions to build trust in the process;

• providing a clear rationale for any Bureau proposals so that all delegations could understand their intent and the careful consideration behind them;

• requesting and supporting delegations and groupings to work together to find solutions.

[i] Bloomfield A, Asiri A. The updated International Health Regulations: good news for global health equity. Lancet 29 June 2024; 403 (10446): 2761-2.