Historic amendments to WHO’s international health regulations pave the way for a fair pandemic treaty

On June 1, in the exciting final hours of the annual meeting of the World Health Assembly in Geneva, countries agreed to a robust package of amendments to the World Health Organization’s 2005 International Health Regulations.

For more than a century, nations have sought to develop international rules to address infectious disease threats while protecting national interests. Building on this history, these regulations constitute the world’s only existing international legal agreement focused exclusively on preventing and combating cross-border outbreaks of infectious diseases.

The last time the rules changed fundamentally was when the international community barely emerged from the grip of the SARS epidemic in 2003. The old rules didn’t say anything about new germs. Realizing their shared vulnerability to new diseases, countries have mobilized to change regulations.

Like SARS, the Covid-19 pandemic has exposed gaps in the global health regulatory framework. However, unlike SARS, almost every corner of the world has felt the long-lasting social, economic and political effects of Covid-19. The pandemic has revealed gaps of a deeper and more systemic nature. It has undermined the world’s ability to face the threats of the pandemic based on justice, solidarity and trust.

To some extent, upcoming regulatory changes aim to fill these gaps. Once these changes come into effect, the world will be better able than ever before to work together to prevent another pandemic.

Equality and solidarity

First, the new regulations increase the transparency and timeliness of information about important public health events. They also foresee a new “pandemic emergency” alert aimed at preparing countries for an imminent threat before it is too late to stop it. Crucially, they also commit countries to work together to ensure that medicines, diagnostics and vaccines have a better chance of reaching the people who need them most, wherever they are.

These are commendable changes. But the amendments’ most profound impact may be symbolic. For the first time in history, more than 190 countries have agreed to bridge the North-South divide on key issues, going beyond a narrow “technical” interpretation of the rules. Under the new rules, the implementation of the regulations must be guided by the principles of justice and solidarity, as well as fundamental human rights.

As a former member of the WHO expert committee that first considered the proposed amendments to the regulations, I am particularly pleased that this part of the committee’s recommendations was taken into account by countries in the negotiations.

Reaffirming that equality and solidarity are fundamental to the application of regulations will not remedy deep-seated global health injustices. Nor can it overshadow glaring failures of solidarity, such as the wasted opportunity to temporarily remove intellectual property barriers that prevented the distribution of life-saving vaccines to areas where they were most needed.

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However, it will help ensure that all future actions taken under the law are guided by these ideals and enable civil society to hold governments to account. The gross injustice of vaccine hoarding and price gouging that has prolonged the Covid-19 pandemic and disproportionately affected the Global South cannot be relived.

Challenges and implementation

We certainly have hard work ahead of us to implement the new regulations. Implementation is a perennial challenge of international law. There is no guarantee that what countries agree on today will be what they do tomorrow. The regulations also give governments one year to decide whether they want to comply with the new regulations.

But for now, in a world full of geopolitical tensions, disinformation and populism, regulation is a rare victory for multilateralism and global health diplomacy. Everyone involved in reaching a consensus in the negotiations should be commended.

They should also harness the celebratory mood of this feat for key upcoming work: developing a new legal instrument on pandemics within the WHO. From the transfer of technology and know-how to the licensing of pandemic-related products, the pandemic treaty offers countries the opportunity to move beyond rhetoric and put into practice equality and solidarity through concrete, evidence-based actions and regulations.

Canada’s role

This is where Canada comes in. Rich countries like Canada often disagree with developing countries on how to ensure equal levels of pandemic preparedness and response. However, success in changing the rules should spur countries to work even harder to reach a consensus on a pandemic treaty.

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As a “middle power” in global health diplomacy, Canada has a particularly important role to play in supporting this consensus. Regardless of its previous negotiating positions, Canada should view these regulations as a reset button and the right to rethink how it can constructively advance the final stage of negotiations.

Recent changes to the International Health Regulations are a testament to what constructive discourse and diplomacy can achieve – even in a world as dangerous as ours. This momentum must be harnessed to create a global health law architecture focused on justice and equity, so that no one is left behind when the next crisis hits. The stakes are too high to settle for anything less.