The IHR Journey: Past Lessons and Future Directions

Abstract The International Health Regulations (IHR), established in 1969 and revised in 2005, represent a binding framework for 196 countries to combat global health threats. Historically, the IHR emerged in response to the need for a collective defence against the spread of infectious diseases. In the present, the IHR provides a legal structure for the World Health Organization (WHO) and its member states to report public health emergencies of international concern, ensuring a coordinated, prompt, and effective response. As we look towards the future, the IHR’s role is pivotal in addressing the complexities of global health security. The emergence of novel pathogens, the risk of bioterrorism, and the impact of climate change on disease patterns call for the evolution of the IHR. Such ammendments comprise: increasing clarity on multilevel jurisdiction; defining a pandemic emergency; introducing the concept of quarantine as a public health measure; stressing a compromise and solidarity approach between States Parties; reinforcing the need for bidirectional action between the WHO and States Parties; underlining cargo, as well as passengers, as relevant for public health measures; certificate digitalisation; among others. Strengthening the IHR is essential for a proactive approach to health policy, ensuring preparedness and resilience against any health crisis that may arise, although it remains in great controversy the right balance between the respect of national sovereignty and supranational impositions over national, democratically elected governments. Calling upon this reflection aims to bridge the gap felt in most WHO’s member states.