Law experts propose revisions for international health regulations

Writing in The Lancet and published online, Lawrence O. Gostin, Mary C. DeBartolo and Eric A. Friedman from the O'Neill Institute for National and Global Health Law at Georgetown University, outline operational and textual reforms that would assist in the implementation and functioning of the Regulations. (The Lancet Viewpoint: 'The International Health Regulations 10 Years On: The Governing Framework for Global Health Security').

The International Health Regulations (IHR), a legally binding instrument, was adopted 10 years ago with the aim "to prevent, protect against, control and provide a public health response to the international spread of disease."

Over the past several years, however, the WHO has been criticized for its handling of crises including the recent Ebola epidemic, leading to what the authors call a 'crisis of confidence' in the International Health Regulations. The authors propose innovative reforms that collectively "could help to build a well functioning global detection and response system."

Gostin argues, "The Ebola epidemic is a wakeup call for the World Health Organization and a turning point for the IHR, the governing international rules for global health security. It we don't act now, creatively and boldly, we will lose the opportunity for fundamental reform for a generation. Now is the time for the international community to do the right thing by building strong, resilient health systems in the world's poorest countries."

Recommendations made by Gostin and his colleagues include developing an 'International Health Regulations Capacity Fund' to build, strengthen and maintain core capacities; clarifying what diseases are to be reported and when; incorporating emergency response frameworks into the IHR; and encouraging WHO to play a more active and public role in encouraging Member States to account for deviations from temporary recommendations.

"10 years after its adoption, the time has come to realize the International Health Regulations' promise," they conclude. "Donor fatigue, fading memories, and competing priorities are diverting political attention. Empowering WHO and realizing the International Health Regulations' potential would shore up global health security -- an important investment in human and animal health, while reducing the vast economic consequences of the next global health emergency."