International Health Regulations
The International Health Regulations or the International Health Regulations (IHR) are a legally binding instrument of international law that aims to protect against, prevent, contain, and protect public health from the international spread of diseases. in ways that are proportionate to, and limited to, risks to public health, while avoiding undue interference with international traffic and trade. The regulations were approved at the 58th General Assembly of the World Health Organization on May 23, 2005, in accordance with Articles 2 and 22 of the WHO Statute, and are published in Arabic, Chinese, English, French, Russian and Spanish.
The origins of the International Health Regulations date back to the 19th century, when the French government organized a series of International Sanitary Conferences starting in 1851 to standardize international quarantine regulations in the event of pandemics. At that time, it mainly concerned the spread of cholera, plague and yellow fever.
In 1948 the World Health Organization was founded and in 1951 published the first regulations for the prevention of infectious diseases, the International Sanitary Regulations. These related to six infectious diseases that gave rise to quarantine: cholera, plague, recurrent fever, smallpox, typhoid and yellow fever. The regulations were revised in 1969, from then on under the English name International Health Regulations. In 1973, the rules on cholera were amended and smallpox was removed from the list.
In 1995 it was decided to revise the regulations from 1969, because of the shortcomings that have become apparent in the meantime:
new infections such as Ebola and Zika were missing from the list of diseases to be reported;
over-reliance on official notification by the states
lack of a formal internationally coordinated mechanism to prevent the international spread of diseases
too rigid measures hampered the meanwhile greatly increased international traffic (travel and trade).
Current Regulations (IHR)
The revision led in 2005 to the current regulations (IHR 2005) which came into effect on 15 June 2007. The regulations are binding on the 196 States Parties, including all 194 member states of the WHO. For example, under the 2005 IHL, notification is required for all events that could constitute a public health emergency of international concern.
Medical Emergency (PHEIC)
In the event of serious epidemics, the WHO can declare an international medical emergency, in the jargon a Public Health Emergency or International Concern or PHEIC. Such a medical emergency is defined in the IHR 2005 as: an extraordinary event that definitely poses a risk to public health in other countries - due to the international spread of disease - and which may require a coordinated international response. This definition implies a situation that:
is severe, sudden, unusual, or unexpected
has implications for public health outside the affected state
may require immediate international action. The declaration of the emergency is a formal declaration by the Director General, following consultations in the expert committee. It includes virologists and other physicians, including at least one from the Member State that reported the disease. The statement is reviewed every three months.
Both the regulations and the declaration of the medical emergency are the subject of controversy, for example in the wake of the Ebola epidemic and the corona pandemic.
International Health Regulations (2005)
PHEIC procedures (archived)