GSL Co-authors Commentary in the Lancet on Reforming the IHR in light of COVID-19

On June 19, GSL Research Fellow Roojin Habibi and GSL Director Steven Hoffman, in collaboration with 13 other global health law experts from around the world, published a commentary in the Lancet arguing for a reimagining of the International Health Regulations (IHR) in the wake of COVID-19. The authors focused on three areas that need particular attention, should the international community re-examine the IHR

1. Public Health Emergency of International Concern (PHEIC)

   After evidence surfaced that China waited weeks to inform the World Health Organization (WHO) of a PHEIC, instead of the 24h agreed upon in the IHR, Taylor et al. suggest changes in reporting and inspection practices: A reimagined IHR should allow for information to be received from non-state actors (without state oversight). Further, international experts should be allowed to conduct missions to inspect potential outbreaks. Provisions in treaties on arms control could serve as examples.

   Taylor et al. also addressed the process of declaring a PHEIC, arguing for greater transparency in the declaration process and potentially replacing the binary option of a situation constituting a PHEIC or not, with a more incremental mechanism involving e.g. a number of stages.

2. Public Health Investment

   The second area of concern tackled by the authors is public health investment. COVID-19 has shown that even countries with health systems that are deemed strong or adequate under the IHR (only 33%) were woefully underfunded and unprepared for an outbreak of this magnitude.

   This means that all countries have to step up funding to domestic public health systems. To address global resource-inequality, Taylor et al. suggest bolstering the IHR provisions for international assistance: Since we are all equally vulnerable to pathogens the IHR should consider incorporating a financial mechanism to assist LMICs in building and sustaining required health system capacities. To ensure accountability, states can integrate reporting mechanisms to monitor implementation.

3. Conflict and Legal Dispute Resolution

   The third area the authors discuss is how legal disputes are settled under the IHR. Measures to counter COVID-19 around the world have caused significant disruption to trade, travel and other economic activity. The legality of some of these measures is at least questionable. Therefore, Taylor et al. call for the signatories of the IHR to use the legal mechanisms already incorporated in the treaties. These could in some cases prevent unnecessarily drawn out judicial processes and lead to prompt and practical resolutions.

In closing, the authors called for less ambiguity in the text of the reimagined IHR (or any alternative global health treaty). A strengthened IHR is better equipped to respond to future global health challenges and can act as an instrument for global solidarity.

Read the full article here.