Content created by Office of Global Affairs (OGA)
The United States is party to the International Health Regulations (IHR) (2005), a legally binding agreement, along with all 196 Member States of WHO. The IHR (2005) require that countries conduct surveillance for potential international health threats of all kinds and report those to WHO in a timely manner. The IHR also require that countries prepare for and respond effectively to contain disease outbreaks and other health hazards at their source before they negatively affect trade and travel, and cooperate with one another to develop coordinated surveillance, communications, and response capabilities. The IHR were recently amended based COVID-19 pandemic lessons learned, and these amendments will enter into force in September 2025.
U.S. IHR National Focal Point (NFP)
The IHR (2005) created a global surveillance network for rapid information sharing among countries on health emergencies with international implications through IHR National Focal Points (IHR NFPs). IHR NFPs work to control outbreaks at their source and prevent the spread of disease across borders. Under the IHR (2005), each country is required to designate or establish a NFP that is always accessible for IHR-related communications with the World Health Organization (WHO) and relevant sectors within the country.
The U.S. IHR NFP was established through a U.S. government interagency process in July 2007, where the HHS Secretary’s Operations Center, HHS SOC, IHR NFP Program, and the Message Authorizing Official constitute a tripartite structure. The U.S. IHR NFP Program, located in OGA, coordinates across the U.S. government on event assessments and notifications; manages and develops IHR NFP policies, procedures, and programmatic work; and leads IHR monitoring and evaluation for the U.S. The HHS Secretary’s Operations Center monitors IHR communications on a 24/7/365 basis and works closely with the U.S. IHR NFP Program to rapidly process and send out communications. The Assistant Secretary for Preparedness and Response (ASPR) serves as the Message Authorizing Official for formal communications and notifications to the WHO on behalf of the USG.
States Party Self-Assessment Annual Reporting (SPAR) Tool
To effectively ensure implementation of the IHR (2005), State Parties use the SPAR tool to annually report on 35 indicators for the 15 IHR capacities needed to detect, assess, notify, report, and respond to public health risks and acute events of domestic and international concern. The U.S. IHR NFP leads the SPAR process for the U.S. and engages with USG partners to ensure the U.S. submission obtains information from all sectors involved in implementing IHR core capacities.
Amendments to the IHR
There were many lessons learned from the COVID-19 pandemic, and the international community recognized the need to improve the IHR to minimize the impacts on countries’ population health, social fabric, national economy, and national security. In January 2022, the United States put forward 13 amendments to the IHR 2005. In May 2022, the World Health Assembly adopted the first U.S. proposed targeted amendment to Article 59 (with corresponding technical adjustments) which allowed for the entry into force of future IHR amendments to be one year from adoption rather than two years. The 75th World Health Assembly (WHA75) directed Member States to work on a package of targeted IHR (2005) amendments through the Working Group on amendments to the International Health Regulations (WGIHR) and provide a package of amendments to be considered by the 77th World Health Assembly (WHA77). The agreement to focus on targeted amendments that are intended to strengthen the IHR (2005) is based on Member State consensus that the current IHR (2005) provide a strong foundation even if certain elements of the instrument require updating.
In proposing these amendments to the IHR (2005), the United States aimed to provide clearer, more transparent, and more actionable steps for detection, reporting, and responding to outbreaks with potential of crossing international borders. The United States is working with Member States to enhance their core capacities and capabilities in surveillance, assessment, notification, and reporting of public health events to prevent future potential international health emergencies.
The Office of Global Affairs works closely with other Departments and Agencies to ensure efficient and effective IHR implementation to protect Americans at home and abroad.