What does WHA approval of the International Health Regulations mean for Africa?

In Geneva a few weeks ago, the World Health Assembly (WHA) finally passed crucial amendments to the International Health Regulations (IHR) after two years of intense negotiations. The approval marks a significant milestone in global health governance and the quest for global health security.

For Africa, a continent facing numerous public health challenges, from the influx of infectious diseases to emerging and reemerging diseases, this development promises to revolutionize how countries prepare for and respond to pandemics. It is a crucial advancement for a continent where health systems often teeter on the brink of collapse under limited resources, relentless outbreaks, insecurity, and other social determinants of health, such as climate change and food insecurity.

Despite initial setbacks and the inability to reach an agreement before the WHA convened, member states worked tirelessly in drafting committees throughout the week. Their commitment and determination paid off, as they often worked for extended hours to secure this landmark achievement.

The Promise of a Safer Tomorrow

“The International Health Regulations, which succeeded the 1951 International Sanitary Regulations, embody the spirit of global collaboration for health security, reminding us that diseases know no borders. Protecting ourselves from health threats is a collective endeavour, whether at home, within our communities, or on a global scale,” said Dr Githinji Gitahi, Group CEO, Amref Health Africa.

“The approval of IHR at WHA 77, following its last update in 2005, marks a significant milestone in applying the lessons learned from COVID-19, particularly in equity and accountability. The establishment of the States Parties Committee and National IHR Authorities fosters a robust framework for national and international collaboration and accountability,” he added.

The COVID-19 pandemic exposed significant weaknesses in the IHR, prompting an extensive review process. Member states submitted over 300 proposed amendments to the Working Group on Amendments to the IHR (WGIHR), chaired by Dr Abdullah Asiri of Saudi Arabia and Dr Ashley Bloomfield of New Zealand.

The newly approved IHR will foster improved surveillance and reporting systems, ensuring that member states enhance their capabilities to detect and report health threats promptly. This improvement is expected to lead to early detection and swift responses to outbreaks, thereby saving countless lives.

International cooperation and support 

The IHR will promote capacity building by encouraging international cooperation and support. African countries, in particular, benefit from technical assistance, training, and resources to bolster their healthcare infrastructure. This is not just about having better tools but empowering local health workers with the skills and resources they need to protect their communities.

Moreover, the regulations promise to weave a tighter network for coordination between countries and international bodies, adopting a more unified and effective response to pandemics. This will translate into a world where information flows seamlessly across borders, where every alert is met with rapid, coordinated action to manage cross-border health threats that can spread rapidly across regions.

Legal framework to ensure swift action

Most importantly, the IHR provides a legal framework for swift action. No more bureaucratic delays or red tape during a crisis—just decisive, life-saving measures implemented when and where needed most. These include quarantine protocols, travel restrictions, and other critical interventions during health emergencies, ensuring a more proactive and organized global response to future health crises. As Dr Tedros Adhanom, the WHO Director-General, stated, “The amendments to the IHR will enhance countries’ abilities to detect and respond to future outbreaks and pandemics by strengthening their national capacities and improving coordination between states in disease surveillance, information sharing, and response.”

Member states generally expressed satisfaction with the final agreement, with the European Union and China hailing it as a testament to the success of multilateralism. However, Ethiopia, representing the 47 African member states and Egypt, urged all countries to leverage the momentum from adopting the IHR amendments to advance the pandemic accord, with the Intergovernmental Negotiating Body (INB) set to meet again in July.

“As we celebrate the IHR amendments, we must not overlook the unresolved consensus on the Pandemic Treaty, crucial for ensuring equitable access to diagnostics, therapeutics, and vaccines during a pandemic. The extension of the Intergovernmental Negotiating Body’s (INB) mandate is a positive signal that humanity must persevere and prioritize public good over individual interests,” emphasized Dr Githinji.

Shadows on the Horizon

Despite the potential benefits, the challenges ahead are formidable. Several concerns must be addressed to maximize the effectiveness of the IHR in Africa. Implementing these comprehensive regulations will require substantial investments in health infrastructure—a daunting task for many resource-limited nations. Political will and governance pose another hurdle, with the corrosive effects of corruption and political instability. Without strong, transparent leadership, the best-laid plans could falter. Additionally, equitable access to resources is another concern. The fear that wealthier nations might monopolize the support and leave poorer countries in the lurch is very real. Ensuring fair aid and technical assistance distribution is essential but far from guaranteed.

Cultural and social barriers also loom large. In some regions, there is a deep-seated distrust of health authorities. No matter how well-intentioned, public health measures could be met with resistance if not handled with cultural sensitivity and respect. Then there is the issue of sovereignty. The IHR requires nations to share information and sometimes implement measures that could be seen as infringing on national autonomy. Balancing global health security with national interests will be a tightrope walk.

A Path Forward

The journey ahead requires a concerted, multi-faceted effort. International support is crucial. Wealthier nations and global organizations must provide the financial and technical assistance required to build robust health systems. Regional cooperation is also key. African countries must strengthen their bonds, leveraging regional bodies like the African Union and Africa Centres for Disease Control and Prevention (Africa CDC) to coordinate efforts and share resources. There is strength in unity, and it is time to harness it fully.

Community engagement is vital. Transparent communication and culturally appropriate interventions are powerful tools. Building trust with communities is essential for the success of public health measures. Finally, enhancing monitoring and accountability will ensure that progress isn’t just promised but delivered. Establishing robust mechanisms to track advancements and hold leaders accountable is paramount.

The WHA approval of the IHR is a new dawn for Africa and the global health community. The road ahead is fraught with challenges, but with determination, collaboration, and unwavering commitment, the continent will build a resilient health system capable of protecting its people from future threats. This is more than just a story of regulations—it is a story of hope, courage, and the relentless pursuit of a healthier tomorrow.

“Let’s remember it’s not equitable until the needs of the most vulnerable are protected and met,” concludes Dr. Githinji Gitahi.