Containing a pandemic is a gigantic task that requires the cooperation of modern titans. On March 11, 2020, the World Health Organization („WHO“) declared a global pandemic of COVID-19, a respiratory disease spread by airborne pathogens of the coronavirus family. Covid-19 has infected nearly 1,500,000 people in 184 countries as of April 9, 2020, killing more than 90,000 people worldwide, and has tested the tools of global health policy developed to protect the population. One of these instruments is the International Health Regulations („IHR“). As a multinational agreement that commits 196 Member States to monitor and report on international health threats, the IHR seeks to coordinate a balanced public health response while minimising disruptions to international travel and trade and respecting human rights. The IHR requires Member States to register, assess and report outbreaks and requires Member States to put in place basic capacities to equip national outbreaks. It is important to note that the IHR also gives the WHO Director-General the authority to declare a public health emergency of international concern („PHEIC“), which mobilizes coordinated international action. In fact, states assume much of the responsibility for generating and reporting the public health measures required to trigger a PHEIC notification. The IHR reflects an accumulation of lessons that past pandemics have taught the global community.

But as the world watches COVID-19 wreak havoc, the future of these regulations remains uncertain. The IHR is an agreement between 196 countries, including all WHO Member States, to work together for global health security.10 Political pressures appear to have hampered the functioning of the IHR. Critics argue that as early as 23 January 2020, who had enough evidence to declare COVID-19 PHEIC, although the Director-General did not officially do so until a week later. Taiwan says the WHO did not respond to reports from its officials to the WHO in December 2019 on human-to-human transmission of the coronavirus. Although the WHO said it was not its mission to shame member states for missteps, it commended China for what many call draconian measures. Critics call this politically motivated support a „deception“ that has given the global community „a false sense of security“ about how easy it is to manage COVID-19. Populism refers to movements that appeal to the local population, who feel that their needs are not prioritized by the ruling elites [3]. An important aspect and a contribution to the growing populist mood is the participation of nations in international agreements (e.B.

the Paris Climate Agreement, multilateral trade agreements), intergovernmental institutions (e.B. United Nations and specialized agencies such as the World Health Organization) and transnational alliances (e.B. European Union, NATO). Disillusionment is fuelled by the belief that these regimes subordinate the interests of nation-states to those of the international community, and that the national population has no voice in the decision-making process, but that these decisions are taken by irresponsible elites [4]. Second, the IHR necessarily imposes obligations on national governments that could supposedly compromise the authority generally enjoyed by subnational, provincial or state governments. Many of the IHR`s detection, reporting, and response requirements may be constitutionally linked to local or state/provincial governments and may not fall under national jurisdiction. In systems where local or state/provincial governments are seen as more receptive or legitimate to local needs and interests, conflict can provoke populist resistance to international health treaties, especially when local and national authorities disagree to report an event [13, 14]. While previous regulations required countries to report incidents of cholera, plague and yellow fever, the IHR (2005) is more flexible and forward-looking, requiring countries to consider the potential impact of all hazards, whether they occur naturally, accidentally or intentionally.3 Despite a broader global consensus on the importance of the IHR (2005), only about 1/3 of the world`s countries are currently able to: Assess and respond to public health emergencies.4 These gaps in global preparedness make Americans and the rest of the world vulnerable. CDC assists countries in developing and strengthening their National Health Security Action Plan (NAPHS) following a Joint External Evaluation (JEE). Through a whole-of-government approach, NAPHS is developed jointly, with contributions from different government sectors and the support of international partners. The development of NAPHS helps countries identify activities targeted on the 19 technical areas of jeE and prioritize them for implementation.

The resulting plan outlines the activities needed to address gaps in a country`s health security capacity. These activities are then monitored to determine what is working, what needs to be changed, and what needs to be focused on next to further increase the country`s capacity. As with most international agreements, there are no formal sanctions associated with non-compliance. Some low- and middle-income countries argue that they do not have the resources to fulfill the mandates of the agreement, and some large middle-income countries have deviated from the measures recommended by the WHO precisely because of the economic impact of these measures. Indeed, some argue that this agreement is particularly beneficial for richer countries that are better able to mobilize their own resources, and more quickly when a threat to global health is reported through IHR mechanisms. For poorer countries, IHR requirements can divert limited public health financial and human resources from addressing national public health threats such as HIV, tuberculosis and malaria, which have a more direct impact on the health of their populations. In addition, the reporting of public health events in the past has led to unjustified restrictions on trade and travel on reporting countries [9, 10]. The Brexit controversy and the withdrawal of the United States from its commitments to the Paris Climate Agreement are two tangible effects of the rise of populism that responds to international governance. The possible effects of populism on highly effective health regulations such as the WHO International Health Regulations (2005) [5, 6] are somewhat less discussed. The IHR (2005) imposes important requirements on States Parties, and some suggest that the Treaty is one of the most invasive international agreements in terms of impact on national sovereignty [7].

Therefore, they have the potential to trigger many of the populist concerns that have been expressed about other international intergovernmental agreements. With the COVID-19 response, some of these concerns have become more evident as local protests against social distancing measures increase and skepticism toward foreign countries and international institutions increases. When used together, these processes can help governments improve their preparedness for infectious disease threats, receive national support for health security work, and direct partners to areas where additional support is needed. In support of IHR activities in countries, the CDC makes an important contribution to global public health efforts to prevent, identify, and respond to public health risks. Some diseases must still be reported under the IHR, no matter when and where they occur, while others become reportable if they present a risk or unusual situation. The International Health Regulations (IHR) is an international legal instrument that includes measures to prevent the cross-border spread of infectious diseases. At the forty-eighth World Health Assembly in 1995, WHO and Member States agreed on the need to revise the IHR (1969). The revision of the IHR (1969) took place because of its inherent limitations, in particular: „The GDWHO selects the members of the Review Committee on the basis of the principles of balanced geographical representation, a balanced ratio of experts from developed and developing countries, a variety of scientific advice, approaches and practical experiences in different parts of the world. and an appropriate interdisciplinary balance. Prioritizing diseases for research and development in emergency contexts The Joint External Assessment (JEI) is a voluntary and comprehensive process of assessing countries` capacities in 19 technical areas to address infectious disease risks through a coordinated response. The formation of an IHR Review Committee is the responsibility of the DGWHO, which ensures their care and nutrition. They are selected from the IHR Committee of Experts and „where appropriate, from other expert advisory bodies of the Organization“.

In addition, the DGWHO „determines the number of members to be invited to a meeting, determines its date and duration, and convenes the committee.“ Lauren Tonti is a PhD student at the Max Planck Institute for Social Law and Social Policy. Minimising health risks at airports, ports and land crossings The 1892 International Health Convention embodies some of the first concerted efforts by international powers to combat cholera epidemics in Europe within a unified framework. To promote these principles, the International Health Regulations were adopted in 1951 by the Member States of the new WHO, which was revised in 1969 and renamed the International Health Regulations. .