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1 1 (June 22, 2022)

handle is hein.crs/govehwj0001 and id is 1 raw text is: Con gressionol Research Service nforming the IegisI9tive debate since 1914 0 June 22, 2022 U.S. Proposals to Amend the International Health Regulations Background Since 1980, outbreaks of new and long-standing infectious diseases have been occurring with greater frequency and causing higher numbers of human infections. The World Health Assembly (WHA), the governing body of the World Health Organization (WHO), has occasionally amended a long-standing set of rules called the International Health Regulations (IHR) to address this growing global threat. In January 2022, the United States introduced amendments to the Regulations that sought to broaden the ways in which WHO could respond to public health threats and increase the pace of such responses. Congressional deliberations of these amendments focused on the potential implications of implementation and whether adoption of the amendments would require congressional consent since the United States consented to be legally bound by the Regulations through an executive agreement. This In Focus addresses common questions regarding the IHR, including the role of Congress and the status of U.S.-proposed amendments to the Regulations. International Health Regulations In 1969, WHA adopted the IHR to stop the spread of six diseases (cholera, plague, yellow fever, smallpox, relapsing fever, and typhus) through quarantine and other infectious disease control measures. The WHA amended the IHR several times, most comprehensively in 2005. The 2005 edition, known as IHR (2005), expanded methods for controlling infectious disease outbreaks beyond quarantine and broadened the type of public health events that would require international coordination. The Regulations provide an overarching legal framework that defines the rights and obligations of parties to the agreement (which includes the United States and all other WHO Member States) in handling public health events and emergencies that have the potential to cross borders. They also outline criteria for declaring a public health emergency of international concern (PHEIC) and requirements for Member States to * report public health events; * designate National IHR Focal Points for communication with WHO; and * establish and maintain core capacities for surveillance and response. IHR (2005) compliance is measured through a self- assessment questionnaire that WHO sends to Member States. Public Health Emergency of International Concern Following the emergence of an event that might be deemed a PHEIC, the WHO Director-General convenes an international team of independent experts to analyze available information on the event and consider the views of the State Party where the event is occurring. The team, called the Emergency Committee, makes recommendations to the Director-General on how to control the event and whether to declare a PHEIC. The composition of each Emergency Committee varies per outbreak. The IHR Emergency Committee for Pneumonia Due to the Novel Coronavirus 2019-nCoV, for example, was composed of 15 scientists from around the world, including an official from the U.S. Centers for Disease Control and Prevention (CDC). Though the Director-General usually follows the advice of Emergency Committees, the Director-General makes final determinations on the event. A PHEIC declaration alerts countries to implement public health emergency responses, as outlined in IHR (2005). The Regulations provide the framework for the response and Member States develop their own implementation plans. In upholding IHR (2005), the Regulations specify that Member States have the sovereign right to legislate and to implement legislation in pursuance of their health policies. As such, a PHEIC declaration does not automatically restrict travel or impose specific quarantine requirements, for example. Following a PHEIC declaration, countries may take a number of actions, including heightening surveillance, reporting incidence of the relevant disease to the WHO, and allocating resources for domestic or international responses. On behalf of the United States, former U.S. Department of Health and Human Services (HHS) Secretary Alex Azar, for example, declared a public health emergency for the entire United States to aid the nation's healthcare community in responding to 2019 novel coronavirus following the WHO PHEIC declaration for Coronavirus Disease 2019 (COVID-19). A declaration can also enable WHO to access certain emergency funding during an outbreak, such as that provided through the United Nations (U.N.) Central Emergency Response Fund and the World Bank Pandemic Emergency Financing Facility. Frequently Asked Questions H ow were the I HR adopted and amended? Articles 21 and 22 of the WHO Constitution authorize WHA to adopt regulations to prevent the spread of infectious diseases, among other things. WHA developed and amended the IHR pursuant to this authority. Article 55 of IHR (2005) specifies that any WHO Member or the WHO Director-General may submit amendments to be considered by WHA. If WHA adopts any amendments, Article 59 of IHR (2005), as amended, specifies that WHO Member States have 10 months to notify their intent to reject all or some of the regulations or to accept them subject to reservations. A reservation functions as a

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