The International Health Regulations (2005) (IHR) are a key part of the global health security system to prevent, protect against, control and provide a public health response to the international spread of disease.

I appreciate your concern over the recent amendments. However, the UK Government is eager to ensure that countries' obligations under the IHR remain fit for purpose and reflect the lessons learnt from the Covid-19 pandemic. Measures that the UK Government wishes to see include a stronger global commitment to effective disease surveillance, early reporting of potential health threats, and transparency in sharing information. I understand that the UK continues to formulate positions during ongoing textual negotiations and has engaged other World Health Organisation member states on the matter, including through the Working Group on Amendments to the IHR (2005).

I can assure you the speculation that somehow the WHO undermines UK sovereignty and gives the WHO powers over national public health measures is simply not the case. The UK remains in control of any future domestic decisions about public health matters—such as domestic vaccination—that might be needed in any future pandemic that we may have to manage. I note that the WHO also has no intention of increasing the scope of its influence: the Director-General of the WHO commented in March 2023 that "the claim that the accord will cede power to WHO is quite simply false".

Moreover, I hope that I can assuage your concerns around the IHR amendment processes’ democratic accountability. Addressing, first, your concern around who is negotiating IHR amendments on the UK Government’s behalf, I understand that it is Civil Servants who are leading negotiations. There is a statutory requirement for Civil Servants to be accountable to Ministers who are, in turn, accountable to Parliament. I have been assured that the Civil Servants negotiating the IHR amendments have political oversight from, and are accountable to, Ministers Andrew Stephenson (Department for Health and Social Care) and Andrew Mitchell (Foreign, Commonwealth and Development Office).

I would also like to clarify that the Ministers will be accountable for any amendments to the WHO’s International Health Regulations (IHR) 2005. Despite there not being any plans in place to hold a direct vote in the UK Parliament, should the UK Government wish to accept an IHR amendment that requires changes to domestic law, this would have to be put to the UK Parliament in the usual way. Ministers are still, therefore, accountable to Parliament and their electorates and I have been assured that the UK will not agree to any IHR amendments that would compromise our ability to take domestic decisions on national public health measures.

Specific proposed amendments

The WHO’s Review Committee has either critiqued or discouraged parties from voting for almost all of the amendments that you mention. Regarding an amendment proposing to delete the term “non-binding” from the definition of “standing recommendations” and “temporary recommendations”, the Review Committee state that recommendations work better in public health emergencies if they are not mandatory and has advised against changing the definition; Likewise, the Committee strongly recommends the retention of the existing text requiring “full respect for the dignity, human rights and fundamental freedoms of persons”; I note that the Committee recognises that removing the Director-General’s requirement to convene an Emergency Committee and to consult with the State Party in whose territory a public health emergency occurs could result in sovereignty concerns and considers it unnecessary to remove these requirements; the proposed expansion of responsibilities in Article 13 is, similarly, dismissed by the Review Committee for being unclear on how the WHO would discharge these duties; The Committee criticises the wording of the amendment in Article 36 - the article proposing certificated of vaccination - for having unclear wording and judges Article 23 - which covers health measures on travellers’ arrival and departure - to be “too specific to be feasibly realized by all State Parties”; The Committee considers the amendments to Article 5(e) - which covers the surveillance amendment you mention - to be “too prescriptive for countries and may not reflect their differing internal government structures.” Whilst the Review Committee’s technical recommendations are not binding, I understand they can be indicative when parties decide on how to vote.