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U.S. Department of Health and Human Services

International Health Regulations

The International Health Regulations (IHR) are a legally-binding international agreement that govern the roles of the World Health Organization (WHO) and all 195 of its Member States around the globe in identifying, sharing information about, and responding to public health events that may have international consequences.  First adopted by WHO Member States in 1969, the old IHR applied to only three diseases: cholera, yellow fever, and plague.  Trade and travel have increased significantly in the 35 years since the last major revision.  The updated rules are designed to prevent and protect against the international spread of diseases, while minimizing interference with world travel and trade.

Under the revised Regulations, countries that have accepted the IHR have broader responsibility to take preventive measures against, as well as to detect and respond to, any event that may constitute a public health emergency of international concern (PHEIC). The IHR also give the WHO clearer authority to recommend to its Member States measures that will help contain the international spread of disease, including public health actions to be taken at maritime ports, airports, land borders, as well as on means of international transport.

The IHR cover all hazards, not just infectious diseases. The revised Regulations include a list of four diseases – smallpox, polio, Severe Acute Respiratory Syndrome (SARS) and new strains of human influenza – whose occurrence Member States must immediately report to the WHO.  In addition, the Regulations provide a decision algorithm to determine whether other incidents, including those of a biological, chemical, radiological, or nuclear nature, may constitute a PHEIC.  The IHR also provide specific procedures and timelines for reporting and responding to these events.  For example, each country has 48 hours to assess an event for its PHEIC potential once the national government becomes aware of it and a further 24 hours to notify the WHO, if the event is assessed to be a potential PHEIC.

On December 13, 2006, the HHS Secretary announced that the United States had formally accepted the revised IHR and would begin the implementation process immediately, instead of waiting for them to take effect in the summer of 2007.  The IHR entered into force for the United States on July 18, 2007.

IHR Implementation in the U.S.

The U.S. implementation process is led by the HHS/ASPR Office of Policy and Planning (OPP).  The initial Federal implementation process was overseen jointly by the Homeland and National Security Councils and built on existing policies, procedures, and systems wherever possible. As part of the IHR policy development process, the IHR Program was created.  The IHR Program focuses its activities in three key areas:

  •  Review, assessment, and notification of potential PHEICs;
  • Domestic implementation and compliance;
  • Providing technical assistance to other countries;

As the primary responsibility for public health resides with the states, the IHR Program maintains regular engagement with various national associations responsible for domestic public health preparedness.

Since the IHR entered into force, the United States has reported a number of potential PHEICs to the WHO.

Contact:us via the International Health Regulations Contact Form or (202) 360-3066

  • This page last reviewed: November 06, 2017