The International Health Regulations (IHR) are a set of rules of the World Health Organization (WHO) that are binding under international law and were first adopted in 1969 and revised in 2005. They serve to prevent, assess and combat public health emergencies of international concern (PHEIC), such as pandemics or outbreaks of infectious diseases. The IHR are binding for 196 contracting states and aim to prevent the cross-border spread of diseases, coordinate health protection measures and at the same time avoid unnecessary disruption to international traffic and trade.

Important elements of the IHR (2005) include:

• Detection and reporting: Countries must provide surveillance systems and laboratories to identify and report potential health threats to the WHO.
  
• Response: Coordinated measures in the event of health emergencies, e.g. through WHO recommendations on travel measures or supply chains.
  
• Core capacities: Obligation of states to set up capacities at border crossings and national contact points (in Germany the Joint Reporting and Situation Center, GMLZ).
  
• Decision scheme: An algorithm for assessing whether an event constitutes a public health emergency of international concern, e.g. for diseases such as SARS, smallpox or polio.
  
• Respect for human rights: Measures should respect people’s dignity, human rights and fundamental freedoms.

The IHR were revised following health crises such as SARS (2003), Ebola (2014/15) and COVID-19 to improve global response capacity. Amendments from 2024 introduce, among other things, the concept of a “pandemic emergency”, improve the testing algorithm for outbreaks and promote solidarity and equity between states.

German draft bill to amend the IHR

Der deutsche Referentenentwurf zur Änderung der Internationalen Gesundheitsvorschriften vom 7. Juli 2025 (veröffentlicht vom Bundesgesundheitsministerium) dient der innerstaatlichen Umsetzung der 2024 von der WHO beschlossenen Änderungen in deutsches Recht. Er basiert auf den Beschlüssen der 77. Weltgesundheitsversammlung vom Juni 2024 und wurde am 16. Juli 2025 vom Bundeskabinett verabschiedet. Der Entwurf bedarf der Zustimmung des Bundesrates.

Content of the draft bill:

Adaptation to the 2024 IHR amendments: The draft enshrines the updated IHR, which were revised following the COVID-19 pandemic to enable faster and more effective responses to global health crises. These include:

• Introduction of the “pandemic emergency” as a new warning level, which enables the WHO Director-General to issue temporary recommendations.
  
• Adaptation of the testing algorithm to speed up the detection and reporting of severe respiratory diseases of unknown cause (e.g. SARS-CoV).
  
• Obligation of states to consult with the WHO at an early stage in the event of unclear health incidents if information for an assessment is lacking.

Establishment of an implementation committee: This committee is to monitor the implementation of the IHR in the signatory states and make it more sustainable. States are obliged to prioritize and track the implementation of the IHR more closely.

Promoting solidarity and equity: The amendments emphasize cooperation between states and with the WHO, e.g. through a coordinated financial mechanism to use core capacities more efficiently.

Support during health crises: States will receive greater support from the WHO in investigating unclear disease outbreaks. The publication of information on threatening events is simplified.

Regulations on health products and supply chains: The draft includes WHO recommendations on the availability and distribution of relevant health products, the maintenance of essential supply chains and travel opportunities for health workers.

Digital evidence: Possibility of using digital evidence in health crises to make measures more efficient.

Unchanged national sovereignty: The draft emphasizes that Germany’s national sovereignty and national health protection measures remain unaffected. WHO recommendations remain non-binding.

Background and objective: The draft bill responds to the lessons learned from the COVID-19 pandemic and other health crises (e.g. Ebola, monkeypox). The aim is to improve global and national preparedness for health crises by strengthening laboratories, hospitals and surveillance systems. The changes are intended to enable faster information sharing and international cooperation in order to contain or prevent pandemics.

Implementation in Germany: The IHR have already been integrated into German law through the IHR Act (2007) and the IHR Implementation Act (2013). The national IHR contact point is the Joint Reporting and Situation Center (GMLZ) at the Federal Office of Civil Protection and Disaster Assistance (BBK), which works together with the Robert Koch Institute (RKI) in the case of communicable diseases.

The draft bill is a step towards adapting German law to the IHR amendments adopted in 2024 in order to strengthen global health security without restricting national freedom of choice.

Further information:

Cabinet decides to adapt the International Health Regulations | BMG

Draft law on the amendments of June 1, 2024 to the International Health Regulations (2005) (IHR) of May 23, 2005

Editorial office: X-Press Journalistenbüro GbR

Gender note. The personal designations used in this text always refer equally to female, male and diverse persons. Double/triple references and gendered designations are avoided for the sake of better readability ected.