November 22, 2015


WASHINGTON (Nov. 22, 2015) – A trio of global health law experts from Georgetown warn the window for fundamental reform of the International Health Regulations – opened by the Ebola epidemic – is “rapidly closing.”

Writing in The Lancet and published online today, Lawrence O. Gostin, Mary C. DeBartolo and Eric A. Friedman from the O’Neill Institute for National and Global Health Law at Georgetown University, outline operational and textual reforms that would assist in the implementation and functioning of the Regulations. (The Lancet Viewpoint: “The International Health Regulations 10 Years On: The Governing Framework for Global Health Security).

The International Health Regulations (IHR), a legally binding instrument, was adopted 10 years ago with the aim “to prevent, protect against, control and provide a public health response to the international spread of disease.” Over the past several years, however, the WHO has been criticized for its handling of crises including the recent Ebola epidemic, leading to what the authors call a “crisis of confidence” in the International Health Regulations. The authors propose innovative reforms that collectively “could help to build a well functioning global detection and response system.”

Gostin argues, “The Ebola epidemic is a wakeup call for the World Health Organization and a turning point for the IHR, the governing international rules for global health security. It we don’t act now, creatively and boldly, we will lose the opportunity for fundamental reform for a generation. Now is the time for the international community to do the right thing by building strong, resilient health systems in the world’s poorest countries.”

Recommendations made by Gostin and his colleagues include developing an “International Health Regulations Capacity Fund” to build, strengthen and maintain core capacities; clarifying what diseases are to be reported and when; incorporating emergency response frameworks into the IHR; and encouraging WHO to play a more active and public role in encouraging Member States to account for deviations from temporary recommendations.

“10 years after its adoption, the time has come to realize the International Health Regulations’ promise,” they conclude. “Donor fatigue, fading memories, and competing priorities are diverting political attention. Empowering WHO and realizing the International Health Regulations’ potential would shore up global health security – an important investment in human and animal health, while reducing the vast economic consequences of the next global health emergency.”

Gostin, faculty director of the O’Neill Institute, is a member of the WHO’s International Health Regulations Expert Roster, the Harvard/London School of Hygiene & Tropical Medicine Independent Panel on the Global Response to Ebola, and the U.S. National Academy of Medicine Commission on a Global Health Risk Framework. (A profile of Gostin is featured in this edition of The Lancet).

DeBartolo is an Associate at the O’Neill Institute and her focus is on the work of The Lancet – O’Neill Institute, Georgetown University Commission on Global Health and the Law.

Friedman is an Associate at the O’Neill Institute and the Project Leader for the Platform on a Framework Convention on Global Health, a proposed global treaty that would be grounded in the human right to health and aimed at closing health inequities.

The O’Neill Institute for National and Global Health Law at Georgetown University is the premier center for health law, scholarship, and policy. Its mission is to contribute to a more powerful and deeper understanding of the multiple ways in which law can be used to improve the public’s health, using objective evidence as a measure. The O’Neill Institute seeks to advance scholarship, science, research, and teaching that will encourage key decision-makers in the public, private, and civil society to employ the law as a positive tool for enabling more people in the United States and throughout the world to lead healthier lives.