Milbank Quarterly   |  May 13, 2016

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The International Health Regulations (IHR) are the governing framework for global health security yet require textual and operational reforms to remain effective, particularly as parallel initiatives are developed.

The World Health Organization (WHO) is the agency charged with oversight of the IHR, and its leadership and efficient functioning are prerequisites for the effective implementation of the IHR.

We reviewed the historical origins of the IHR and their performance over the past 10 years and analyzed all of the ongoing reform panel efforts to provide a series of politically feasible recommendations for fundamental reform.

This article offers proposals for fundamental reform — with politically feasible pathways — of the IHR, their operations and implementation, WHO oversight, and State Party conformance.

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