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The extraordinary cost of COVID-19 in human lives, social disruption, and economic distress reveals weaknesses in existing global health security architecture, the core of which are the International Health Regulations (IHRs). Agreed to as a binding treaty negotiated under the auspices of the World Health Organization (WHO), the IHRs regulate country conduct before and during global public health emergencies. The IHRs aim to “prevent, protect against, control and provide a public health response to the international spread of disease in which to avoid unnecessary interference and international traffic and trade.”

The adoption of the IHRs by the World Health Assembly in May 2005 established fundamental legal requirements for all countries, seeking to enhance international coordination in the detection of, and response to, public health risks that cross borders. Importantly, each signatory agreed to develop core …