On June 1, 2024, the World Health Assembly adopted a suite of amendments to the World Health Organization’s (WHO) International Health Regulations (2005) (IHR). The amendments are the most significant reform of the Regulations since their adoption following the severe acute respiratory syndrome (SARS) outbreak two decades ago. Reflecting the global health injustices seen during successive public health emergencies, including the COVID-19 pandemic, the Regulations now expressly include equity and solidarity as principles for the interpretation and implementation of the treaty. This is reinforced by new provisions to ensure equitable access to health products, a financing mechanism, and additional requirements for international collaboration and cooperation. The amendments further add a new power to declare pandemic emergencies, establish a non-punitive states parties-led implementation committee, and a range of clarifying and modernizing updates to existing provisions. While the amendments are one step towards more equitable international law for global health emergencies, there are a range of areas for improvement to greater realize global health security, solidarity, and equity. While limited by the current geopolitical climate, the amendments demonstrate shifting global power dynamics and negotiation blocks in global health. They also provide compelling evidence of a broad interpretation of the World Health Assembly’s (WHA) unique opt-out power to make regulations with respect to preventing, preparing for, and responding to the international spread of disease. This Article discusses the breadth and content of the amendments to the IHR adopted in 2024 while examining the implications of textual and subject-matter choices on WHO Member State participation, the legal nature of the new obligations, and the scope of the WHA’s law-making authority. This Article then identifies areas for normative development and future reform to advance security, solidarity, and equity. Finally, we examine the early impacts of the second Trump presidency on the United States’ membership in the WHO and status as an IHR States Party, and the subsequent normative implications for the IHR amendments globally.

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