Health
Amended International Health Regulations enter into force
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Today marks a milestone in global health governance as the amendments to the International Health Regulations (IHR) enter into force. This reflects a renewed global commitment to cooperation in the face of public health emergencies, shaped by hard-earned lessons of the COVID-19 pandemic.
The IHR are global regulations that guide 196 States Parties, including all 194 WHO Member States, on their rights and obligations concerning public health risks. They recognize that infectious diseases and other public health risks do not respect borders, and that coordinated global action is critical.
The origins of the IHR can be traced back to the 19th century, when the expansion of travel and trade accelerated the spread of disease from port to port, prompting the introduction of quarantine measures. Initially governed by bilateral and regional treaties, these efforts were made global under the International Sanitary Regulations in 1951 following the founding of WHO. These regulations were later renamed the IHR and have since evolved to meet the changing landscape of global health.
In 2024, WHO Member States adopted amendments by consensus at the Seventy-seventh World Health Assembly in Geneva. One of the changes is the introduction of a new level of global alert – a “pandemic emergency” – to trigger stronger international collaboration when a health risk escalates beyond a public health emergency of international concern (PHEIC) and poses the risk of becoming, or has already become, a pandemic, with widespread impact on the health system and disruption to societies. The amendments also introduce the establishment of National IHR Authorities by governments to coordinate IHR implementation, and include provisions to strengthen access to medical products and financing based on equity and solidarity.
These changes were driven by lessons learned during the COVID-19 pandemic. The last major revisions were adopted in 2005 following the SARS outbreak.
“The strengthening of the International Health Regulations represents a historic commitment to protect future generations from the devastating impact of epidemics and pandemics,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “We know that no one is safe until everyone is safe. The IHR amendments reaffirm our shared responsibility and solidarity in the face of global health risks.”
Alongside the amended IHR, Member States also adopted the WHO Pandemic Agreement at this year’s World Health Assembly and are actively negotiating an annex to the agreement on Pathogen Access and Benefit Sharing.
States have the sovereign right to implement legislations related to health policies. Under the IHR, WHO serves as the Secretariat, without authority to compel action by countries.
Eleven of the 196 IHR States Parties rejected the 2024 amendments. For them, previous versions of IHR continue to apply, though rejections may be withdrawn at any time. WHO will support IHR States Parties, as requested, in integrating the amendments to the regulations into national legal frameworks and strengthening institutional capacities to work together to build a safer, healthier future for all.
Note to editors
The text of the IHR, as amended in 2024, is published on the WHO website. Currently available in English, the text in the other official languages will be published in the coming days.
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Bystander CPR in cases of out-of-hospital cardiac arrest in this country increased by 24 per cent between 2012 and 2024. Bystander CPR happens when someone who has witnessed or comes across a cardiac arrest steps in to provide CPR.
Overall, in 2024 there were 2,885 cases of out-of-hospital cardiac arrests where resuscitation continued after the arrival of the Emergency Medical Services.
The figures are contained in the 2024 annual report of the Out-of-Hospital Cardiac Arrest Register (OHCAR) which has been published by the National Ambulance Service.
Of the 2,885 patients, 68 per cent were male and the median age was 68 years – patients ranged in age from less than one year to over 100 years of age. Women who suffered a cardiac arrest were on average older by 5 years than men (71 years vs. 66) and the majority or 68 per cent of all cardiac arrests happened in the home.
Of the 2,885 people who suffered an out-of-hospital cardiac arrest where resuscitation was attempted, 232 individuals or 8.0 per cent survived to leave hospital alive, according to the report.
Bystander CPR was attempted in 84% of cardiac arrests in 2024 which were not witnessed by members of the Emergency Medical Services.
Attempted defibrillation before the arrival of Emergency Medical Services has increased to 12% of all patients (n=339/2,885).
Latest figures show that defibrillation was attempted in 962 cases last year and that 35% of those attempts were made prior to the arrival of the Emergency Medical Services (n=339/962), highlighting the valuable life-saving work of First Responders in the community.
First Responders can include members of the general public, off-duty healthcare workers, members of Community First Responder groups, Local Authority Fire Services, voluntary organisations (such as the Irish Red Cross, Order of Malta, St. John Ambulance, and the Irish Coast Guard), auxiliary services such as Civil Defence and members of An Garda Síochána.
Community First Responders and other First Responders play a very important role in supporting the delivery of prehospital emergency care in local communities.
Professor Conor Deasy, Chair of the OHCAR said: “It’s great to see that bystander CPR in cases of out-of-hospital cardiac arrest in this country increased by 24 per cent between 2012 and 2023. In line with previous years, surviving patients were more likely to be younger and have been witnessed to collapse in a public urban location. Knowing what to do; ring 999/112, put your phone on a speaker while speaking to the 999 Call Taker and start chest compressions.’’
“Members of the public defibrillated 339 patients, of whom 90 survived (27%). This achievement emphasises the importance of Community First Responders and Public Access Defibrillators in saving lives.”
The OHCAR is hosted and funded by the National Ambulance Service (NAS) and captures the work of EMTs, Paramedics and Advanced Paramedics working for the National Ambulance Service, Dublin Fire Brigade and Airport Fire and Rescue Service, Dublin Airport – aiming to improve outcomes in Ireland for this extreme emergency by continuous evidence based performance measurement and feedback to service providers and the broader community.
Last updated on: 24 / 09 / 2025
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