Global Health Rules: From Sanitary Conferences to the IHR

Diseases cross borders, so states have long tried to agree on shared health rules. Cholera outbreaks in the 19th century led to the first International Sanitary Conference in Paris in 1851, where states debated quarantine. These meetings eventually produced international sanitary conventions. After World War II, the World Health Organization was founded in 1948, and in 1969 it adopted the International Health Regulations (IHR), which required countries to report certain diseases.

After the SARS outbreak of 2002–2003 showed the weaknesses of this system, the IHR were revised in 2005 and entered into force in 2007. They created the category of Public Health Emergency of International Concern, first declared for H1N1 influenza in 2009. The regulations depend on countries reporting honestly and quickly, which can conflict with fears about trade, tourism or national reputation. Global health rules show the tension between sovereignty and shared safety.