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Strengthening global health security by embedding the International Health Regulations requirements into national health systems
  1. Hans Kluge1,
  2. Jose Maria Martín-Moreno2,
  3. Nedret Emiroglu3,
  4. Guenael Rodier4,
  5. Edward Kelley5,
  6. Melitta Vujnovic6,
  7. Govin Permanand7
  1. 1 Health Systems and Public Health, World Health Organization Regional Office for Europe, Copenhagen, Denmark
  2. 2 Preventive Medicine and Public Health and University Clinical Hospital INCLIVA, University of Valencia, Valencia, Spain
  3. 3 Communicable Diseases and Health Security, World Health Organization Regional Office for Europe, Copenhagen, Denmark
  4. 4 Country Health Emergency Preparedness and IHR, World Health Organization, Geneva, Switzerland
  5. 5 Service Delivery and Safety, World Health Organization, Geneva, Switzerland
  6. 6 World Health Organisation Representative, Moscow, Russian Federation
  7. 7 Health Systems and Public Health, World Health Organization Regional Office for Europe, Copenhagen, Denmark
  1. Correspondence to Dr Govin Permanand; permanandg{at}


The International Health Regulations (IHR) 2005, as the overarching instrument for global health security, are designed to prevent and cope with major international public health threats. But poor implementation in countries hampers their effectiveness. In the wake of a number of major international health crises, such as the 2014 Ebola and 2016 Zika outbreaks, and the findings of a number of high-level assessments of the global response to these crises, it has become clear that there is a need for more joined-up thinking between health system strengthening activities and health security efforts for prevention, alert and response. WHO is working directly with its Member States to promote this approach, more specifically around how to better embed the IHR (2005) core capacities into the main health system functions. This paper looks at how and where the intersections between the IHR and the health system can be best leveraged towards developing greater health system resilience. This merging of approaches is a key component in pursuit of Universal Health Coverage and strengthened global health security as two mutually reinforcing agendas.

  • health policies and all other topics
  • public health
  • health systems

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  • Handling editor Seye Abimbola

  • Contributors HK provided strategic guidance. GP developed the concept and undertook the purposive literature review, and GP and HK drafted the manuscript. JMM, NE, GR, EK and MV reviewed the manuscript and provided expert input and revision. GP is the author for correspondence.

  • Disclaimer HK, NE, GR, EK, MV and GP are staff members of the World Health Organization. The author alone are responsible for the views expressed in this publication and they do not necessarily represent the views, decisions or policies of the World Health Organization.

  • Competing interests HK, NE, GR, EK, MV and GP work for WHO. JMM is a consultant and advisor to the WHO Regional Office for Europe on public health.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.