The initial assumptions on the apparently narrow and technical nature of the IHR are now being tested, with realpolitik inevitably now shaping these negotiations. As WHO member states get deeper into discussing and negotiating the proposed amendments to the IHR, it is becoming obvious that several difficult choices will need to be made in order to make this instrument better fit for purpose.
Various stakeholders including some developed countries, have shown propensity to focus on surveillance, broadly, prevention-related measures, that they feel would likely attract consensus more easily. But developing countries continue to push for fairer treatment of response related amendments to the IHR, including notably equity proposals such as access to countermeasures among others.