Key points
- Global health security is the work of preventing, detecting and responding to health threats that cross borders — at the level of systems and policy, not individual illness.
- The International Health Regulations (2005) are the binding rules: 196 States Parties must build core capacities to detect, assess, notify and respond.
- The WHO Pandemic Agreement was adopted on 20 May 2025 at the Seventy-eighth World Health Assembly — the second treaty in WHO's history under Article 19 of its Constitution.
- The Agreement is not yet open for signature: the annex on sharing pathogens and benefits is still being negotiated, and it enters into force only after 60 ratifications.
- Readiness is measured at country level — through joint external evaluations and the Global Health Security Agenda — never as a league table of airports or hospitals.
Direct answer: Global health security is the work of preventing, detecting and responding to health threats that cross borders — infectious disease outbreaks, and the systems that stop them becoming pandemics. It operates at the level of countries and institutions, not individual patients: the rules countries agree to, the laboratories that spot a new pathogen, the workforce that responds, and the supply chains that move vaccines and protective equipment. Its three anchors are the International Health Regulations (2005), the Global Health Security Agenda, and the WHO Pandemic Agreement adopted on 20 May 2025. This guide explains the system. For what is happening now, read the pandemics guide; for the rules at airports, read the guide on how airports protect traveller health.
Prevent, detect, respond
Global health security is usually described in three verbs. Prevent means reducing the chance a threat emerges or spreads: surveillance of animal and human disease, safe laboratories, vaccination coverage, clean water and sanitation. Detect means spotting a threat early and reporting it honestly: laboratories that can identify a pathogen, surveillance systems that notice unusual patterns, and a legal duty to tell WHO quickly. Respond means acting fast and together once a threat is confirmed: emergency operations, medical countermeasures, travel measures that are proportionate, and communication that tells the public what is known.
The three verbs depend on each other. Detection without response is a warning nobody acts on; response without detection arrives too late; prevention without either is luck. The COVID-19 pandemic exposed gaps in all three, which is why the rules were rewritten afterwards — the International Health Regulations were amended in 2024, and the Pandemic Agreement was adopted in 2025.
The International Health Regulations (2005)
The International Health Regulations, known as the IHR, are a binding agreement among 196 States Parties — all WHO Member States. Their purpose is to prevent, protect against, control and provide a public-health response to the international spread of disease, in ways that avoid unnecessary interference with international traffic and trade. Countries must build and sustain core capacities: to detect, assess, notify and report public-health events, and to respond to them — including at designated airports, ports and ground crossings, as the airports guide explains.
The IHR were amended in 2014, 2022 and 2024. The 2024 amendments entered into force on 19 September 2025, except for States Parties that rejected them, and they added a new “pandemic emergency” tier above a public health emergency of international concern. Since 2009 there have been nine public health emergencies of international concern, of which two are active: polio and Ebola (Bundibugyo). The full policy picture — who can declare an emergency, and how the IHR sit inside public health policy — is in the guide on public health policy.
The Pandemic Agreement, adopted 20 May 2025
The WHO Pandemic Agreement was adopted on 20 May 2025 at the Seventy-eighth World Health Assembly, through resolution WHA78.1. It is only the second treaty adopted by WHO under Article 19 of its Constitution since the Framework Convention on Tobacco Control in 2003. Its objective is to prevent, prepare for and respond to pandemics, with equity as its main guiding principle — equity in access to the tools needed to prevent and prepare for pandemics, including vaccines, personal protective equipment, information and expertise, and access to health care for all people.
The Agreement covers strengthening disease surveillance and a One Health approach; strengthening health systems; safeguarding the health and care workforce; coordinating research and development; improving local production capacity, including through technology transfer; better coordination across governments and societies; and improved communication with the public. A central pillar is the Pathogen Access and Benefit-Sharing system, which aims to ensure rapid sharing of pathogens with pandemic potential and fair sharing of the benefits that arise — including diagnostics, vaccines and treatments. Manufacturers in the system would aim to give WHO 20% of their real-time production of vaccines, treatments and tests during a pandemic, of which 10% would be donated and the rest offered at affordable prices.
The Agreement has not entered into force. It is not yet open for signature: the annex on pathogen access and benefit-sharing is still being negotiated by the Intergovernmental Working Group, with the outcome to be considered by the World Health Assembly. Once the annex is adopted, the Agreement opens for signature and ratification, and it enters into force 30 days after 60 countries have ratified it. The Agreement strongly reaffirms that it does not give WHO authority to impose measures such as lockdowns or vaccine mandates on any country.
How readiness is measured
Readiness is measured at country level, not per hospital or per airport. The main tool is the joint external evaluation: a voluntary, independent assessment of a country’s IHR core capacities, carried out with WHO, covering prevention, detection, response and the points of entry. Countries publish the results and use them to plan improvements. Alongside it sits the Global Health Security Agenda, a partnership of countries and organisations working to strengthen the same capacities — laboratories, surveillance, workforce and emergency response — with shared targets and peer support.
What does not exist is a public score for individual facilities. WHO does not publish a per-airport health scorecard, and no honest site can give an airport a health compliance rating. Readiness is a property of a country’s system, assessed as a whole, and the assessments are published so that gaps can be fixed — not so that places can be ranked.
One Health, and what this guide is not
One Health is the idea that human, animal and environmental health are connected: most new infectious diseases in people start in animals, and the way land, farming and climate change shape that spillover. The Pandemic Agreement includes strengthening surveillance and a One Health approach among its key areas. One Health is a lens for prevention, not a separate programme, and this guide treats it as such.
This guide is also deliberately narrow. It is about systems and policy — rules, agreements and readiness. It is not outbreak news: for what is happening now, including the active Ebola emergency, read the pandemics guide. It is not personal advice: it does not tell any individual what to do, and it carries no symptom list, no risk score and no recommendation about travel. And it is not a prediction: nothing here claims the next pandemic is near or far.
Frequently asked questions
Does the Pandemic Agreement let WHO impose lockdowns or vaccine mandates?
No. The Agreement reaffirms that it does not give WHO authority to impose measures such as lockdowns or vaccine mandates on any country. Decisions about such measures stay with national governments.
Is global health security the same as following outbreaks?
No. Following outbreaks is news; global health security is the system underneath it — the rules, laboratories, workforce and supply chains that let countries detect a threat early and respond together. Outbreak news is covered in the pandemics guide; this guide covers the system.
Has the Pandemic Agreement entered into force?
No. It was adopted on 20 May 2025, but it is not yet open for signature — the annex on pathogen access and benefit-sharing is still being negotiated — and it enters into force 30 days after 60 countries have ratified it.