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When the International Health Regulations (IHR) came into force in 2007, WHO announced that “the global community has a new legal framework to better manage its collective defences to detect disease events and to respond to public health risks and emergencies”.1 The IHR aim to enable the prevention, detection, and containment of health risks and threats, the strengthening of national capacities for that purpose, and the coordination of a global alert and response system. [...]many countries only applied the IHR in part, were not sufficiently aware of these regulations, or deliberately ignored them,3,4 and that WHO did not make full use of the powers given to it through the wording and spirit of the IHR. [...]the IHR are not deficient, but their implementation by member states and by WHO was inadequate. There was a marked lack of national responses both to WHO's first alerts—eg, published risk assessments and guidance on public health response and statements by the WHO Director-General—and to the Public Health Emergency of International Concern declaration.