In 2005, the World Health Organization adopted the revised InternationalHealth Regulations, or IHR (2005), to establish obligationsfor detecting and responding to public health emergencies ofinternational concern.
The success of the IHR (2005) rests on the ability of statesto implement the objectives and to execute the regulations ina legal and politically acceptable manner. Implementation ofthe IHR (2005) may be challenging for federalist nations, wheremost public health regulatory power lies in local rather thanin national governments.
We examine the implementation strategies of 4 nations: Australia, Canada, Germany, and India. The methods currently being considered by these nations for executing the IHR (2005) are potentially applicable models for the United States to consider.