The Independence of National Focal Points Under the International Health Regulations (2005)

As the world grapples with the response to the COVID-19 pandemic, all eyes are now on the People's Republic of China: when did the national government know the atypical pneumonia cases indicated a novel coronavirus? How long did the national government delay the reporting of those cases to the World Health Organization and the rest of the international community? While these are key questions, they overlook the structure of China's legal relationship with the world's most important infectious disease control treaty, the International Health Regulations (2005). Under that treaty, China delegated information gathering and reporting to its provinces which were in turn supposed to notify China's National Focal Point - the body responsible for communicating potentially emergency infectious disease events to the World Health Organization and the rest of the international community. This was not the first time that National Focal Points failed: they also did so with MERS-CoV, Ebola, and H1N1. While National Focal Points are the backbone of the International Health Regulations, little is actually known about them. This Article situates the most important empirical study of National Focal Points to date - funded by the World Health Organization and conducted by the authors, a clinician and a legal scholar - to understand why they fail. The answer is that they are not independent - they must communicate information that can be economically damaging, they coordinate with other ministries that do not understand their purpose, and they almost never have an independent budget. If the International Health Regulations are to protect the world from future pandemics, reform must start with the independence of these crucial points of information gathering and communication.