Health security governance
Health security depends on institutions far beyond the health sector. Outbreaks cross borders before information does, and hospitals stop working when power, water or supply chains fail. The Global Risks Forum (GRF) convenes health authorities, operators and researchers to clarify cross-border and public health responsibilities, and to design exercises that test whether those responsibilities hold. Its specialist counterpart, Health and Biosecurity Governance, is in development. GRF supports dialogue only; health authorities and international health bodies keep their mandates.
- 01InstitutionThe Global Risks Forum (GRF)
- 02Service levelR0: information and enquiries
- 03In briefThe short answer
- 04The governance questionsWhere health responsibilities meet
- 05The legal baselineAmended Health Regulations and an unfinished Agreement
- 06Beyond the health ministryThe duties that sit with other institutions
- 07ResponsibilitiesWho holds which duty
GRF · Institution · service level R0
The short answer.
Health security governance is the clarification of cross-border and public health responsibilities among health authorities, operators and researchers, because outbreaks cross borders before information does and hospitals stop when power, water or supplies fail. GRF convenes these actors and designs exercises that test whether those responsibilities hold.
Access to care in World.
How far each division sits from a large city, with the roads and airports that carry patients and supplies, in World.
Where health responsibilities meet.
Shared responsibilities
How are notification, information sharing and coordinated measures handled when a threat crosses borders?
Health systems that keep running
Which dependencies on power, water, transport and supply chains could stop health services, and who manages them?
Human, animal and environmental health
How do the institutions responsible for human, animal and environmental health work together on shared threats?
Amended Health Regulations and an unfinished Agreement.
| Instrument | What changed | Status |
|---|---|---|
| International Health Regulations (2005), 2024 amendments | A pandemic emergency alert level above a public health emergency of international concern, National IHR Authorities, a States Parties Committee for implementation and a Coordinating Financial Mechanism | In force since 19 September 2025 for most States Parties; a few have later dates |
| WHO Pandemic Agreement | Prevention, One Health, research and development, technology transfer, a supply chain and logistics network, and a pathogen access and benefit-sharing system | Adopted by the World Health Assembly in May 2025; opens for signature only once the PABS annex is adopted, which WHA79 referred onward to further negotiation |
| Joint External Evaluation and SPAR | Assessment of core capacities | Periodic, country-led |
The duties that sit with other institutions.
The 2024 amendments ask each state to name a National IHR Authority to coordinate implementation, which in most countries means connecting the health ministry with border agencies, transport, agriculture and veterinary services, environment and finance. GRF dialogues work on those connections: who closes a port, who pays for surge staff, who speaks to the public, and how animal and environmental surveillance reach the health side under a One Health approach.
This page addresses capacity and oversight only. Evidence on health systems sits with GCRI's Health Nexus; the specialist community is Health and Biosecurity Governance.
Who holds which duty.
| Actor | Responsibility |
|---|---|
| National public health authorities | Surveillance, notification and public health measures under national law |
| International health bodies | Coordination and guidance under their own mandates, including the International Health Regulations (2005) of the World Health Organization |
| Health system operators | Continuity of care, with their own continuity duties |
| Infrastructure operators | Power, water and supply services on which health systems depend |
| Research institutions | Evidence on threats, interventions and system behaviour |
Named instruments are references for dialogue, not claims of alignment. International health bodies are audiences for GRF's work, not partners, and GRF does not assess anyone's conformity with their rules.
Dialogue, mapping and exercises.
- 01
Responsibility maps
Maps of who decides what across health and infrastructure institutions, using the decision rights method.
- 02
Exercise design
Controlled exercises that test continuity and cross-border coordination, run with containment so simulated alerts never reach the public.
- 03
Continuity dialogues
Dialogues between health authorities and the operators of power, water, transport and supply services on which hospitals and laboratories depend, recording who acts when a dependency fails.
- 04
Platform in development
Health and Biosecurity Governance is a proposed community, in development, for health security, pandemic cooperation, One Health and biosafety institutions.
Exercises involving health data use only data agreed for the purpose. Personal health information is never needed for a governance dialogue and should not be sent to GRF.
Science and finance perspectives.
The Global Centre for Risk and Innovation (GCRI) studies health and biosecurity as science. Related GRF areas are disaster and crisis governance, all-hazards governance and information and public trust, which matters greatly when health guidance must be trusted. The framework is on risk governance.
Terms used on this page.
Each term as this page uses it. Where a standard-setting body defines the term, the wording follows that body.
| Term | Definition |
|---|---|
| International Health Regulations | A binding WHO instrument that sets obligations on states to detect, assess, notify and respond to public health risks that may spread internationally. |
| One Health | An integrated approach that aims to balance and optimise the health of people, animals and ecosystems, recognising their interdependence. |
| Public health emergency of international concern | An extraordinary event that poses a public health risk to other states through international spread and may need a coordinated response. |
| Joint External Evaluation | A voluntary, multisectoral peer assessment of a country's capacity to prevent, detect and respond to health threats. |
Where this page's references lead.
The bodies and documents this page is read against. Status and editions change; each link goes to the issuing body.
Questions and answers.
Does GRF issue health guidance?
Is Health and Biosecurity Governance an active platform?
Can a health authority propose an exercise?
Around GRF.
Start with an enquiry.
The current service level is R0: information and enquiries. An enquiry receives a reference and names the next step; applications, payments, compute allocations and registrations open only when their team, terms and review capacity exist.