Ethics and global health security

Abstract

The International Health Regulations (IHR), which is legally binding in 196 countries, provides the foundation for global health security (GHS). Although the IHR aligns with human rights principles, it presents no explicit ethical framework. A more explicit engagement with ethics in the IHR, and GHS more generally, is urgently needed to improve global readiness for and responses to future pandemics. Addressing existing inequities and power imbalances in GHS requires a framework for balancing existing ethics frameworks for public health, research, and healthcare delivery. Public health measures should be framed and evaluated in terms of human dignity and values, taking marginalized persons into account. Recommendations are presented on how ethics and human rights can be better integrated into the IHR to support GHS. Existing models for balancing ethics during public health emergencies may be a useful model for developing a framework for ethics and GHS. © 2023 Elsevier Inc. All rights reserved.