Analysis of the complementarity between the International Health Regulations and the Pandemic Agreement

Abstract

The COVID-19 pandemic exposed structural fragilities in the international health regime, especially the insufficiency of the International Health Regulations to ensure rapid, coordinated, and equitable global responses. The adoption in 2025 of the Pandemic Agreement gained relevance, conceived to fill gaps in preparedness, logistics, technology transfer, and fair access to medical countermeasures. Objective: to demonstrate that the relationship between these two documents is one of functional complementarity, and not of overlap or supersession, clarifying how each instrument occupies a distinct and synergistic role in the architecture of health governance. Method: a deductive and qualitative approach was employed, with documentary review and comparative analysis of international norms. Results: indicate that the International Health Regulations function as a comprehensive alert system, yet with recommendations generally non-binding and without instruments to guarantee equitable access and logistical management in crises, which contributed to fragmented responses and practices of vaccine nationalism. The Pandemic Agreement, in turn, establishes more robust legal obligations, operationalizes cooperation through the sharing of pathogens and benefits, conditions the production and allocation of supplies on risk and need criteria, and encourages geographic diversification and the transfer of know-how. Conclusion: the International Health Regulations establish the “what” of global health security by triggering the alarm and coordinating notification, while the Pandemic Agreement defines the “how” by structuring a collective, binding, and equitable response; together, they inaugurate a more resilient institutional design, capable of mitigating inequalities and strengthening preparedness and response to future pandemics.