The amendments, adopted at the World Health Organization assembly, were agreed upon at a meeting seen as a once-in-a-generation chance for the UN health agency to strengthen its role after some 15 million deaths during the Covid-19 pandemic.

The breakthrough – amendments to Article 59 of the IHR that will speed up the implementation of reforms – came after early opposition from Africa and others was overcome this week.

The changes sought by Washington, and backed by others such as Japan and the European Union, mark a first step in a broader reform of the IHR, which set out countries’ legal obligations around disease outbreaks, expected to take up to two years.

Sheba Crocker, US ambassador to the UN in Geneva, hailed as “a significant achievement” the initial amendments and an agreement on establishing a working group to consider targeted, substantive amendments.

“An updated, modernised IHR will help all countries and will ensure we have the information, resources, capacity, and transparency needed to address future global health crises,” she said in a statement.