Competing interests: The BMJ has judged that there are no disqualifying financial ties to commercial companies. The authors declare the following other interests: ALP is the representative for a relevant stakeholder to the IHR amendment process and pandemic agreement negotiations, has advocated for the amendments and agreement, and has provided informal advice to member states on the negotiations. LOG is a member of the WHO IHR review committee and director of the WHO Collaborating Center for Global Health Law. RH served as an independent expert on the WHO review committee regarding amendments to the International Health Regulations. BMM has served as a consultant on WHO projects. Further details of The BMJ policy on financial interests are here: https://www.bmj.com/sites/default/files/attachments/resources/2016/03/16-current-bmj-education-coi-form.pdf. Provenance and peer review: Commissioned; not externally peer reviewed.