International Health Regulations mandate that countries share information about illness that may affect people beyond their borders. It's being put to the test after a Russian plague researcher died.

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President Trump, the World Health Organization and other leaders are asking for more information about a 28-year-old woman who died last week. She worked at a Russian research institute that studies the plague. A centuries-old law requires countries to disclose exactly this type of information, as NPR's Gabrielle Emanuel reports.

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TEDROS ADHANOM GHEBREYESUS: We don't yet have the full picture of this event.

GABRIELLE EMANUEL, BYLINE: Tedros Adhanom Ghebreyesus heads the WHO. At a press conference this week, he said the answer to this murky picture lies in something called the International Health Regulations.

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TEDROS: Timely, complete and transparent information sharing under the International Health Regulations is essential to clarify conflicting reports.

EMANUEL: This law requires countries to share health information that could have international implications. It goes back to the 1850s with cholera outbreaks in Europe. Now it's among the most widely ratified international treaties, with 197 signatories, including the U.S. and Russia. Alexandra Phelan is at Johns Hopkins. She says there's one core obligation in the law.

ALEXANDRA PHELAN: Parties or states must notify WHO within 24 hours of detecting an event.

EMANUEL: There's a checklist for what constitutes an event, but pneumonic plague - what some fear this woman may have had - would trigger an urgent notification. But Russia did not notify WHO. Instead, WHO learned through media reports and then went to Russia seeking verification. Russia says she died of pneumonia of unknown origin.

PHELAN: Russia's response, firstly, was delayed, but also it wasn't comprehensive.

EMANUEL: Like many international laws, there's no mechanism for making countries comply. Lawrence Gostin directs the WHO center on global health law.

LAWRENCE GOSTIN: This case shows the good, the bad and the ugly of the IHR.

EMANUEL: He says he wouldn't want a world without this law. It's the primary way to demand information. And the WHO receives thousands of notifications each year from all over the world. But some countries don't abide by it, like China at the beginning of the COVID pandemic.

GOSTIN: You know, countries that are hiding the ball.

EMANUEL: In this case with Russia, he says, the risk of illness to the general public seems very low.

GOSTIN: But it's a blaring siren about how unprepared we are.

EMANUEL: Gostin says infectious diseases don't follow national borders, and so the world needs health rules that everyone follows. Gabrielle Emanuel, NPR News.

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LOS TEXMANIACS: (Singing in Spanish).

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