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The US secretary for health and human services, Robert F Kennedy Jr, announced that the US had rejected recent amendments to the World Health Organization’s (WHO) International Health Regulations, citing concerns over excessive WHO authority and global surveillance. 1 Despite this stance Kennedy’s department acknowledged that the amendments remained binding.2 Experts told Stat News that the move was mostly symbolic,3 noting that the US had already indicated non-acceptance during its WHO withdrawal and that the UN backed body lacked enforcement power.