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The international community joined together during the late twentieth century to form a world trade system. Although imperfect, the world trade system contains adjudicable and enforceable norms designed to facilitate global economic activity. Human health is at least as important as trade in terms of its effects on the wellbeing of populations. Moreover, health hazards-biological, chemical, and radionuclear-have profound global implications. Whether these threats' origins are natural, accidental, or intentional, the harms, as well as the response, transcend national frontiers and warrant a transnational response. Despite their high importance, the International Health Regulations (IHR) are antiquated, limited in scope, and burdened by inflexible assumptions and entrenched power structures.' This essay examines problems of obsolescence, narrow reach, and rigidity associated with the IHR, and proposes a new conception for world health law in the 21st Century.