The SARS outbreak in 2003 gave a sense of urgency to the revision process of the International Health Regulations (IHR) and led to the realization that an international public health emergency not only affects human and animal health, but also economic life and countries’ economic development. It is against this background that the author of this paper, who chaired the negotiations to revise the International Health Regulations between October 2004 and May 2005, describes the process of these negotiations. The paper outlines the organization of work, the issues at stake, the negotiating actors, as well as the challenges encountered within the negotiation process from the first session of the Open-ended Intergovernmental Working Group to the adoption of the text by consensus during the World Health Assembly in May 2005. The author concludes by arguing that the IHR negotiations were unique in their common sense of purpose, in their technical yet political set-up, in re-affirming diplomacy as a unique profession, and in the support received from the WHO secretariat to enable the successful conclusion of the revision of the treaty