The COVID-19 pandemic has shown that no country was fully prepared to deal with a pandemic of such scale, speed, severity and impact. A new mechanism, the Universal Health and Preparedness Review (UHPR), has been proposed as means to increase accountability and transparency among Member States in capacity building for better health emergency preparedness. The peer-review nature of the envisioned UHPR ensures that key issues identified will be acted upon at the highest political levels of government and that relevant recommendations will be followed up upon on a regular basis. In November 2020, the Director-General announced the Universal Health and Preparedness Review. In resolution WHA74.7 (2021), Member States requested the Director-General to develop a detailed concept note for the consideration of Member States as they determine the next steps on the voluntary pilot phase of the Universal Health and Preparedness Review mechanism, based on the principles of transparency and inclusiveness, and on how it builds on existing International Health Regulations (2005) monitoring and evaluation framework components. As part of resolution WHA75/21, the UHPR concept note was presented to the health assembly and noted by Member States.