Global health crises, particularly widespread pandemics, have demonstrated that effective responses to transboundary health threats cannot be achieved solely within the jurisdiction and capacity of a single state and require joint cooperation and accountability among states and international organizations. Adopting a descriptive-analytical approach, this article examines the legal foundations of the responsibility of states and international organizations in addressing global health crises and analyzes the challenges surrounding the determination, attribution, and enforcement of international responsibility. In this context, the principles of international cooperation, good faith, prevention, due diligence, and the obligation to protect the right to health are examined in light of the rules governing the international responsibility of states and international organizations. The findings indicate that ambiguity regarding the scope of obligations, weak supervisory mechanisms and enforcement guarantees, fragmented jurisdictions, and the absence of effective mechanisms for allocating responsibility constitute major obstacles to accountability in global health crises. Accordingly, the article proposes an optimal framework based on shared responsibility, transparency, institutional coordination, strengthened oversight, and effective enforcement mechanisms to promote fair and efficient accountability for transboundary health crises and reduce legal and institutional gaps in managing future crises