To my knowledge, China, Australia, and India have not had official (observer or participant) status in previous ICH guidance processes. By participating in Q7A, do they agree to be bound by it?

China’s representation was spotty during EWG deliberations; sometimes an industry person and
sometimes a government person. The regulators in China would have to specifically agree or
adopt this document.
India did not have regulator representation. There was a conference in Hyderabad that was the
first conference to discuss the document. Even at the point where Q7A drafts were not supposed
to be distributed, officials in India had a copy of the Q7A document and it was the subject of the
conference. However, the regulators in India have not yet agreed to adopt Q7A