TWN Info Service on Health Issues (Jan08/02)

30 January 2008

The Executive Board (EB) of the WHO met from 21- 26 January to prepare for the 61st World Health Assembly that meets in May. Some of the issues discussed were the sharing of avian influenza viruses, climate change and health, IPRs and the WHO publications policy.

Documentation presented and discussed at the EB is available at http://www.who.int/gb/

Below is a news report on EB Board’s discussion on one of the most controversial issues that dogged WHO in 2007 i.e. the sharing of avian influenza viruses and benefit sharing.

Best Wishes
Sangeeta Shashikant
Third World Network
email: ssangeeta@myjaring.net

WHO Executive Board discusses avian flu issues
Published in SUNS #6398 dated 23 January 2008

Geneva, 21 Jan (Sangeeta Shashikant and Riaz K. Tayob) -- The sharing of avian influenza viruses and access to vaccines, climate change and health, were some of the issues discussed Monday at the Executive Board (EB) of the World Health Organization.

The 34-member EB, which began Monday, is preparing for the 61st World Health Assembly which meets in May. The EB also heard a report from the WHO Director-General Dr. Margaret Chan and opening statements by EB members. The EB meeting is from 21-26 January.

The EB, meets at least twice a year, with the main function of giving effect to the decisions and policies of the Health Assembly, as well as to advising and generally facilitating the WHA's work.

Director-General Chan, in her report, highlighted that primary health care will be addressed in this year's World Health Report and that this year is the 30th anniversary of the Declaration of Alma Ata and the 60th anniversary of the WHO.

She said that primary health care is making a comeback on the development agenda, and it is being revisited partly in the context of stalled progress in meeting international goals. She further said that "we will not be able to reach the health related Millennium Development Goals (MDGs) unless we return to the values, principles and approaches of primary health care."

She added that "we must reach these goals as the ability of countries to adapt to climate change will depend on the state of population health and the systems in place to protect it."

Chan also referred to some of the issues discussed at the WHO's Intergovernmental Meeting on avian flu. The IGM is seeking a timely, fair, transparent and equitable system for sharing of viruses and benefits. She further added that the Intergovernmental Working Group on Innovation, Public Health and IP sought to influence supply and demand in industry.

The influenza virus and benefit sharing, discussed on the first day of the EB meeting, is one of the most controversial issues that has dogged the WHO in 2007.

In early 2007, Indonesia highlighted the issue when it suspended its voluntary transfer of avian flu virus samples to WHO collaborating centres, complaining that its viruses were being used for commercial activities without its knowledge, and asking that a fair system be established whereby developing countries are assured of vaccines and assisted with technology to produce them.

The 2007 World Health Assembly that considered the issue adopted Resolution WHA60.28, outlined the convening of processes to come up with a transparent, fair and equitable virus and benefit sharing mechanism.

One of the processes, the Intergovernmental Meeting (IGM), met in November 2007 and considered several proposals by member states including proposals by Thailand, Indonesia and the Africa Group.

On this issue, the EB had before it a set of documents, with a progress report on the outcome of the last intergovernmental meeting on virus and benefit sharing (EB 122/5).

The set of documents includes among others the scope of discussions of the IGM, an interim statement of the IGM on virus and benefit sharing, a compilation of proposed draft principles and operational elements for the virus and benefit sharing mechanism etc.

Mali, on behalf of the 46 members of the Africa Region, said that about 8 members of the African region had suffered from bird flu and that the region lacked national detection capacity and resources to implement preparedness plans. It also stressed that the purpose of the WHA resolution was to have a fair and transparent mechanism with fair access.

At the IGM, the interim statement was controversial (see SUNS #6374 dated 27 November 2007) with the African Group registering reservations, as it was unhappy with the late presentation of the statement (it was presented only on the final day of the IGM) and with the non-transparent process wherein the African Group was not consulted.

The interim statement acknowledges a breakdown of trust in the existing WHO influenza virus sharing system known as the Global Influenza Surveillance Network (GISN). It requests the WHO Director-General to set up a traceability mechanism to track all shared H5N1 and other potentially pandemic human viruses and the parts thereof as well as an advisory mechanism to monitor and guide the virus sharing system.

While awaiting the setting up of a permanent virus and benefit sharing system, the interim statement says that members agree to share viruses with GISN consistent with national laws and regulations.

Some members of the African Group also privately expressed concern that the interim statement would be used as a tool to delay negotiations.

While subsequently, the statement was accepted by the Africa Group, several of these concerns were again raised at the EB.

Malawi sought assurance from the Secretariat that the follow-up meeting (to the IGM) will resume before May 2008 in time for the final report to be submitted to the 61st World Health Assembly. It also sought clarification on the legal status of the Interim Statement. "Can the Director-General act on an interim statement by an intergovernmental Meeting before the Health Assembly has approved it?"

It further sought assurance that the proposals submitted by the African Region, Indonesia and Thailand on virus and benefit sharing mechanism will be published by the WHO and made available before the end of the EB meeting.

This concern was raised as the African Group proposal, presented at the 2007 November IGM, has to date not been placed on the WHO website nor officially issued.

Indonesia said that it looked forward to the interim statement and to a new mechanism that is more fair, transparent and equitable including a traceability and advisory mechanism.

China, a country very much affected by avian flu, stressed on equitable sharing of benefits in order to increase developing countries' response to avian flu. It said that the country providing the viruses should obtain information about the research results and have as a priority, access to relevant technologies. It also added that skilled technical personnel from countries providing the virus should be part of the research so as to build capacity of the provider country.

It further added that WHO should organize and coordinate member states on standard operating procedures for sharing of virus, with the scope of use clearly specified. It said that it hoped that the laboratories that receive the virus strains do not use the viruses provided for other types of research. It also supported stockpiling of drugs and vaccines to respond to pandemic influenza.

Slovenia, on behalf of the EU, expressed concerns about the procedural aspects of the IGM, while acknowledging the importance of the interim statement. However, it said that the role of the interim statement was not entirely clear and welcomed explanations. It also said that the statement stressed the importance of timely sharing of viruses.

It said that the EU will continue to support integrated approaches to pandemic preparedness and underlined the leading role of the WHO in the Global Influenza Surveillance Network (GISN).

However, said Slovenia, it was necessary to improve the transparency, efficiency and scope of the current GISN, and called for an independent body of experts to establish an annual report on the GISN activity. It also said that it was committed to existing initiatives such as the WHO Global Pandemic Influenza Action Plan to Increase Vaccine Supply.

The US said that it would like as an outcome a projectable and reliable virus sharing system that ensures broad access to the influenza viruses by the academic and the private sector. As for benefit sharing, the US supported it in the context of development assistance, access to stockpiles and countermeasures.

Iraq, on behalf of the Eastern Mediterranean Regional Office (EMRO), said that none of the EMRO countries could produce influenza vaccines and the WHO should provide technical support to build adequate infrastructure to produce vaccine. It added that international cooperation will be needed to accelerate the much needed technology. It also stressed the need for a reliable system for tracking the biological materials given to the WHO, adding that without the tracking system, WHO's credibility was at stake.

Sri Lanka, supporting Indonesia, told the EB that it would be appropriate to set up a slightly more efficient and modified approach to facilitate the work of the IGM.

The legal counsel, Mr. Bill Kein, responding to the queries raised, said that it was not common to issue an interim statement. However, he said, the last paragraph of the statement invited the WHO Director-General to take the actions mentioned in the Statement. He also said that in terms of the nature of the measures, they were temporary and the IGM could agree on different measures.

He agreed that the papers proposed such as the Africa Group proposal was not yet up on the website, and that they will be put up following the EB.

In relation to the follow-up meeting to the IGM, the legal counsel mentioned that it was not possible for the open-ended working group to meet prior to the WHA in May and that the open-ended working group is most likely to take place in August, while the IGM in November.

David Heyman, a WHO Assistant Director-General, mentioned that the tracking mechanism would be about viruses shared with the WHO as of 24 November. It would track which countries have provided viruses and where the viruses have gone. The advisory mechanism and the definitive tracking mechanism are being established, he added.

The issue of climate change and health was also before the EB on the first day but its discussion was delayed following the US's request. On this, there was a Secretariat report on Climate Change (EB122/4) and a draft resolution sponsored by Germany, the Netherlands, New Zealand, UK and Ireland. (EB122/Conf. Paper no. 3).

Right from the start of the meeting, the US complained that the Secretariat report was produced late and pushed for the issue to be discussed later in the week. It added that it could not support the Secretariat's report.

The UK, a proponent of the draft resolution, said that it pushed strongly for the inclusion of climate change on the agenda as it was an area of public health that was not given sufficient attention.

The issue is to come for discussion later in the week. +