Info Service on Health Issues (May20/16)
Geneva, 20 May (Kanaga Raja) – The World Health Assembly (WHA) on Tuesday adopted a landmark resolution on the response to COVID-19, that amongst others called for equitable access to and fair distribution of all essential health technologies and products to combat the virus.
It also called for an independent and comprehensive evaluation of the global response, including the WHO’s own response to the pandemic.
The 73rd World Health Assembly, held on 18-19 May, was conducted for the first time ever in a virtual setting.
The European Union-led resolution on the COVID-19 response, co-sponsored by over 130 countries including China, India, Japan, the United Kingdom as well as the African Group, was adopted by consensus on Tuesday.
While the United States did not object to the adoption of the resolution, it however disassociated itself from several operative paragraphs in the resolution (see below).
The adoption of the resolution showed the US isolated, with other nations lining up support to the WHO, ignoring the US efforts to divert attention from its own failures to tackle the pandemic by shifting the blame onto the WHO (and China).
Meanwhile, in a joint statement, EU High Representative Josep Borrell and EU Commissioner for Health and Food Safety Stella Kyriakides, welcomed the WHA’s adoption by consensus of the resolution that was initiated by the European Union and its Member States.
“The virus knows no borders, and neither should our response. Strengthening multilateralism is now more important than ever. The resolution underlines the importance of responding to this crisis through solidarity and multilateral cooperation under the umbrella of the United Nations. We commend the WHO for its leading role in guiding the response to this crisis,” they said.
“The role of equitable access to a vaccine in bringing the pandemic to an end is crucial. As a global, public health good, it has to be affordable and accessible to everyone. Also, access to affordable equipment, medicines and treatments is vital,” they emphasized.
The joint statement noted that on 4 May, together with global partners, the EU had launched a global pledging effort, which has so far gathered 7.4 billion euros from donors worldwide to ensure universal and affordable access to new solutions to detect, treat and prevent COVID-19.
“We invite, once again, all countries and partners to contribute with pledges to “the Coronavirus Global response” in favour of the Access to COVID-19 Tools (ACT) Accelerator,” the EU officials said.
[See related article: “Pledges of 7.4 billion euro raise several ambiguities”.]
“Today’s resolution recognises the need for engagement with the public through reliable information and the need to combat the proliferation of misinformation and disinformation.”
According to the joint statement, the resolution “also recalls the need for all of us to evaluate our performance. An independent investigation of how this pandemic started and spread will be important, as we will need to draw lessons from the current crisis to strengthen our global preparedness for the future.”
“By working together, united, and in solidarity, we will overcome this pandemic. Now is the time to work together. The health of each of us depends on the health of all of us,” said the joint statement.
RESOLUTION ON COVID-19 RESPONSE
The resolution adopted by the 73rd WHA on Tuesday (A73/CONF./1 Rev.1) called, in the spirit of unity and solidarity, for intensification of cooperation and collaboration at all levels to contain, control and mitigate the COVID-19 pandemic.
It acknowledged the key leadership role of WHO and the fundamental role of the United Nations system in catalyzing and coordinating the comprehensive global response to the COVID-19 pandemic and the central efforts of Member States therein.
It expressed its highest appreciation of and support to the dedication, efforts and sacrifices, above and beyond the call of duty of health professionals, health workers and other relevant frontline workers, as well as the WHO Secretariat, in responding to the COVID-19 pandemic.
The WHA called for “the universal, timely and equitable access to and fair distribution of all quality, safe, efficacious and affordable essential health technologies and products including their components and precursors required in the response to the COVID-19 pandemic as a global priority, and the urgent removal of unjustified obstacles thereto; consistent with the provisions of relevant international treaties including the provisions of the TRIPS agreement and the flexibilities as confirmed by the Doha Declaration on the TRIPS Agreement and Public Health.”
It reiterated the importance of urgently meeting the needs of low- and middle-income countries in order to fill the gaps to overcome the pandemic through timely and adequate development and humanitarian assistance.
The WHA recognized “the role of extensive immunization against COVID-19 as a global public good for health in preventing, containing and stopping transmission in order to bring the pandemic to an end, once safe, quality, efficacious, effective, accessible and affordable vaccines are available.”
It called on Member States (and regional economic integration organizations as appropriate), in the context of the COVID-19 pandemic, to:
1. Put in place a whole of government and whole of society response including through implementing a national, cross-sectoral COVID-19 action plan that outlines both immediate and long-term actions with a view to sustainably strengthening their health system and social care and support systems, preparedness, surveillance and response capacities as well as taking into account, according to national context, WHO guidance, engaging with communities and collaborating with relevant stakeholders.
2. Implement national action plans by putting in place, according to their specific contexts, comprehensive, proportionate, time-bound, age- and disability-sensitive and gender-responsive measures across government sectors against COVID-19, ensuring respect for human rights and fundamental freedoms and paying particular attention to the needs of people in vulnerable situations, promoting social cohesion, taking necessary measures to ensure social protection, protection from financial hardship and preventing insecurity, violence, discrimination, stigmatization and marginalization.
3. Ensure that restrictions on the movement of persons and of medical equipment and medicines in the context of COVID-19 are temporary and specific and include exceptions for the movement of humanitarian and health workers, including community health workers to fulfil their duties and for the transfer of equipment and medicines required by humanitarian organizations for their operations.
4. Take measures to support access to safe water, sanitation and hygiene, and infection prevention and control, ensuring that adequate attention is placed on the promotion of personal hygienic measures in all settings, including humanitarian settings and particularly in health facilities.
5. Maintain the continued functioning of the health system in all relevant aspects, in accordance with national context and priorities, necessary for an effective public health response to the COVID-19 pandemic and other ongoing epidemics, and the uninterrupted and safe provision of population and individual level services, for, among others, communicable diseases, including by un-disrupted vaccination programmes, neglected tropical diseases, non-communicable diseases, mental health, mother and child health and sexual and reproductive health and promote improved nutrition for women and children, recognizing in this regard the importance of increased domestic financing and development assistance where needed in the context of achieving UHC (universal health coverage).
6. Provide the population with reliable and comprehensive information on COVID-19 and the measures taken by authorities in response to the pandemic, and take measures to counter misinformation and disinformation as well as malicious cyber activities.
7. Provide access to safe testing, treatment, and palliative care for COVID-19, paying particular attention to the protection of those with pre-existing health conditions, older persons, and other people at risk, in particular health professionals, health workers and other relevant frontline workers.
8. Provide health professionals, health workers and other relevant frontline workers exposed to COVID-19, access to personal protective equipment and other necessary commodities and training, including in the provision of psychosocial support, taking measures for their protection at work, facilitating their access to work, and the provision of their adequate remuneration, consider also the introduction of task-sharing and task-shifting to optimize the use of resources.
9. Leverage digital technologies for the response to COVID-19, including for addressing its socioeconomic impact, paying particular attention to digital inclusion, patient empowerment, data privacy, and security, legal and ethical issues, and the protection of personal data.
10. Provide WHO timely, accurate and sufficiently detailed public health information related to the COVID-19 pandemic as required by the IHR (International Health Regulations).
11. Share COVID-19 related knowledge, lessons learned, experiences, best practices, data, materials and commodities needed in the response with WHO and other countries, as appropriate.
12. Collaborate to promote both private sector and government-funded research and development, including open innovation, across all relevant domains on measures necessary to contain and end the COVID-19 pandemic, in particular on vaccines, diagnostics, and therapeutics and share relevant information with WHO.
13. Optimize prudent use of antimicrobials in the treatment of COVID-19 and secondary infections in order to prevent the development of antimicrobial resistance.
14. Strengthen actions to involve women’s participation in all stages of decision-making processes, and mainstream a gender perspective in the COVID-19 response and recovery.
15. Provide sustainable funding to WHO to ensure that it can fully respond to public health needs in the global response to COVID-19, leaving no one behind.
The WHA called on international organizations and other relevant stakeholders to:
1. Support all countries, upon their request, in the implementation of their multi-sectoral national action plans and in strengthening their health systems to respond to the COVID-19 pandemic, and in maintaining the safe provision of all other essential public health functions and services.
2. Work collaboratively at all levels to develop, test, and scale-up production of safe, effective, quality, affordable diagnostics, therapeutics, medicines and vaccines for the COVID-19 response, including, existing mechanisms for voluntary pooling and licensing of patents to facilitate timely, equitable and affordable access to them, consistent with the provisions of relevant international treaties including the provisions of the TRIPS agreement and the flexibilities as confirmed by the Doha Declaration on the TRIPS Agreement and Public Health.
3. Address, and where relevant in coordination with Member States, the proliferation of disinformation and misinformation particularly in the digital sphere, as well as the proliferation of malicious cyber-activities that undermine the public health response, and support the timely provision of clear, objective and science-based data and information to the public.
The WHA requested the WHO Director-General to:
1. Continue to work with the United Nations Secretary-General and relevant multilateral organizations, including the signatory agencies of the Global Action Plan for Healthy Lives and Well-Being, on a comprehensive and coordinated response across the United Nations system to support Member States in their responses to the COVID-19 pandemic in full cooperation with governments, as appropriate, demonstrating leadership on health in the United Nations system, and continue to act as the health cluster lead in the United Nations humanitarian response.
2. Continue to build and strengthen the capacities of WHO at all levels to fully and effectively perform the functions entrusted to it under the IHR.
3. Assist and continue to call upon all States’ Parties to take the actions according to the provisions of the IHR, including by providing all necessary support to countries for building, strengthening and maintaining their capacities to fully comply with the IHR.
4. Provide assistance to countries upon their request, in accordance with their national context, to support the continued safe functioning of the health system in all relevant aspects necessary for an effective public health response to the COVID-19 pandemic and other ongoing epidemics, and the un-interrupted and safe provision of population and individual level services, for, among others, communicable diseases, including by un-disrupted vaccination programmes, neglected tropical diseases, non-communicable diseases, mental health, mother and child health and sexual and reproductive health and promote improved nutrition for women and children.
5. Assist countries upon request in developing, implementing and adapting relevant national response plans to COVID-19, by developing, disseminating and updating normative products and technical guidance, learning tools, data and scientific evidence for COVID-19 responses, including to counter misinformation and disinformation, as well as malicious cyber activities, and continue to work against substandard and falsified medicines and medical products.
6. Continue to work closely with the World Organization for Animal Health (OIE), the Food and Agriculture Organization of the United Nations (FAO) and countries, as part of the One-Health Approach to identify the zoonotic source of the virus and the route of introduction to the human population, including the possible role of intermediate hosts, including through efforts such as scientific and collaborative field missions, which will enable targeted interventions and a research agenda to reduce the risk of similar events as well as to provide guidance on how to prevent SARS-COV-2 infection in animals and humans and prevent the establishment of new zoonotic reservoirs, as well as to reduce further risks of emergence and transmission of zoonotic diseases.
7. Regularly inform Member States, including through Governing Bodies, on the results of fundraising efforts, the global implementation of and allocation of financial resources through the WHO Strategic Preparedness and Response Plan (SPRP), including funding gaps and results achieved, in a transparent, accountable and swift manner, in particular on the support given to countries.
8. Rapidly, and noting OP2 of RES/74/274 and in consultation with Member States (and regional economic integration organizations as appropriate), and with inputs from relevant international organizations, civil society, and the private sector, as appropriate, identify and provide options that respect the provisions of relevant international treaties, including the provisions of the TRIPS agreement and the flexibilities as confirmed by the Doha Declaration on the TRIPS Agreement and Public Health to be used in scaling up development, manufacturing and distribution capacities needed for transparent, equitable and timely access to quality, safe, affordable and efficacious diagnostics, therapeutics, medicines, and vaccines for the COVID-19 response taking into account existing mechanisms, tools, and initiatives, such as the Access to COVID-19 Tools (ACT) accelerator, and relevant pledging appeals, such as “The Coronavirus Global Response” pledging campaign, for the consideration of the Governing Bodies.
9. Ensure that the Secretariat is adequately resourced to support the Member States’ granting of regulatory approvals needed to enable timely and adequate COVID-19 countermeasures.
10. Initiate, at the earliest appropriate moment, and in consultation with Member States (and regional economic integration organizations as appropriate), a step-wise process of impartial, independent and comprehensive evaluation, including using existing mechanisms, as appropriate, to review experience gained and lessons learned from the WHO-coordinated international health response to COVID-19, including (i) the effectiveness of the mechanisms at WHO’s disposal; (ii) the functioning of the IHR and the status of implementation of the relevant recommendations of the previous IHR Review Committees; (iii) WHO’s contribution to United Nations-wide efforts; and (iv) the actions of WHO and their timelines pertaining to the COVID-19 pandemic, and make recommendations to improve global pandemic prevention, preparedness, and response capacity, including through strengthening, as appropriate, WHO’s Health Emergencies Programme.
11. Report to the Seventy-fourth World Health Assembly, through the 148th session of the Executive Board, on the implementation of this resolution.
US POSITION ON COVID-19 RESOLUTION
In a written statement explaining its position on the COVID-19 resolution, while conceding that the resolution makes an important contribution to the global response to COVID-19, the United States disassociated itself from several paragraphs in the resolution.
It dissociated itself from operative paragraphs 7.5 and 9.4 of the resolution, because it did “not accept references to ‘sexual and reproductive health,’ or other language that suggests or explicitly states that access to abortion is included in the provision of population and individual level health services”.
The US also disassociated from operative paragraphs 4, 8.2 and 9.8 that referred to the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and the 2001 Doha Declaration on the TRIPS Agreement and Public Health, arguing that the wording of these paragraphs “send the wrong message to innovators who will be essential to the solutions the whole world needs”.
It further provided its interpretation of the reference in operative paragraph 8.2 to “existing mechanisms for voluntary pooling … of patents” limiting it to voluntary mechanisms existing before the COVID-19 pandemic, not new or proposed “patent pooling” mechanisms created in response to the pandemic.+