TWN Info Service on Health Issues (May24/09)
13 May 2024
Third World Network

WHO: DG Pushes Member States to conclude pandemic instrument negotiations before WHA 77

Geneva, 13 May 2024 (TWN) – The WHO Director-General has pushed delegations to conclude negotiations on a pandemic instrument by the beginning of the 77^th session of the World Health Assembly (27 May to 1 June 2024).

This thrust for negotiations risks pushing developing countries to agree to a highly inequitable pandemic instrument.

The proposed way forward adopted by the Intergovernmental Negotiating Body (INB) on the last day of its resumed 9^th session (10 May), contains several meetings spread across two weeks up until 22 May and two full-day meetings on 25 and 26 May.

The tentative schedule of the upcoming negotiations are as follows:

(i) 14 May and 15 May, Tuesday and Wednesday - 3 hours each;

(ii) 18 and 19 May, Saturday and Sunday – 6 hours each;

(iii) 20 and 21 May, Monday and Tuesday - 3 hours each;

(iv) 25 and 26 May, Saturday and Sunday - Full days (in person/hybrid).

This schedule ignores hectic schedules of other important intergovernmental negotiations both within and outside WHO that involve the same delegates (especially from developing countries) and is bound to change as several countries registered concerns relating to the possibility of meeting on these days. The schedule collides with the schedule of other important meetings in Geneva including:

●     WIPO Diplomatic Conference on Genetic Resources and Associated Traditional Knowledge (13-24 May);

●     Working Group on Amendments to International Health Regulations 2005 (16-17 May);

●     Programme, Budget and Administration Committee meeting of the WHO Executive Board (22-24 May).

The initial option given to the countries was to choose two days for full day negotiations prior to the 77^th session of the World Health Assembly (WHA77). However, several countries such as India, Russia, Bangladesh, Malaysia, Syria, China, Iran, New Zealand, Australia, Belarus, Jamaica, Canada, Indonesia, and the United States raised the concern that two additional days will not bring any consensus and requested the INB to be more pragmatic by sending a progress report to the WHA77 and to seek an extended mandate.

India even told the INB Bureau that the INB is negotiating on a very crucial issue which puts human lives at stake and there is no need to rush to conclude the negotiations which can have unintended negative consequences. Several developed and developing countries spoke on the way negotiations are conducted and how it is forcing convergence on a draft that ignores real public health concerns.

Nevertheless, the European Union, the Africa Group and the United Kingdom expressed their commitment and hope to conclude as expeditiously as possible.

The WHO Director-General Tedros Adhanom Ghebreyesus then intervened and proposed to continue negotiations for the next two weeks, if an additional two days cannot forge consensus. Instead of postponing the negotiations beyond WHA77, which would give time to build a better pandemic instrument, DG Tedros said the INB has two more weeks before the WHA77 to arrive at a compromise deal. He then invoked the spirit of compromise shown by the small group of friends who worked on the Pathogen Access and Benefit Sharing (PABS) system negotiations during the first week of May 2024 – an unhealthy compromise that was criticized by developing countries for giving up on all important equity-related benefits that the PABS system could deliver to developing countries.

As the prospects of getting countries to commit themselves to additional two weeks of negotiations looked very grim, even after the DG Tedros’ request, the INB Bureau announced a short break in the meeting. The Bureau then quickly got the WHO Secretariat to write down a schedule for staggered meetings spread across two weeks (as above) and this was presented on-screen to Member States.

The Ethiopian delegation expressed the African countries’ commitment to conclude the INB negotiations by WHA77. The delegation told the INB that Africa has no mandate to continue negotiations beyond WHA77. Brazil said they are committed to negotiate not only for 3 hours, but also for whole days and are willing to get the pandemic instrument adopted by WHA77.

At this stage some of the countries who told the INB to be pragmatic before the break, agreed to continue negotiations, expressing their solidarity with the delegations who wanted to continue negotiations.

However, some delegations such as Iran, Syria, Monaco, Belarus, Eswatini and Cuba said the schedule and way forward plan will take a toll on small delegations and their personnel’s health as well. Though Bangladesh, Peru, Malaysia, Indonesia, Russia and India expressed similar concerns, they agreed to work in the way the Bureau had proposed based on the Secretariat’s suggestion.

WHO DG plans to submit the text to the World Health Assembly

Sources from the Secretariat confirmed with Third World Network (TWN) that DG Tedros has made the need for a pandemic treaty entrenching One Health obligations as a matter of his legacy. He is constantly pushing the INB Bureau to present a clean text to the WHA. 

This was inadvertently reflected in the words of the INB Bureau during the last session on the 10 May, when the schedule for continuing negotiations was presented. The Co-chair of the INB Bureau remarked while discussing the way forward that the Bureau understands that there would not be a consensus in the end, but then she also said there will be a clean text presented to the WHA.  Russia questioned this inconsistency and requested clarity on the way forward – what if the proposed negotiations also do not yield a consensus text before WHA77

The Bureau then clarified that the goal of INB meetings is to clean the draft text as much as possible before WHA77, rather than forcing a compromise or producing a clean text.

A developing country delegate privy to a private conversation by the WHO DG and his staff, told TWN that the DG’s plan is to get this draft adopted at WHA. He apparently instructed his staff to make delegates negotiate as much as possible prior to the WHA, remove all colour coding from the negotiating text that indicate lack of consensus, and present a clean text to the ministers at the WHA. He would then ask health ministers of the various Member States “whether they can live with the text” amounting to forcing a political compromise.

According to negotiators who spent a whole day on PABS, last week, DG Tedros sat through the negotiations and intervened, attempting to make compromises primarily on proposals from developing countries.

Sources have also confirmed that earlier in the week the DG had reached out to certain country capitals, whose delegations were actively seeking meaningful deliverables on equity in the pandemic instrument that were resisted by developed countries. He requested the ministries to discourage their delegations from making demands that would really address inequities in the draft giving priority to reaching a deal.

If the current negotiating text of the pandemic instrument gets adopted, it will further entrench the deep inequities existing between developing and developed countries when it comes to health emergency preparedness and response.

The current draft does not have provisions that will predictably deliver equity or access to medicines or vaccines in developing countries when the instrument enters into force. It does not have a financial mechanism accountable to the Parties of the agreement that will aid implementation of the agreement in developing countries.

At the same time, it will increase the surveillance and information sharing obligations of Parties without any corresponding obligations on WHO to handle the information carefully or to deliver equity.

Further, the WHO Secretariat is given authority to coordinate with non-state actors and international organisations etc. without any limitations or Member State scrutiny. There are no accountability mechanisms mentioned in the instrument which hold the WHO Secretariat or the other institutions which it may partner with, responsible for delivering equity during public health emergencies.  There are also concerns that the free hand given to the WHO will undo the disciplined structure of information sharing under the International Health Regulations 2005 and can create further confusions in the rolling out of WHO’s World Health Emergencies Programme. 

All these issues warrant a careful consideration of the draft of the pandemic instrument before its adoption, if the instrument has to bring any meaningful change to the inequitable status quo and this needs more time.