TWN Info Service on Health Issues (May24/16)
27 May 2024
Third World Network

WHO: Ministers to weigh unfinished business of pandemic agreement, international health regulations negotiations

Geneva, 27 May (Nithin Ramakrishnan) – The 77th Session of the World Health Assembly (WHA77) that will take place this week will look into the unfinished business of the Intergovernmental Negotiating Body (INB) which was developing a new pandemic instrument under the aegis of the WHO, and the Working Group on the Amendments to the International Health Regulations 2005 (WGIHR).

The WHA77 that is an annual meeting of health ministers will be held in Geneva from 27 May and 1 June 2024.

Both the INB and WGIHR were not able to complete their work since developed countries continue to refuse to draft and adopt legally binding provisions which ensure equitable access to medicines, diagnostics and vaccines to developing countries to respond to public health emergencies of international concern (PHEIC) and pandemics such as Covid-19.

Developed countries want developing countries to take on legally binding obligations on various types of surveillance and rapid information sharing systems in the name of pandemic prevention, without taking into account the lack of health systems and other basic health facilities in the developing countries.

The G7 countries specifically intervened in both processes to oppose calls for a new financing facility, accountable to Parties to the instruments, which can provide financial assistance to establish the core capacities for prevention, preparedness and response. They are continuously persuading developing countries to rely on existing financing arrangements, which are established outside WHO governance. These existing facilities often prioritise surveillance-related capacities over prevention and response capacities.

According to the provisional agenda of WHA77 the outcome documents of INB and WGIHR are submitted through documents A77/10 and A77/9 respectively. The reports will be discussed under Agenda item 13.4 and 13.3.

The draft final report of the resumed session 9^th session of the INB (A/INB/9/5) reads:

“The INB decided to submit to the Seventy-seventh World Health Assembly the draft text of the WHO Pandemic Agreement reflecting progress up to Friday 24 May at 12:00 CEST, and an accompanying covering note.”

Another draft document seen by TWN, marked as A77/10, also indicates the same. It states:

“Following its mandate as set out in SSA2(5), the INB drafted and negotiated the text of the WHO Pandemic Agreement, the draft of which, as of the conclusion of its ninth meeting, is contained in the Appendix. The INB did not reach consensus on the text.”

The document also says that the draft text reflecting progress up to Friday, 24 May at 12:00 CEST will be integrated into the file prior to online posting for WHA 77.

The draft text begins with an explanation as follows:

“Recalling that the INB did not reach consensus on the text of the WHO Pandemic Agreement, and worked on the basis of the principle that “nothing is agreed until everything is agreed”, highlighting and brackets in the text indicate the following:  

• Green highlighting: text for which initial agreement was reached;
• Yellow highlighting: text for which initial convergence was reached;
• Text without highlighting: text for which no convergence was reached;
• Text in [brackets]: Text with respect to which there were divergent views”.

The report of the WGIHR also follows a similar approach. However, the colour codes are different, and the Bureau has also attempted to propose some updated language on contentious text, wishing to undertake some more discussions to conclude by WHA77.

The WGIHR Bureau also expressed a commitment to support the next steps agreed by the WHA. A proposed note from the WGIHR Bureau for the outcome report states as follows:

“The Bureau’s view is that the Working Group is close to agreeing a consensus package of amendments to the IHR and that there is a strong willingness to conclude the process successfully. The mandate of the WGIHR Co-Chairs and Bureau has now finished, but we stand ready to support the next steps agreed by the Health Assembly, including facilitating any further discussions during Seventy-seventh World Health Assembly if that is the path decided on”.

Options for way forward under consideration for continuing INB Work

Delegations are presented with a decision tree outlining the way forward for negotiating the WHO Pandemic Agreement in the INB. The decision tree has two main suggestions: first, to negotiate during WHA77, and second, to continue negotiations after WHA77.

The second suggestion further includes three options:

1. Suspend WHA77 and continue INB negotiations with the goal of reporting to a resumed WHA77;
2. Conclude WHA77 with a decision to hold a WHA Special Session to consider the outcomes of the INB negotiations, and continue negotiations until this Special Session;
3. Conclude WHA77 with a mandate to negotiate the pandemic instrument in the INB until the next WHA in 2025.

Member States are presented with the above choices and requested to discuss the chance of a successful negotiation in the given timelines and the changing political context, in case they choose the second suggestion of negotiating the pandemic instrument beyond WHA77. However, no such question is presented for the first suggestion; instead, 5 days from 28 May to 1st June are marked as negotiating days in such a case.

However, several negotiators from both developed and developing countries told Third World Network that they are already exhausted with accelerated negotiations conducted by the INB, for the past one year and the marathon negotiations over the last six weeks. The negotiators of the small sized delegations have been working even through weekends, deprived of their personal and family time, challenging their endurance.

For this reason, negotiating through WHA77 or negotiating in a rushed manner by suspending WHA77 for a few days seems to be not a preferred option for many delegations. They prefer 6 months to 1 year to complete the negotiations.

Moreover, it is clear that if INB negotiations continue during WHA77 or the WHA77 is suspended for weeks, then developing countries are under a severe pressure not only to postpone negotiations for the pathogen access and benefit sharing (PABS) system as well as accept the new European Union call for One Health instrument for pandemic prevention. This is because the current proposal of the INB Bureau and WHO Secretariat is to adopt a half-baked pandemic agreement and continue negotiating additional international legal instruments on PABS and One Health to supplement the same.

According to sources the French delegation has already indicated that negotiations for the PABS instrument can only start if there are concurrent negotiations for the One Health instrument.

TWN has reported on how the proposed solution of adopting pandemic agreement at WHA77 and attempting to develop additional instruments will fragment the health emergencies regime.

A developing country delegate told TWN that “Several of us cannot understand the logic being presented to us. The conservative political parties are going to come into power in the upcoming elections (in the United States) and therefore we should adopt the pandemic treaty now. For that to happen, developing countries have to compromise the call for new fund, technology transfer and the benefits under the Pathogen Access and Benefit Sharing system.

Developed countries can hold onto their demands, and they haven’t committed to any legally binding obligation to deliver equitable access to the health products during PHEIC or pandemics. All these are understandable, but how on earth are they expecting us to adopt a pandemic instrument the way North wants and continue negotiating on issues that are important for us later. Whether these so-called conservative parties whom they fear will block the pandemic agreement won’t block the PABS instrument? Will they grant us all benefits including technology transfer?”