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Info Service on Health Issues (May24/18) WHO: Drafting group starts negotiations on IHR amendments Geneva, 30 May (TWN) – A drafting group of the ongoing World Health Assembly (WHA) has started negotiations on the pending amendment proposals to the International Health Regulations (IHR) 2005. The drafting is largely focused on Article 13 on equitable access to relevant health products, Article 44 on collaboration, assistance and financing, and Article 54 on a committee for the effective implementation of IHR 2005. The drafting group was set up by the President of the WHA’s Committee A, which deals with technical health issues. (Committee B is responsible for finance and administrative issues.) 0n 28 May when Committee A took up the agenda item on matters related to the pandemic instrument and IHR 2005 amendments, the President announced the establishment of the drafting group and requested the WHO Secretariat to provisionally include the work of the drafting group in the daily journal of WHA. Prior to the announcement the following white paper was circulated to Member States explaining the modalities of the drafting group: “The Chair of Committee A proposes that Committee A establish a single drafting group, to be co-chaired by one Bureau member from, respectively, the Intergovernmental Negotiating Body (INB) and the Working Group on Amendments to the International Health Regulations (2005) (WGIHR), to consider the matters related to agenda item 13.3 and the matters related to agenda item 13.4, including further work with respect to the proposed amendments to the IHR (2005). Further, the Chair proposes that the drafting group first consider matters under item 13.3 (WGIHR), to be followed by consideration of matters under 13.4 (INB). It is proposed that the drafting group begin its work at 9am on Wednesday, 29 May, with further details to be provided in the Journal. This arrangement would promote predictability, transparency and inclusivity. It would also assist to avoid parallel meetings. It is properly within the role of the Chair to present this proposal, and within the prerogative of the Committee to accept it. The support of all Member States for the predictable handling of this matter, through this arrangement, is appreciated.” Wide support to wrap up WGIHR’s work Several developing country negotiators embraced the idea of finalising amendments to IHR 2005. Saudi Arabia on behalf of EMRO (Eastern Mediterranean) region stated: “… we are committed to reaching an acceptable compromise throughout the process of work to find common ground. We urge all Member States to seize this historic opportunity to protect future generations from the impact of the pandemic and epidemic by lending their support to the amendments. Let us commence to this amendment and build the future where global health security is reversed, resilient and equitable for all”. Kenya on behalf of the Africa Group stated: “… the Africa Member States proposed the inclusion of a new Article 13A highlighting the importance of technologies and know-who in terms of public health response. Another Article 44bis address the findings of the IHR committee on the need for financing of co-capacities. It proposes supporting IHR at global and regional and national levels. Such a mechanism will contribute to enhancing greater equity in preparedness efforts. …We remain committed to the issues and reiterate the importance of mainstreaming equity in both the IHR and the pandemic agreement in order to ensure that the world is better prepared to deal with the health emergencies in a fair and more equitable manner. We stand ready to engage and present a consensus package to the assembly for adoption”. Bangladesh said, “We would like to highlight that the failure to deliver on Article 13 on public health response and Article 44 on collaboration, assistance and financing, prior to and during the COVID-19 pandemic triggered the amendment of IHR. Therefore, it would be crucially important to amend Articles 13 and 14, taking into account the concern of developing countries. In going forward the whole set of amendments proposed by the Member States are to be treated as a package with the caveat that nothing is agreed until everything is agreed. We have already agreed to promote equity and solidarity in Article 3 on principles. Now we need to be bold and courageous to finalise the text in Articles 13 and 14 showing equity and solidarity in the spirit of achieving health equity for everyone, everywhere”. Botswana also expressed concerns over the delay in finalisation of the Articles designed to increase compliance with the regulations and render equity, i.e. Articles 13, 44 and 54. Malaysia, too, expressed its concern that “The World Health Assembly schedule is already fully packed and for smaller delegations, this would be a constraint. A fully agreed package of amendments will need the consensus of all the Member States and we recognise the fact that throughout these Member State-led negotiations the principle of nothing is agreed until everything is agreed has been upheld.” Switzerland, one of the major countries blocking consensus on the amendment provisions relating to equitable access to health products in the WGIHR, said that it seeks only targeted amendments, which will preserve the universality and technical nature of the IHR 2005. Switzerland is of the view that incorporating provisions relating to equitable access would risk them having to take the amended IHR 2005 for a deliberative process within their national government, which could be ambivalent and may make Switzerland reject the amendment proposals. However, the Swiss delegation had last week expressed its commitment towards finding creative ways to address equity with IHR 2005. Contentious Issues Despite widespread support for the negotiations there is no guarantee that the negotiations would lead to the successful conclusion of the amendment process. Three major issues are yet to find a solution. These are technology transfer, finance and the governance mechanism. Finance: There is no convergence between developing countries and developed country Member States, who are not willing to create any new funds for the implementation of IHR 2005. The Group of 7 (G7) wants IHR States Parties to seek funds from external financing institutions, which often prioritise donor interests. During discussions the United States categorically stated that it “does not support the establishment of a new fund”. Norway also suggested that the WGIHR should explore if consensus can be found to have periodic reviews to address gaps in financing and enable access to financing by addressing such gaps, rather than establishing a new fund. According to the Africa Group their proposal for a new financial mechanism currently reflected under Article 44 is based on the findings of the IHR Review Committee that highlighted the need for more financial resources to address the gaps in IHR 2005 implementation. Nigeria, on the other hand, while reiterating the position of the Africa Group stated that “Nigeria does see the overarching necessity for a financial mechanism established under the IHR. Such fund along with other vital equity considerations in the amendment process will ensure the mistakes of the past are not repeated. It would address the implementation and compliance of the IHR”. Negotiations within the drafting group have yet to find a solution on the proposal on the creation of new fund for IHR implementation. The text on the fund stands as follows. Proposal of the Africa Group under Article 44.2 ter (c): … [establish a fund, under WHO and that would commence on 1 October 2030, to provide financing to develop, strengthen and maintain the core capacities set out in Annex 1, particularly in developing countries.] (Brackets around negotiation text indicate lack of consensus.) Alternative proposal of the EU supported by the US and Iraq: [(c) to establish a Coordinating Financing Mechanism aimed to: (i) increase the efficient utilization of existing financing instruments relevant to supporting the effective implementation of these Regulations, and in particular to develop, strengthen and maintain core capacities set out in Annex 1[ADD A IRQ], with special attention to the diverse needs of developing countries, and (ii) work towards mobilizing further financial resources. The Mechanism shall function under the guidance of the World Health Assembly and be accountable to it. Its operation shall be supported by one or more existing international entities to be selected by the Assembly by consensus. The Assembly is encouraged to enter into the necessary working arrangements with the selected entity or entities within 24 months of the 77th WHA.] Governance Mechanism: While there is more or less consensus to establish a committee to facilitate and oversee the effective implementation of the IHR 2005 there is no consensus to create a sub-committee to directly report to the WHA, an idea opposed by many Member States. According to these countries the sub-committee would be able to bypass the implementation committee, which consists of the all IHR State Parties. The drafting group discussion could not reach a consensus on this issue on the first day. Article 54 bis reads as follows: 1. The States Parties Committee for the [Effective (DEL CHN)] Implementation of the International Health Regulations (2005) is hereby established to facilitate and oversee the effective implementation of these Regulations, in particular of Article 44, and perform any other functions entrusted to it by the Health Assembly. The Committee shall be facilitative and consultative in nature only, and function in a non-adversarial, non-punitive, assistive and transparent manner, guided by the principles set out in Article 3. To this effect: (a) The Committee shall have the aim of promoting and supporting learning, exchange of best practices, and cooperation among States Parties [for the effective implementation of these Regulations (CHN)]; (b) The Committee shall establish a Subcommittee to provide technical advice and report to the Committee. 1. The Committee shall be comprised of all States Parties and shall meet at least once every two years. Terms of reference for the Committee, including the way that the Committee conducts its business, and for the Subcommittee shall be adopted at the first meeting of the Committee by consensus. 2. The Committee shall have a Chair and a Vice-Chair, elected by the Committee from among its State Party members, who shall serve for two years and rotate on a regional basis. CHN: China Technology Transfer: The discussions on the technology transfer under Article 13.8.e is yet to find a consensus. Discussions are centred around the use of the terms” voluntarily and mutably agreed terms”. While developed countries especially the US insists to retention of terms developing countries argue for the deletion of these terms. The US has proposed a footnote durn the last round of negotiations i.e.16 and 17 May. However, consensus is yet to reach on the paragraph and the footnote. After the first day of negotiations within the drafting group the text stands as follows: [(e)
support States Parties, upon their request, [and, DEL EU] as appropriate,
[and, EU] subject to Article 2 of these Regulations, through relevant
WHO-coordinated and other networks and mechanisms, [pursuant to subparagraph
8(c) of this EU : European Union EGY: Egypt AF: Africa Group KEN: Kenya RUS: Russia
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