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Many members on 30 May called for preserving the two-tier dispute settlement system, including the binding Ap pellate Body, to ensure the continuation of a robust enforcement function at the Wo rld Trade Organization, said people familiar with the discussions.

At the first formal meeting on dispute settlement reform at the level of He ads of Delegation (HoD) on 30 May, the new facilitator, Ambassador Usha Dwarka-Canabady of Mauritius, explained the process that she would follow i n the coming days and months.

In an "urgent" email sent to members on 27 May, Ambassador Canabady, who had participated in one or two dispute settlement panels in the past, infor med members that "the focus of the 30 May 2024 DS Reform HoDs meeting should be on how to resolve the questions of appeal/review and accessibility."

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A new report suggests a handful of innovative antimicrobials that could be approved within the next few years could save up to 160,000 lives if made available, and used appropriately, in the low- and middle-income countries (LMICs) where they're most desperately needed.  

But the companies developing these products are not doing as much as they could be to make this goal a reality.

The report from the Access to Medicine Foundation tracks four innovative, late-stage antimicrobial research and development projects, and one recently approved product, that collectively treat a variety of drug-resistant infections, which disproportionately affect people in LMICs. It finds that while the companies developing these products are employing some strategies to increase access and promote stewardship in LMICs, there's much more they could be doing to ensure that these drugs will be available to every patient everywhere.

Did they or didn’t they?

This has been one of the many questions plaguing beleaguered negotiators in Geneva negotiating a Pandemic Agreement at WHO this week, when uncertainty around a Presidential communication from South Africa caused complications exacerbating already difficult circumstances. Conflicting signals from the government of South Africa on the overall position of the Africa Group, a key player in these negotiations, has led to confusion at a critical time in these discussions.

In this story, we try to unpack what has transpired over the last 48 hours, even as uncertainty continues at the time of publishing this edition.

The South African case is illustrative of the pressures faced by governments from different quarters and interest groups as countries negotiate a Pandemic Agreement under difficult circumstances. South Africa heads into election mode next week on May 29th, when the World Health Assembly considers a resolution on the Pandemic Agreement.

The pandemic instrument as a treaty under Article 19 of the WHO Constitution raises concerns on the fragmentation of the health emergency regime, which the Intergovernmental Negotiating Body (INB) has not taken up for discussion.

The draft negotiating text and the draft resolution for its adoption proposes that the pandemic instrument would be adopted under Article 19 of the WHO Constitution as a treaty. Further, some Member States are moving towards the notion of a protocol for the Pathogen Access and Benefit Sharing (PABS) system and for the proposed instrument on One Health Approach.

The rising cost of healthcare is one of the most significant burdens on countries, especially low- and middle-income countries. Research has shown that self-care can be critical in reducing unnecessary expenses for healthcare systems. Global self-care activities generate substantial monetary and healthcare workforce savings, totalling at least approximately $119 billion per year, according to a policy brief published by the United for Self-Care Coalition.

“Increased access to self-care products and services could further alleviate the burden on health systems by freeing up resources and time for healthcare providers to attend to more serious conditions,” explained Judy Stenmark, Director General at the Global Self-Care Federation (GSCF). “Globally, a total of 10.9 billion individual hours and 1.8 billion physician hours are saved every year through self-care practices.”

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In a number of global negotiations on the transfer of technology and knowledge, there are industry-led lobbying efforts to limit such transfers to measures that are on mutually agreed Page 2 of 27 terms (MAT), or voluntary and on mutually agreed terms (VMAT). Sometimes it is asserted that as a practical matter, the transfer of manufacturing know-how can only be provided through voluntary measures, and assertions are sometimes made that there is no legal basis for transfers of know-how, access to materials such as product samples and cell lines, or access to and the use of regulatory filings and data.

This note looks at one type of legal mechanism, competition law, and provides some examples of cases where the United States competition authorities have mandated the transfer of manufacturing know-how and access to materials and regulatory filings.

Read note in full

See also subsequent post by Arianna Schouten, "What measures do US competition authorities refer to in technology transfer mandates"

AMR is one of the biggest challenges to keeping infectious diseases under control.

In 2019, drug-resistant infections caused over 1.27 million deaths. Without action, these numbers are expected to increase significantly over the next couple of decades, with low- and middle-income countries particularly affected.

Despite notable progress in some areas over the last 15 years, overall, the global response remains too weak and fragmented to match the escalating challenge. Action on AMR happens locally – in health systems and in communities – but we need urgent action from global leaders to help secure faster progress and greater global impact.

Several high-level political events, including the World Health Assembly, UN General Assembly and Fourth Ministerial Conference on AMR, make 2024 a unique year to renew political attention and establish strong governance mechanisms for addressing AMR.

This policy brief sets out Wellcome’s recommendations for a more effective global response.

Access to effective antibiotics is essential to every health system in the world, however, antimicrobial resistance (AMR) threatens this backbone of modern medicine and is already leading to deaths and disease which would have once been prevented. This Series highlights that, although AMR can affect anyone throughout the life course, the very young, very old and severely ill are the ones suffering the most. Through novel modelling data, this Series shows how stopping infections through improved vaccination and water and sanitation can not only prevent a significant proportion of deaths due to AMR in low- and middle-income countries, but also reduce the use of antibiotics to preserve its effectiveness. The Series also addresses how a rethink of drug development is needed to support investment in antibiotic, diagnostics, and vaccine development according to the burden of infection and resistance. Lower drug development costs will also make antibiotics more affordable and accessible. Finally, the authors argue for the need of targets to trigger political commitment and accelerate progress in addressing AMR.

The narrowing economic gap between the United States and China has led to growing use of World Trade Organization (WTO) security exceptions, a development requiring a review to prevent abuse of the concept. A balance between these exceptions and free trade must be maintained through restoring the WTO's legislative function, realising the goals of Joint Statement Initiatives and clarifying trade remedy measures.

The rapid narrowing of the economic and technological gap between the United States and China since the late 2010s has triggered confrontation. Because of this, security-based perspectives have shaped various measures introduced into trade and commerce around the world.

Equity in the context of pandemics encompasses more than fairness and justice, which are fundamental values fostering trust and cooperation. It’s also a necessity for human security, safeguarding not only health but also mitigating the inevitable impact of epidemics and pandemics on our economies and societies. As a result of the COVID-19 pandemic, policy and decision-makers now acknowledge that “nobody is safe until everyone is safe”, but much more needs to be done to translate this concern into policy practice.

The GPMB calls on countries, in collaboration with other stakeholders such as the private sector, civil society and international organizations, to urgently implement the following key actions to improve equity: