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Member States of WHO secured a desperate win in reaching consensus on the amendments to the International Health Regulations, following more than two years of systematic and intense negotiations, culminating in an astonishing agreement in the final hours of the 77^th World Health Assembly. The consensus assumes greater significance in an otherwise difficult meeting of WHO member states this year, that was fraught with several political resolutions laced with rounds of voting among 194 countries.

Foreword by Her Excellency Ellen Johnson Sirleaf and The Right Honourable Helen Clark

In May 2021, the Independent Panel for Pandemic Preparedness and Response presented a package of evidence-based recommendations to the World Health Assembly that was urgent, ambitious, and practical. Our goal was to make COVID-19 the last pandemic of such devastation. At the current rate of change, it will not be.

The world now marks time as “before” and “after” the pandemic. Many want to forget the pandemic itself and block the collective trauma. Yet we cannot afford to forget.

Government leaders may have turned their attention to other issues, but they must not neglect their responsibility to act now and unite to safeguard the public and prevent future pandemics.

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.

Sixteen leading scientists and manufacturers involved in vaccine development and production worldwide issue an urgent call for a pandemic accord that can be a ‘win-win for all.’ The full list of authors is available below.

Health misinformation was not invented during COVID-19 but was certainly brought to a higher, more malevolent  and destructive pitch during the pandemic.  That hostile crusade has since been (mis)directed at two landmark agreements, the Pandemic Prevention, Preparedness and Response Agreement (Pandemic Agreement), and amendments to the International Health Regulations (IHR), that are currently being negotiated by WHO’s 194 member states for approval at the World Health Assembly.  

The overarching goal of ensuring that the world will deal more equitably with the next pandemic appears to be elusive as we near the deadline of May 2024 for the close of the negotiations.

Several social media and news outlets have claimed that the WHO is negotiating two instruments that will afford the agency far-reaching powers in case of a future pandemic. 

In a powerful, hard-hitting letter, Cyril Ramaphosa, President of South Africa, also the African Union Champion on Pandemic Prevention Preparedness & Response, has laid down the most important priorities for the Africa Group in the negotiations for a new Pandemic Agreement currently underway at WHO in Geneva.

Geneva Health Files has learned that the letter, dated May 20th, 2024, was sent to key institutions and stakeholders on the African continent.

We publish the letter sent by the Presidency of South Africa on May 20, 2024, laying down the most important priorities for the continent.

This is what it says (also uploaded below):

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The last negotiations on the pandemic treaty revealed a split within the Africa group that some fear would compromise its bargaining position and undermine low- and middle-income countries' solidarity as they again engage in marathon talks this week to reach an agreement ahead of the 77th World Health Assembly.

According to sources close to the talks, a few African countries aligned with the European Union’s proposed text on pathogen access and benefit-sharing, or PABS — a multilateral arrangement that facilitates access to virus samples and genetic sequence data with pandemic potential, and lays out obligations on users to share the benefits with countries through WHO. The benefits include access to health products and monetary contributions. 

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There is considerable misinformation on social media and from some politicians and other influencers regarding the negotiations for a WHO pandemic treaty. In order to provide better understanding of what is actually being negotiated, this note provides commentary on several key articles, based upon the INB’s May 10 draft text, as published by Health Policy Watch. 1 of 17 https://healthpolicy-watch.news/wp-content/uploads/2024/05/Pandemic-Agreement-Draft-Reflec ting-progress-up-to-10-May.pdf In general, as the negotiations have progressed, in many areas, the obligations have become softer, as the WHO INB pushes for consensus. That said, the text does create norms in several areas, and mandates and mechanisms for cooperation that are potentially important going forward. The discussion covers Articles 4 through 13bis, and Articles 19, 20, 27, 29, 30 and 31.

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The latest draft of the World Health Organization’s (WHO) pandemic agreement, which was sent out to member states on Wednesday (15 May), shows just how far the talks still have to go.

Health Policy Watch obtained a copy of the draft agreement, which we are sharing on our paywall-free site:

READ: Latest Pandemic Agreement Draft, reflecting progress up to 10 May

Around a third of the text is still white, indicating either that it has not been agreed on or not even discussed. According to a stakeholder briefing, there were some 300 paragraphs to negotiate on at the last meeting of the Intergovernmental Negotiating Body (INB).

However, some of the most significant articles are awash with yellow and green highlights, indicating progress.

Yellow means the text has been agreed to in a working group. Green means it has been agreed to in the plenary of the Intergovernmental Negotiating Body (INB).

The latest draft of the World Health Organization’s (WHO) pandemic agreement, which was sent out to member states on Wednesday (15 May), shows just how far the talks still have to go.

Health Policy Watch obtained a copy of the draft agreement, which we are sharing on our paywall-free site:

READ: Latest Pandemic Agreement Draft, reflecting progress up to 10 May

Around a third of the text is still white, indicating either that it has not been agreed on or not even discussed. According to a stakeholder briefing, there were some 300 paragraphs to negotiate on at the last meeting of the Intergovernmental Negotiating Body (INB).

However, some of the most significant articles are awash with yellow and green highlights, indicating progress.

Yellow means the text has been agreed to in a working group. Green means it has been agreed to in the plenary of the Intergovernmental Negotiating Body (INB).