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Hours before the scheduled deadline on May 10^th to conclude the negotiations towards a Pandemic Agreement, unable to find consensus WHO member states struggled to find a way to extend the negotiations.

Diplomatic sources told us that countries were divided on devising a way ahead to continue the discussions. While some preferred to take “sufficient” time conclude these crucial talks carefully, groups of countries are keen on having an agreement “at any cost” ahead of the World Health Assembly that begins on May 27th.

Countries have now decided to continue to work till the last mile in an attempt to reach consensus. How they will do so, is less clear at this point.

In this story we describe the dynamics and events that unfolded at the close of the meeting of the Intergovernmental Negotiating Body on May 10.

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Negotiations on the International Health Regulations go down to the wire as countries were unable to complete the discussions at the end of the final meeting of the Working Group to amend the IHR, that concluded this week. Riding on a constructive approach and an overall positive momentum, countries made steady progress under the decisive leadership of co-chairs Abdullah Asiri and Ashley Bloomfield, but a few areas of contention remained as the clock ticked away towards the conclusion of the meeting on April 26, Friday.

The working group decided to buy additional time to conclude the negotiations and are expected to meet on May 16-17 to complete the process. More time is needed to reach consensus on key contentious matters including on technology transfer, a dedicated fund, governance of an implementation committee, among other areas, diplomatic sources said.

In the eighth meeting of the Working Group on Amendments to the International Health Regulations (WGIHR), which was suspended yesterday until 16 May, State Parties to the IHR took a major step towards agreeing on the package of amendments which will be put forward to the World Health Assembly, which takes place from 27 May–1 June.

The amendments, proposed by IHR State Parties in the wake of the COVID-19 pandemic to strengthen the international community’s ability to detect and respond to pandemic threats, will be further discussed at the resumed eighth meeting on 16-17 May with a view to finalizing an agreed package for submission to the World Health Assembly in May for its consideration and, if agreed, formal adoption.

The World Health Organization’s (WHO) working group has failed to meet its deadline of Friday (26 April) for amending the rules governing global disease outbreaks – the International Health Regulations (IHR) – and will reconvene.

This emerged late afternoon on Friday (26 April) at a briefing after the week-long Working Group of Amendments to the IHR (WGIHR), when drawn co-chair Dr Ashley Bloomfield announced that the group would reconvene on 16 and 17 May for a final two days’ negotiation.

“The mood in the room has been outstanding, and we have worked really hard to make amazing progress. We’re not quite cracking the bottles of champagne and sparkling grape juice, but we were getting very close and I have every sense that you are all committed to finishing the job,” said Bloomfield.

WHO Deputy Director General Dr Mike Ryan commended the group, saying he was “very confident” that the IHR would be  “a clearer, better instrument for your efforts, something that we can apply better on your behalf and on behalf of the people that you serve”.

The US plans to double the number of countries it supports to prevent infectious disease outbreaks, opting for bilateral agreements with at least 100 countries, according to its new Global Health Security Strategy (GHSS).

“Recent outbreaks, from mpox to Marburg, cholera, and other diseases… are wake-up calls for anyone who thought COVID was a once-in-a-lifetime experience,” said Dr Stephanie Psaki, US Coordinator for Global Health Security.

“US national security and prosperity depend on countries around the world being prepared to prevent outbreaks when possible, and to rapidly detect and respond to emerging infectious-disease threats when they occur,” added Psaki, who is also White House National Security Council’s Deputy Senior Director for Global Health and Biodefense. 

“Global health and community health are all interconnected,” remarked Dr Michelle A Williams, former dean of Harvard’s School of Public Health. “A threat anywhere is a threat everywhere when a pathogen can travel anywhere in the world in 72 hours.” 

Developed countries are pushing to dilute the proposal on equity from the Bureau of the Working Group on Amendments to the International Heath Regulation 2005 (WGHIR).

The Bureau’s proposal is itself weak already as it lacks an effective implementation means to address the lack of equity in IHR especially its silence on access to health products and the lack of financial vehicle to assist the implementation.

The 8^th meeting of the WGIHR is taking place from 22 to 26 April at the WHO Headquarters in a hybrid mode.

The first day of WGIHR8 discussed the Bureau’s proposals on Articles 13 and 44 immediately after the opening plenary.  There were no statements from the regional groups or individual Member States.

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On 17 April 2024, the World Health Organization (WHO) published the Proposed Bureau’s text in advance of the 8th meeting of the Working Group on Amendments to the International Health Regulations (2005) (WGIHR) which meets from 22–26 April 2024. Accompanying the 64 page Bureau text is an accompanying, non-public document on the rationales underpinning the proposed Bureau’s text for WGIHR 8.

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The penultimate meeting of a World Health Organization (WHO) working group to amend the International Health Regulations (IHR) began in Geneva on Monday amid stakeholder praise and criticism for the latest 64-page draft.

The IHR are legally binding and sets out countries’ rights and obligations in handling public health events and emergencies that have the potential to cross borders. But they were found lacking during the COVID-19 pandemic and the Working Group on Amendments to the IHR (WGIHR) has been considering over 300 amendments over the past two years.

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Equity is listed as a "guiding principle and approach" in the current proposed negotiating text for a new pandemic instrument.

"Equity is at the centre of pandemic prevention, preparedness and response, both at the national level within States, among and within countries or regions, and at the international level between States…” as per Article 3 of the negotiating text that elaborates on the principle of equity.

Similarly, EB decision 150(3), which spells out the scope of the amendment of the International Health Regulations 2005 (IHR) also mandates to address the issue of equity. It states: “Such amendments should be limited in scope and address specific and identified issues, challenges – including equity, technological or other developments – or gaps that could not effectively be addressed otherwise but are critical to supporting effective implementation and compliance of the International Health Regulations (2005)”.

Text has been proposed by the Bureau of the Working Group on Amendments to the International Health Regulations 2005 (WGIHR) that seeks to make WHO prequalified vaccines as a compulsory requirement for the issuance of vaccine or prophylaxis certificates, raising concerns of vaccine supply concentration.

This took place at the recent 7^th meeting of the WGIHR held from 5 to 9 February 2024.

Vaccine certificates are used as evidence of vaccination to facilitate international travel. Article 36 of the IHR states that travellers in possession of a vaccine certificate should not be denied entry unless the competent authority has verifiable indications and/or evidence that the vaccination or other prophylaxis was not effective.