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Global leaders highlight the need to defeat meningitis – a leading cause of disability – at a high-level meeting co-hosted by the World Health Organization (WHO) and Government of France, under the High Patronage of Emmanuel Macron, President of the French Republic. The event is taking place on 26 April 2024 at the Institut Pasteur and is supported by prominent athletes advocating on the cause ahead of the Paris Paralympics.

Building on news of Nigeria successfully rolling out a new, safe and highly effective vaccine, which targets five major strains of bacterial meningitis in Africa, leaders committed to implement the global roadmap for “Defeating Meningitis by 2030”, which needs a catalytic investment to action. This groundbreaking plan looks holistically at how to detect, control and beat meningitis in every region of the world, and how to provide rehabilitation to those who have suffered from the deadly disease.  

In the Democratic Republic of Congo, the fight against mpox – previously known as monkeypox – is entering a new phase.

While many are anxious to contain the outbreak – the largest mpox outbreak ever recorded in the DRC with more than 4,500 cases so far this year – experts say that's not yet possible: There are no vaccines or treatments in the country right now, and even the testing capacity is severely limited. Instead, this new phase of the mpox fight involves simply getting a better understanding of what exactly is going on.

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The DRC's mpox outbreak is noteworthy not only for its size but for the changing nature of the virus.

According to Africa CDC, 11 African countries have reported mpox cases but the DRC is the clear epicenter, with a caseload three times what it was this time last year. The virus, which usually jumps from a small animal to a human and then spreads between people, causes painful lesions and sometimes fever, malaise and even death.

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”.

On 16 April, the Bureau of the Intergovernmental Negotiating Body (INB) to draft and negotiate a convention, agreement or other international instrument under the Constitution of the World Health Organization to strengthen pandemic prevention, preparedness and response, published its Proposal for the WHO Pandemic Agreement to be discussed at the resumed session of INB9. This Proposal is based on discussions and negotiations among WHO member states that have taken place over the last two years. 

It has not been an easy two years. The spirit of solidarity that was fuelling the decision to start negotiating a Pandemic Agreement vanished quickly when proposals regarding product sharing, technology transfer, management of intellectual property (IP), access to know-how, transparency, and pathogen access and benefit sharing (PABS) were put on the table. These are all essential elements of greater equity in access to pandemic countermeasures.

We have been following several key elements of the equity agenda, in particular, the issues related to technology transfer and IP, including access to undisclosed information and know-how.

We, the undersigned civil society organizations, are reaching out to you to underscore our grave concerns regarding the negotiation process of the Intergovernmental Negotiating Body (INB) for the Pandemic Agreement.

The resumed 9 th session of the INB is the last round of negotiation prior to the 77 th World Health Assembly (WHA). The INB Bureau and the WHO Secretariat are pushing hard for acceptance of the draft Pandemic Agreement as proposed by the Bureau and the Secretariat with minimal changes, at the resumed session, setting the stage for its adoption at the 77 th WHA. While we acknowledge the importance of adopting a Pandemic Agreement earliest possible, such an Agreement must contain concrete measures and mechanisms that change the status quo, operationalize equity and foster international solidarity for pandemic prevention, preparedness and response (PPPR).

African governments are falling far short in their commitments to prioritize public spending on health care, contributing to widespread inequalities in healthcare access and outcomes, Human Rights Watch and the Kampala-based Initiative for Social and Economic Rights (ISER) said today. As the 23rd anniversary of African Union states’ historic commitment approaches, new data reveal alarming stagnation, widening regional inequalities, and pointing up the need to correct course.

On April 27, 2001, African Union (AU) governments adopted the Abuja Declaration, in which they set a target of allocating at least 15 percent of their national budgets to improve health care. But recent analysis of two decades of data found that only two of the AU’s 55 member countries — Cabo Verde and South Africa — met this target in 2021, the most recent year for which data is available.

While no cases of human-to-human transmission have been recorded in the current H5N1 avian outbreak, scientists are concerned about its transmission speed in mammals and whether this might result in a mutated pathogen that can infect people more easily.

“H5N1 is (an) influenza infection, predominantly started in poultry and ducks and has spread effectively over the course of the last one or two years to become a global zoonotic – animal – pandemic,” said Dr Jeremy Farrar, the World Health Organization’s (WHO) Chief Scientist.

“The great concern, of course, is that in doing so and infecting ducks and chickens – but now increasingly mammals – that that virus now evolves and develops the ability to infect humans. And then critically, the ability to go from human-to-human transmission,” Farrar told a media briefing in Geneva last week.

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.” 

This Policy Brief considers the negotiating process conducted so far by the Intergovernmental Negotiating Body (INB) for an instrument on pandemic prevention, preparedness and response under the World Health Organization (WHO), and some aspects of the draft text for the Resumed Ninth meeting of the Intergovernmental Negotiating Body (INB9R), as well as of the draft proposed resolution for consideration by the World Health Assembly in May 2024. The Policy Brief provides recommendations to assist member States in their negotiations during the INB9R to be held from April 29 to 10 May 2024.

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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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