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For centuries, colonialism has shaped global healthcare, leaving behind a legacy of disparities and injustices between the Global North and Global South that continues to exert a profound influence on the health and well-being of marginalised and indigenous populations across the globe.

Today, colonialism’s legacy is being challenged by a growing movement to decolonise the healthcare sector by shifting power to marginalised communities and empowering them to design and deliver their own care.

At a recent panel discussion hosted by the Global Health Centre of the Geneva Graduate Institute, in collaboration with Medicus Mundi, experts from across the health spectrum discussed practical steps to decolonise global health governance and give marginalised communities a greater voice and agency in their own healthcare systems.

Industry pans it, developing countries say draft “unbalanced” with a one-sided focus on prevention, falling short on obligations on response.

After more than two years of discussions on what countries would like to see in a Pandemic Accord, the Negotiating Text from the Bureau of the Intergovernmental Negotiating Body set up to broker this new instrument, has sought to strike a balance to in order to first draw countries into negotiations – but is being perceived as unbalanced and one-sided with a focus on prevention relative to obligations on response, diplomats said.

From suggesting provisions on pathogens access and the sharing of benefits, to language on One Health, from a new financing mechanism, to sustainable production, the draft might be able to get countries to begin text-based negotiations. Some developing countries hope to add text to strengthen the draft so that they can begin negotiations, diplomatic sources told Geneva Health Files.

 The draft negotiating text on the pandemic instrument released by the Bureau of the Intergovernmental Negotiating Body (INB) is unbalanced, essentially serving the interest of developed countries without any concrete deliverables on equity.

This draft text is to be considered by the 7th meeting of the INB for conversion into a formal negotiating text. The 7^th meeting of INB is to be held at the WHO Headquarters, Geneva from 6-10 November.

Article 2 Objectives

1. The general objective of this Protocol is to support the attainment of the objectives of the AfCFTA, stipulated in Article 3 of the Agreement, by establishing harmonised rules and common principles and standards that enable and support digital trade for sustainable and inclusive socio-economic development and the digital transformation of the continent.

2. The specific objectives of this Protocol are to:

a. promote and facilitate intra-African digital trade by eliminating barriers to digital trade among State Parties;

b. establish clear, predictable and transparent harmonised rules, and common principles and standards for digital trade;

c. create a transparent, open, predictable, secure, and trustworthy digital trade ecosystem for businesses and consumers;

d. enhance cooperation among State Parties on matters related to digital trade;

e. establish an institutional framework for the implementation and administration of this Protocol;

f. promote common and open standards to enable the interoperability of frameworks and systems to facilitate cross-border digital trade;

The chair of the World Trade Organization’s General Council (GC) has issued a “state of play” report for the Senior Officials Meeting on 23-24 October where the key issues of MC12 TRIPS Decision extension and the permanent solution for public stockholding (PSH) programs for food security appear to have been eclipsed in the meeting’s agenda.

The facilitator overseeing the informal discussions on reforming the World Trade Organization’s dispute settlement system issued a confidential zero draft text on 3 October that appears to curtail the organization’s vital enforcement function.

The United States, the European Union, and several South American countries allegedly blocked attempts by the Chair of the Doha agriculture negotiations to kick-start discussions on the permanent solution for public stockholding (PSH) programs for food security.

The initial assumptions on the apparently narrow and technical nature of the IHR are now being tested, with realpolitik inevitably now shaping these negotiations. As WHO member states get deeper into discussing and negotiating the proposed amendments to the IHR, it is becoming obvious that several difficult choices will need to be made in order to make this instrument better fit for purpose.

Various stakeholders including some developed countries, have shown propensity to focus on surveillance, broadly, prevention-related measures, that they feel would likely attract consensus more easily. But developing countries continue to push for fairer treatment of response related amendments to the IHR, including notably equity proposals such as access to countermeasures among others.

In August 2023, Johnson & Johnson (J&J) reduced the price of the lifesaving tuberculosis (TB) medicine, Bedaquiline, from US$272 to $130 per treatment course of six months for many low- and middle-income countries (LMICs). This price reduction was the result of a competitive tender by the Stop TB Partnership’s Global Drug Facility (GDF), an international pooled procurement mechanism for procurement of TB health products, and represents a watershed moment in the decade-long struggle for expanding access to Bedaquiline.

Though fast disappearing from public and political consciousness, COVID-19 continued to cast a long shadow in the discussions on Pandemic Prevention, Preparedness and Response at the UN High Level Meetings in New York this week where a declaration was accepted.

This clears the way, and sets the stage for deep negotiations in Geneva to take these discussions to a logical conclusion in the form of a new instrument to address pandemics and to amend the IHR.

In Geneva, diplomats met today for a resumed session of the intergovernmental negotiating body for a stocktaking session at the conclusion of informal consultations on certain provisions. A negotiating text for a pandemic accord is expected to be ready by mid-October as we reported previously.  

In this story we bring you a quick wrap of key statements from countries and other actors.