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At the end of this week’s negotiation on the pandemic accord, Roland Driece, co-chair of the Intergovernmental Negotiating Body (INB) charged with drafting a pandemic accord, told the final plenary on Friday that “it’s not easy” – a phrase that he repeated four times in the space of minutes.

To ease difficulties, the INB piloted a new approach involving informal sessions to “bridge gaps” on the sidelines of the formal drafting session, Driece said. 

Two informal sessions were held on one of the trickiest aspects of the negotiations: Article 9 (Chapter Two) of the current pandemic accord draft, dealing with the research and development (R&D) of pandemic products. Mexico and Norway facilitated the sessions, while experts were on hand to respond to technical questions.

Meanwhile, in the formal drafting committee, member states “exchanged views” on Articles 9 (R&D), 10 (liability risk management), 11 (technology transfer), 12 (access and benefit-sharing of pathogen), 13 (supply chain) and 14 (regulatory strengthening).

As an interim step to a first draft of the World Health Organization (WHO) Pandemic Treaty, a new text has recently been released that was intended to reflect proposals that countries had submitted and to serve as a framework for the deliberations of the Intergovernmental Negotiating Body (INB)[1] at its meeting from 12 to 16 June 2023. While the updated text mentions equity as a principle and recognises the importance of ensuring fair access to pandemic-related health products, medicines and technologies, it fails to clearly set out the set of legal obligations required to achieve this objective, and many of the options put forward are geared towards maintaining the status quo rather than progressing towards a new paradigm. Chapter II deals with the articles most directly related to equitable access.

Salud por Derecho would like to draw attention to the following areas that need to be improved in the text:

In today’s edition, we bring you a guest essay on the lessons from the negotiations on the Framework Convention on Tobacco Control that could offer clues on tackling and understanding the beast we are confronted with today - the negotiations towards a Pandemic Accord. As a range of stakeholders from overworked diplomats, to resigned activists try to keep up the momentum in these crucial and important negotiations, we hope you find this contribution useful.

Leah Shipton, who works at the intersection of public health and political science, has authored this essay, distilling the past into an insightful analysis relevant for current global health negotiations, while also noting how the nature of the beast has changed over the years.

The multiple overlapping discussions underway on medical countermeasures (MCMs) — vaccines, medicines, tests, and other health technologies to prevent, detect, and control disease outbreaks — must do more than tinker in the margins of the status quo. Learning hard lessons from previous experiences that failed to achieve timely and equitable access to such health technologies in large parts of the world, we must raise the ambition and design a truly transformative MCMs platform for research and development, manufacturing, and access centered on equity from start to finish.

Timely and equitable access to effective medical countermeasures that are suited to the realities of the local health context is critical to stop disease outbreaks when and where they occur.

By Els Torreele, Dr. Joanne Liu, Michel Kazatchkine

The multiple overlapping discussions underway on medical countermeasures (MCMs) — vaccines, medicines, tests, and other health technologies to prevent, detect, and control disease outbreaks — must do more than tinker in the margins of the status quo. Learning hard lessons from previous experiences that failed to achieve timely and equitable access to such health technologies in large parts of the world, we must raise the ambition and design a truly transformative MCMs platform for research and development, manufacturing, and access centered on equity from start to finish.

The African region of the World Health Organization (WHO) has condemned the weakening of equity clauses in latest draft of the pandemic accord and called for this week’s negotiations to focus on principles and key areas of concern rather than the detailed text.

The 47 WHO Africa group countries made their submission at the resumption of the Intergovernmental Negotiation Body (INB) meeting in Geneva on Monday. 

“The African member states recognise the hard position that the bureau finds itself in trying to keep everyone at the negotiating table,” said Ethiopia on behalf of Africa.

“However, it is unfortunate that, in that process, the core of what this instrument is supposed to address, namely equity, has been presented in a weakened or reduced format, especially in those articles that would result in a meaningful realisation of equity.”

Access by affected countries to Ebola treatments is at a “standstill”, more than two years since their approval and five outbreaks of Ebola virus disease (EVD) later.

This was exposed by MSF Access Campaign in its recently launched report titled “Ensuring Access to New Treatments for Ebola Virus Disease”.

Sangeeta Shashikant (London) – Access by affected countries to Ebola treatments is at a “standstill”, more than two years since their approval and five outbreaks of Ebola virus disease (EVD) later.

This was exposed by MSF Access Campaign in its recently launched report titled “Ensuring Access to New Treatments for Ebola Virus Disease”.

Negotiations on a pandemic instrument will resume on 12 to 16 June at the World Health Organization’s headquarters in Geneva.

However, the Bureau of the Intergovernmental Negotiating Body (INB) has proposed a work programme for the resumed session of the 5th meeting of the INB that invites relevant ideas and concepts on a text prepared by the Bureau, instead of textual proposals from Member States.

Throughout the coronavirus disease 2019 (COVID-19) pandemic, inequities in access to COVID-19 vaccines, diagnostics and therapeutics have been vast and persistent. By the end of 2022, only 26% of people in low income countries had received a COVID-19 vaccine dose.¹ Less than one in 50 of the three billion diagnostic tests administered globally by March 2022 were performed in low income countries.² Further, low and middle income countries have had very little access to therapeutics, particularly antivirals such as nirmatrelvir–ritonavir (Paxlovid, Pfizer) and molnupiravir (Lagevrio, Merck Sharpe & Dohme).²

Unless action is taken quickly, the gap in access to antivirals between high and low income countries seems set to repeat the inequities in distributing COVID-19 vaccines.