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he COVID-19 pandemic has reaffirmed the urgent need for a multi-disease, end-to-end medical countermeasures platform for the rapid development of, and equitable access to, pandemic tools. A comprehensive process is needed to devise such a platform to bring coherence to a fragmented landscape of initiatives, and ensure that equity and the needs of underserved populations are at its  centre.

In this context, and as indicated by the WHO Director-General following the publication of the ACT-A Evaluation in October 2022, WHO is convening a design and consultation process on a new medical countermeasures platform for pandemics. This process will engage a range of global, regional, and national stakeholders and build on experiences and learnings from the Access to COVID-19 Tools Accelerator (ACT-A), Pandemic Influenza Preparedness Framework (PIP) and other relevant inter-agency initiatives.

WHO member states began discussions on the Pandemic Accord based on a Zero Draft that was adopted at the fourth meeting of the Intergovernmental Negotiating Body this week in Geneva. The meeting was a complex discussion on process, modalities and a first reading of all the provisions of the Zero Draft. Countries also began with text-based negotiations.

It also saw the exclusion of non-state actors (NSAs) from participating as observers in the closed door drafting sessions that included mostly member states. The sheer diversity and the strength of the statements from NSAs including CSOs and other organizations, have been striking, and have made their presence felt in these discussions that have so far been relatively transparent and inclusive.

The Zero Draft of the proposed pandemic instrument to be negotiated at the World Health Organization creates an illusion of equity.

The Bureau of the Intergovernmental Negotiating Body (INB) released the document WHO convention, agreement or other international instrument on pandemic prevention, preparedness and response known as “WHO CA+” on 1 February 2023.

This concept note describes a WHO-convened consultative process to design a multi-disease, multitool, end-to-end platform for coordinating the rapid development and equitable access to medical countermeasures for pandemics and major epidemics.

A key goal of this process is to help achieve convergence of the many parallel discussions underway on enhancing access to countermeasures, with the aim of ensuring that all these efforts are working to common purpose.

The consultation process will engage a broad range of global, regional, and national stakeholders and will build on experiences and learnings from the Access to COVID-19 Tools Accelerator (ACT-A), Pandemic Influenza Preparedness Framework (PIP) and other relevant inter-agency/international initiatives focused on epidemic-prone diseases such as Ebola (e.g. the International Coordinating Group, ICG).

1. In recognition of the catastrophic failure of the international community in showing solidarity and equity in response to the coronavirus disease (COVID-19) pandemic, the World Health Assembly convened a second special session in December 2021, where it established an Intergovernmental Negotiating Body (INB) open to all Member States and Associate Members (and regional economic integration organizations as appropriate) to draft and negotiate a WHO convention, agreement or other international instrument on pandemic prevention, preparedness and response, with a view to its adoption under Article 19, or under other provisions of the WHO Constitution as may be deemed appropriate by the INB.

Reflecting on the up-to-date global experience of the coronavirus disease 2019 (COVID-19) pandemic is of crucial importance in order to draw conclusions needed for the design of policies aiming the prevention of new epidemics and the effective protection, preparedness and response of any new emerging. Ongoing environmental destruction, excess mortality by COVID-19 and non-COVID diseases reflecting the dismantlement and commodification of both public health services and healthcare services, deep economic crisis, increasing and deepening social inequalities are the main characteristics raised by the pandemic. The causes of the causes of all these are the dominant rules of the capitalistic system, driven mainly by the unlimited greed for profit on the expenses of the majority of the society. The effectiveness of any proposed correction of this system is discussed and the need for another society responding to the needs of the population is argued.

The COVID-19 pandemic has highlighted that as a global community, we need to strengthen systems to prevent, prepare for and respond to public health emergencies. Member States and the World Health Organization have agreed that in order to achieve this we must amend the International Health Regulations and negotiate a new international legal agreement on pandemics, the ‘Pandemic Accord’.

The success of the amended IHR and the pandemic accord will depend not only on the text of these instruments themselves but on the capacity of governments to work with their people to implement its obligations, in times of both calm and crisis. The inclusion of civil society perspectives in the drafting, negotiation, implementation, monitoring, and compliance of these instruments is the only way to ensure that the content of the instruments is centred on the needs of the poorest and most vulnerable communities and groups. And it is the only way to build trust and mobilise support for the implementation of amended frameworks and treaties.

We are writing on behalf of some public interest stakeholders invited to participate in the Pandemic Treaty Negotiations and other civil society organizations sharing their concerns and expectations about the  “Conceptual Zero Draft of the proposed WHO convention, agreement or other international instrument on pandemic prevention, preparedness and response” (the Pandemic Treaty)  which is expected to be published by the INB Bureau in mid-November and form the basis of formal negotiations after the next INB session on December 5-7, 2022.  

A global mechanism to share intellectual property (IP), know-how and technology for the production of essential medical innovations can play a key role in responding equitably and effectively to a pandemic. It can help maximize global production of and access to these products and increase self-sufficiency of low- and middle-income countries.

For this reason, the World Health Organization (WHO) set up the Covid-19 Technology Access Pool (C-TAP) at the beginning of the Covid-19 pandemic. Unfortunately, C-TAP has not reached its full potential as only a limited amount of research institutes and not a single private pharmaceutical company have shared their knowledge around Covid-19 technologies through this mechanism.

A year ago, the second Special Session of the World Health Assembly (WHASS) unanimously agreed to start a diplomatic process for a new binding instrument aimed at ensuring the international community is better prepared for the next health emergencies. The establishment of an Intergovernmental Negotiating Body (INB) at the WHO paved the terrain for a proper negotiation, which has started to unfold. The INB will be releasing the “conceptual zero draft” of the treaty text in early December 2022.

Whatever the outcome of the process, one of the inescapable pillars of any new international agreement is addressing how to finance pandemic prevention, preparedness and response (PPR). This is the reason why the Geneva Global Health Hub (G2H2) decided to embark into the contentious relationship between the international financial architecture and current health financing models, towards highlighting the pitfalls the world must avoid to ensure a healthier post-COVID world.