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The Intergovernmental Negotiating Body set up to establish a new Pandemic Agreement resumed its discussions this week in a final lap aiming to conclude the negotiation, with numerous hurdles along the way to the finish line including process concerns, divergence on key issues and factors external to the World Health Organization.

Crunch time dawns in the hallways of WHO, where 194 countries are meeting to hash out a new legal instrument in a desperate face-saving exercise running against a vengeful clock. All-too-familiar fears of a H5N1 outbreak are snapping at the heels of governments, as they grapple with the big questions of a new health emergency architecture – from surveillance to financing, from Pathogen Access and Benefits-Sharing to One Health.

Despite widespread acknowledgement that trust is important in a pandemic, few concrete proposals exist on how to incorporate trust into preparing for the next health crisis. One reason is that building trust is rightly perceived as slow and challenging. Although trust in public institutions and one another is essential in preparing for a pandemic, countries should plan for the possibility that efforts to instil or restore trust may fail. Incorporating trust into pandemic preparedness means acknowledging that polarization, partisanship and misinformation may persist and engaging with communities as they currently are, not as we would wish them to be. This paper presents a practical policy agenda for incorporating mistrust as a risk factor in pandemic preparedness and response planning.

On Monday 29 April negotiations started and, as TWN had been reporting, the modalities proposed by the INB Bureau - which had already sidelined developing countries, excluded them from informal negotiations and altogether erased language proposed by them - have reiterated these effects during the INB session for key provisions.

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Negotiations surrounding the Pandemic Treaty continue as the deadline for endorsing the new mechanism approaches. However, the version under discussion fails to address critical issues pertaining to health equity.

The next round of Intergovernmental Negotiating Body (INB) negotiations for the Pandemic Treaty began on April 29, following two years of discussions. With the treaty text set to be finalized at the World Health Assembly at the end of May, uncertainties persist regarding the current state of negotiations, marked by numerous unresolved issues. The main question remains: will the Treaty genuinely fulfill its promise of equity and justice, or will it merely pay lip service to these ideals?

The World Health Organization’s (WHO) pandemic agreement negotiations begin their final two-week stretch on Monday (28 April) amid a gamble with the process, a show of unity from African member states – and more suggestions for the draft text.

This final intergovernmental negotiating body (INB) meeting will focus on finding “common ground and consensus”, according to a decision taken at the last fractious meeting.

The programme of work sets down 12-hour days, with the first week (29 April-3 May) focusing on finalising the substantive negotiations on the draft text. 

A “stock take” of progress will be held on Friday 3 May, and the second week (6-10 May) will look at outstanding articles, along with the draft resolution for the World Health Assembly at the end of May.

The INB Bureau has also undertaken to provide daily briefing to relevant stakeholders on progress.

A few health civil society organizations also issued a joint statement criticizing key aspects of the INB process and advocating for their demands. They comprehend issues of intellectual property, benefit-sharing and healthcare workers on the important aspects the current draft neglects.

Four legally binding provisions in 83 paragraphs between Article 4-24. Only 4.8% of the entire substantive provisions are legally binding. All the rest are best endeavour, opt outs, non-mandatory, general statements.

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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.

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.

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.