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The draft text of the World Health Organization pandemic accord reaffirms countries’ rights to use to the full the flexibilities contained in the World Trade Organization TRIPS Agreement and the Doha Declaration on TRIPS and Public Health. However, in reality, countries that do use TRIPS flexibilities encounter complaints and pressure from the European Union and other countries (such as the United States) not to use them to their full extent.

It is, therefore, no surprise that countries are seeking additional assurances in the pandemic accord, which is in its final days of negotiations before it is meant to go to the World Health Assembly. In March, a group of developing countries proposed the following wording:

4bis. The Parties shall not challenge, or otherwise exercise any direct or indirect pressure on the Parties that undermine the right of WTO Members to use TRIPS flexibilities at any multilateral, regional, bilateral, judicial or diplomatic forum. 

The governance of intellectual property in health emergencies caused much grief during the pandemic of COVID-19, when countries struggled to agree on the trade response in swiftly addressing the access to medical products. The pandemic petered out, even as countries, as members of the World Trade Organization, ultimately failed in articulating such a response. Since then, the discussion has moved to the WHO, as countries are working to put in place legal mechanisms around Pandemic Prevention Preparedness and Response.

As the UN’s only technical agency, and as the nucleus of global health policy-making, WHO has been seen as an important venue for safeguarding health from commercial interests.

YJ: We are together this afternoon to discuss an issue that both of us are very interested in, which is the quality of health care services especially in public health services. We are limiting our discussion to the Indian scenario.  So, if you permit, may I start shooting off questions that I would want you to answer as well as you know.

TS:  Yes, we should focus on the problems and challenges that public providers and health care managers encounter when they work at improving quality of care as well as some of the policy challenges in this area.

YJ: Let me start with a very generic question.  When we talk about quality of healthcare, what is it that you think of?

TS: In a broader sense, quality refers to specific attributes of a process that ensures that user-needs are met.  In the context of health policy, we understand universal access to healthcare services as universal access to quality health services. In other words, the right to health care is a right to quality healthcare. In this context the specific attributes would be:

The WHO is announcing the publication of six country case studies that explore the ecosystem for local production of pharmaceuticals, vaccines, and biologicals in low- and middle-income countries (LMICs). This comprehensive research underscores WHO's ongoing commitment to supporting member states in strengthening local production to improve access to essential medical products.

The six countries included in the study are Bangladesh, Kenya, Nigeria, Pakistan, Senegal, and Tunisia. The case studies were conducted by the Local Production and Assistance (LPA) Unit,  within the Innovation and Emerging Technologies (IET) Department, part of the Access to Medicines and Health Products Division, at WHO. The LPA Unit's mission is to support sustainable local production and technology transfer in LMICs, helping them achieve timely and equitable access to quality, safe, and effective essential medical products.

“The world is off track to reach most of the Triple Billion targets and the health-related Sustainable Development Goals,” said World Health Organization (WHO) Director General  Dr Tedros Adhanom Ghebreyesus. 

His comments were part of the WHO Results Report 2023 released on Tuesday.

The triple billion targets involve one billion more people benefitting from universal health coverage, one billion more people better protected from health emergencies, and one billion more people enjoying better health and well-being by 2025. 

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While negotiations on the Pandemic Agreement  are close to the finish line, the world is already witnessing the next emergency in the making:  Highly Pathogenic Avian Influenza (HPAI). It is currently raging through the planet from Antarctica to the United States, infecting birds, cows and other mammals.

WHO Chief Scientist Jeremy Farrar has already labelled HPAI a “global zoonotic – animal- pandemic”.  With avian influenza having reached new forms of cross-species transmission, infecting dairy cows and even cats that drank their milk – HPAI risks turning into the next human pandemic.

It is precisely the type of global health challenge that the pandemic agreement should address, especially when considering that HPAI has a human fatality rate of 56%. The latest outbreak is a wake-up call. It shows the great urgency for effective global instruments to prevent other pathogens from evolving the extent to which HPAI already has.

Well-intentioned decision to switch oral polio vaccines in 2016 backfired, new draft report says

Something momentous happened in the history of polio eradication in April 2016: Over a period of 2 weeks, 155 countries and territories started to use a new version of Albert Sabin’s classic oral polio vaccine (OPV) that no longer protected against one of the three types of poliovirus. Type 2 virus had been eradicated by then, and the only remaining type 2 polio cases were touched off by the live virus in the vaccine itself. Dropping the type 2 component from the vaccine would end those cases as well, the thinking went.

Hosts to the biggest pharmaceutical companies, the European Union and the U.S., drew four African countries into an exclusive closed-door informal meeting on May 3, in a bid to bridge positions on the proposed mechanism on Pathogen Access Benefit Sharing [PABS] – a cornerstone to the new Pandemic Agreement under negotiation at World Health Organization, diplomatic sources and experts familiar with the development said.

The African countries invited to the meeting reportedly include Botswana, Ethiopia, Kenya and South Africa. Sources said that this was an invitation-only meeting, suggesting that not  all countries were aware of it, and were not a part of such a meeting that took place along the sidelines of the on-going meeting of the Intergovernmental Negotiating Body currently underway till May 10^th.  

(By the time this story went to print, no responses were received to our queries sent on Sunday evening to all five countries and the EU, seeking more information on the meeting. We will update this story if we receive any responses subsequently.)

Halfway to the 2030 deadline for Universal Health Coverage, the world is severely off track. Nearly half of the global population lacks access to essential health services, with one in four facing devastating healthcare costs

May 05, 2024 by WHO-Watch Team

A discussion on UHC during session of World Bank Group Spring Meetings, 2014. Photo: Simone D. McCourtie / World Bank

WHO member states finally began text-based negotiations on a new Pandemic Agreement at WHO this week after more than two years since the process commenced. This comes far too late, with just over a handful of negotiating days left to conclude this process. As a result, the risk of a weak text emerging out of this process is nearly certain now.

The outcome of such an agreement will have implications worldwide – if done badly it could complicate the governance of pandemics, observers say. If nothing is done, status quo will preserve existing paradigms on how the world responds to health emergencies – it will be a missed opportunity. There is no time left within existing timelines to do this well, unless countries find a way of continuing these vital reforms work in the coming months and years with a commitment to find lasting, meaningful change towards Pandemic Prevention Preparedness and Response.

Later today, the Intergovernmental Negotiating Body will decide on the way forward for this process. We will update this story subsequently.