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Text-based Negotiations on Pandemic Agreement Begin at WHO, But Too Late. Proposed One Health Instrument Adds to Complexity  

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.

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.

“Get this done” – and if you disagree, don’t block consensus, was the heartfelt plea made by World Health Organization (WHO) Director-General Dr Tedros Adhanom Ghebreyessus to member states negotiating a pandemic agreement on Friday (3 May).

Tedros was addressing the ‘stocktake’ in the middle of the final 10-day meeting of the intergovernmental negotiating body (INB), and it was clear that member states were nowhere close to the finish.

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A crucial stocktake of the state-of-play of the World Health Organization (WHO) pandemic agreement talks on Friday afternoon (3 May) will determine the way forward for the final five days’ negotiations.

But progress has been slow in the past four days, according to reports – with differing opinions about whether a skeleton agreement can or even should be nailed down in time for the World Health Assembly (WHA) at the end of the month – or whether it should be deferred for another year.

An array of civil society organisations wrote to WHO Director-General Dr Tedros Adhanom Ghebreyessus last week expressing concern that the Bureau co-chairs of the intergovernmental negotiating body (INB) are pushing hard for countries to adopt an agreement that “perpetuates the status quo, entrenching discretionary, voluntary measures and maintaining inequitable access as the norm for addressing PPPR” [pandemic preparedness, prevention and response]. 

The United States on 26 April appears to have adopted a “diversionary” stance on Colombia’s proposal for a comprehensive review of the implementation of the World Trade Organization’s controversial TRIPS Agreement, saying that it is ready to accommodate the issues as a review of the domestic implementation of the Agreement, which is contrary to the mandate, said people familiar with the development.

At the WTO’s TRIPS Council meeting that concluded on 26 April, the US position seemed like skirting the main issue of a comprehensive review of the implementation of the TRIPS Agreement, which is supported by many developing countries, said people familiar with the discussions.

On the second day of the resumed session of the Intergovernmental Negotiating Body (INB) on the pandemic instrument two Working Groups started text-based negotiations on Articles 4, 10, 14 and 17.

The resumed session 9^th INB session started on 29 April in hybrid mode at the WHO headquarters in Geneva.

Currently there are three working groups focusing on the following articles.

n April 11, 2024, Moderna announced that it had paused a $200 million plan to build a vaccine production plant in Kenya. Given little demand for COVID vaccines in Africa, the plans are unlikely to be resurrected. 
 
This is a far cry from two years earlier, when the pharmaceutical and biotechnology company announced a $500 million investment in the Kenyan site to supply Africa with as many as 500 million doses per year of its mRNA vaccines. Although the initial plan was to start production in early 2023, the timeline and total investment was scaled back as demand for vaccines faded. In its cancellation announcement, Moderna stated that demand in Africa "is insufficient to support the viability of the factory planned in Kenya."  

At the mid-point of the 2030 target for the Sustainable Development Goals (SDGs), progress towards achieving universal health coverage (UHC) is off track (1). According to the latest data, at least 4.5 billion people — more than half of the world’s population — are not fully covered by essential health services (2). Financial protection is also deteriorating, with two billion people experiencing financial hardship due to out-of-pocket health costs (2). People in vulnerable and marginalized situations, particularly those living in low- and middle-income countries, are affected most severely (3).

UHC2030’s 2024–2027 Strategic Framework describes how UHC2030 operates and adds value, now, on the path towards the next UN high-level meeting on UHC in 2027, and in the last stretch before the 2030 milestone for the SDGs.

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The coronavirus disease 2019 (COVID-19) pandemic laid bare the vulnerabilities and inequities engrained in economic and social systems in many countries. This pandemic exposed significant inequalities in access to life-saving vaccines and other medical countermeasures because of insufficient and geographically limited production capacity, economic imbalances and export restrictions, among other factors.¹ High-risk populations in lower-income countries – including older people, health workers and people with comorbidities – received vaccines long after lower-risk populations in higher-income countries.

The resumed meeting of the Intergovernmental Negotiating Body (INB) on the pandemic instrument has initiated negotiations in a working group and other informal discussion to push for consensus.

A working group was constituted to discuss Articles 4 and 5 i.e. on pandemic prevention and surveillance. Further, Germany has convened an informal meeting to discuss issues around Article 7 dealing with health and care workforce.