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WHO member states came together in recent days in the first substantive joint session that brought together the bureaux of the Intergovernmental Negotiating Body and the Working Group of amendments to the International Health Regulations.

With a mere ten months away from the May 2024 deadline, where both these processes are expected to conclude and culminate in the adoption of new amendments to the IHR and a potentially new pandemic instrument, countries this week grappled with the basics such as what would legally constitute a pandemic, how it would be declared, what kind of actions would it trigger and most importantly, how would these elements sit across the two different, overlapping legal mechanisms. There was also consideration of a few key topics that have featured in both these tracks of negotiations.

… Overlooking the inclusion of Africa CDC, which is the sole continental public health institution, was an unfortunate oversight. As a result, Africa’s health security gaps remain inadequately addressed, leading to the absence of multi-country/regional proposals from the continent. Africa CDC would like to recall that in February 2023, it reiterated its stance as an observer at the Pandemic Fund’s Board, emphasizing the significance of inclusive representation in the Fund’s governance structures, technical teams, and Secretariat to inform its crucial work. Africa CDC would also like to echo the call from African Heads of State and Government for a better representation of Africa in all multilateral constituencies. Africa CDC further urges for equitable representation of African countries and regional organizations in the relevant structures to ensure fair and inclusive outcomes. Therefore, Africa CDC once again urges the Pandemic Fund to take decisive action for the admission of Africa CDC as an Implementing Entity to join the ones identified in 2022.

India has long been known as the “pharmacy of the world,” producing generic medicines at prices that other developing countries and global institutions can afford. The country was the single largest supplier of pharmaceutical products to Africa in 2018, and accounted for a fifth of the continent’s pharmaceutical imports.

However, as the European Union now negotiates free trade agreements with India and Indonesia — another major generics-producing nation — the bloc’s been proposing far stricter protection of intellectual property rights. And such protection could threaten the affordability of generic medicines these countries export to the Global South.

It’s vital we remember the lessons of the HIV and AIDS pandemic. 

High cost has prevented some cancer drugs from being included in the World Health Organization’s (WHO) updated Essential Medicines List (EML) and Essential Medicines for List Children (EMLc) released on Wednesday.

These include “patented, highly-priced” treatments for lung and breast cancer.

“With the cancer medicines, we are facing now an issue where we have a very high burden of disease and very expensive, highly-priced medicines,” said Dr Benedikt Huttner, secretary of the expert committee that advises the WHO on the EML.

“For some of the medicines [cost] was one of the factors leading the expert committee not to recommend them currently,” Huttner told a WHO global press conference.

The final reading of the Political Declaration for the United Nations High-Level Meeting on Pandemic Prevention, Preparedness and Response (PPPR) is scheduled for Tuesday in New York – and while the revised text has a few more practical clauses than the bland zero-draft, it remains more aspirational than actionable. The revised version, which has been shared with Health Policy Watch, puts “equitable, people-centered and community-based” primary health care at the centre of countries’ pandemic mitigation. … In terms of equity, the declaration commits to strengthening “research and development capacity in developing countries” funded by “greater official development assistance”, surge financing and other “innovative financing”.

Before COVID-19 came along, the two most lethal infectious diseases were HIV and tuberculosis (TB). Even though HIV still lingers, with 1.5 million people contracting the infection every year, epidemiologists point to the availability of many HIV prevention options as a primary reason for the decreasing caseload.

According to the World Health Organization (WHO), over the past two decades, new HIV infections decreased by 49%, HIV-related deaths decreased by 61% and an estimated 18.6 million lives were saved because of new treatments that minimise the infection and prevent its spread.

… According to global health charity Medicins Sans Frontieres (MSF), J&J currently prices the drug at USD1.50/day for an adult treatment (USD272/six months). But with scale-up and unrestricted generic competition, it says the price of bedaquiline could get closer to USD0.50 per day. … But even if the deal does bring the price down to that level, some of the countries which would benefit from purchasing the drug at a lower price will not be able to as they have been excluded from it. Nine countries in the Eastern European and Central Asian region, which have some of the highest TB burdens in the world, are not covered by the deal because of an exclusive supply agreement J&J has with a Russian pharma firm. … The exclusion has infuriated senior health officials in some of the excluded countries. In a rare instance of its kind, the national tuberculosis (TB) programme (NTP) of Belarus sent an open letter to J&J demanding urgent action to improve equitable access to bedaquiline in Belarus, and all other countries with a high burden of TB.

The fourth meeting of the Working Group on Amendments to the International Health Regulations (WGIHR4) is to discuss various developed country amendment proposals focusing on accelerated information sharing and compliance. These proposals are from the USA, the European Union (EU), Switzerland and New Zealand. WGIHR4 will take place at the WHO Headquarters in Geneva on 24-28 July in a hybrid mode. … The third meeting of WGIHR had focussed on amendment proposals on Article 13 (public health response), new article 13 A (equitable access to health products, technologies and know-how), 43 (additional health measures), 44 (collaboration and cooperation), new article 44A (financing mechanism), New Article 53A (implementation and compliance). This week the majority of the amendment proposals under consideration are from developed countries. Many of these aim at enhancing the obligations on information sharing and compliance that on the surface seem reasonable but can be negative for developing countries.

Thirty-seven countries have received grants worth $338 million from the Pandemic Fund to boost their resilience to pandemics in the first round of the fund’s disbursements. Three disbursements involve multi-country grants: to 12 Caribbean countries to strengthen their early warning surveillance, build laboratory systems and workforce development; to seven Latin American countries to engage communities […]

That definitive conclusion has energized a major HIV/AIDS conference this week