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After nearly half a century without any treatments, the world now has two approved treatments for Ebola virus disease (EVD) – mAb114 and REGN-EB3. The approval of these treatments was the outcome of a collective effort, comprising contributions by patients and survivors, the US and European governments, countries affected by EVD, pharmaceutical corporations, the World Health Organization and non-governmental organisations (NGOs). 

However, more than two years after their approval, the process of ensuring that people who need these treatments can access them is at a standstill. As crucial contributors to the R&D of these treatments, survivors, affected countries and NGOs should have a say in this process. But decisions related to access and affordability are currently left only to the private corporations holding legal rights and regulatory data, and to the goodwill of these corporations and national governments. 

A new “Zero+” version of a proposed World Health Organization pandemic accord being negotiated by member states has dropped previously strong language that conditioned use of public R&D funds to private sector commitments to price transparency and tech transfer of end products, among other measures. However, the updated draft text, obtained by Health Policy Watch, still contains ‘optional’ language linking developing countries’ sharing of pathogen information to a guaranteed supply of drugs, vaccines and other health tools that they would access a WHO distribution scheme. While not a formal part of this week’s World Health Assembly (WHA) proceedings, the text drafted by the “Bureau” of six member states guiding the talks is being circulated this week as they prepare for another round of negotiations over the new accord, scheduled by the Intergovernmental Negotiating Body (INB) 12-16 June. … However, both civil society and pharma appear likely to oppose parts of the updated text – for very different reasons.

Richer countries should be asked to better pull their weight in helping the world cope with pandemics, according to a new draft of a treaty being negotiated at the World Health Organization. Countries with more "capacities and resources" should bear a "commensurate degree" of responsibility for preparing for and responding to global health threats, the document, seen by Reuters on Tuesday, suggests. … The 42-page document sent to member states and non-governmental organisations on Tuesday was drawn up based on suggestions from all member states in response to previous versions of the text. Countries have the option to remove numerous paragraphs from it in future negotiations, including the one about responsibilities. … A clause in an earlier draft obliging pharmaceutical companies to make details of their deals with governments public appears to have been dropped. The document also defines "pandemic" - one of several sticking points that have already taken up negotiating time - as "the global spread of a pathogen or variant" that spreads easily, is dangerous, overwhelms health systems, and requires international coordination.

In February, WHO launched a design and consultation process for a platform to combat pandemics. The aim is to ensure that when a new health threat emerges, there will be a platform ready to coordinate access to lifesaving medical products, or what the global health community has dubbed “medical countermeasures.” … The goal of the WHO-led process on medical countermeasures is to have a prototype by April and an “interim working platform” by September, although those timelines can change. … In a draft working paper seen by Devex, dated May 18, the platform will consist of a steering group made up of 25 members, representing countries, international and regional organizations, civil society, and the private sector. The steering group will be constituency-based, although no details yet on who will be part of it and how that will be organized.

… As the who’s who of global health descends on Geneva in the coming days for the World Health Assembly — the annual meeting of the decision-making body of the World Health Organization — the fate of the treaty will be the main topic of discussion over glasses of champagne at swanky receptions. … On intellectual property rights, the U.S. has taken a big red pen to the draft text, stripping out mention of waivers of intellectual property rights. It also wants to weaken provisions that would require pharmaceutical companies to license other manufacturers to produce their products. For the debate over whether sharing information regarding new pathogens should be linked to some kind of benefit — potentially monetary — the line is less clear. The Global South, which is pushing to include the benefits link, has the biggest ask, said a second Geneva-based diplomat who also requested anonymity to talk about confidential negotiations. But a flat no from the Global North could see them lose timely access to those pathogens — something that could delay the development of pathogen-specific vaccines or treatments, and cost lives.

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.