PandemicTreaty

No Time to Gamble: Leaders Must Unite to Prevent Pandemics

dlegge — Sat, 06 Jul 2024 05:01:32 +0000

No Time to Gamble: Leaders Must Unite to Prevent Pandemics

01 June 2024

dlegge Sat, 06/07/2024 - 15:01

Author/s

Helen Clark and Ellen Johnson Sirleaf

The Independent Panel

No Time to Gamble: Leaders Must Unite to Prevent Pandemics

Foreword by Her Excellency Ellen Johnson Sirleaf and The Right Honourable Helen Clark

In May 2021, the Independent Panel for Pandemic Preparedness and Response presented a package of evidence-based recommendations to the World Health Assembly that was urgent, ambitious, and practical. Our goal was to make COVID-19 the last pandemic of such devastation. At the current rate of change, it will not be.

The world now marks time as “before” and “after” the pandemic. Many want to forget the pandemic itself and block the collective trauma. Yet we cannot afford to forget.

Government leaders may have turned their attention to other issues, but they must not neglect their responsibility to act now and unite to safeguard the public and prevent future pandemics.

A pandemic threat can emerge at any time, in any country. Today dangerous disease outbreaks are occurring around the globe: for example, avian influenza A (H5N1) is infecting more mammals, including domestic cattle. There is a scramble now to diagnose human cases and to purchase vaccines in case the worst happens and H5N1 begins to transmit from person to person. A deadlier new form of mpox has led to child deaths in the Democratic Republic of the Congo, where there is no access to vaccine. A new pandemic threat, “Disease X,” could emerge at any time. Every day that preparation for a new threat is delayed is a dangerous gamble.

There is recent cause for some optimism concerning the rules for pandemic preparedness and response. On June 1, 2024, after many challenging days and nights of negotiation, the World Health Assembly adopted amendments to the International Health Regulations (IHR). These amendments won’t immediately make the world’s population safer. They will be meaningful only when Member States and the World Health Organization fully invest in and abide by them. However, in a fractious world, countries demonstrated that multilateralism could still deliver and unite us against existential threats. Member States must now prioritise negotiation and adoption of a pandemic agreement— with equity at its heart—that will complement the IHR. This should happen before the end of 2024.

Discussions in Geneva are essential but must not hold up actions to prepare for the next pandemic threat. While three years is a short time in multilateral negotiations, it is a dangerously long time to leave gaping holes in the national, regional, and international systems meant to protect 8 billion people from a new pandemic.

In our main report to the World Health Assembly in May 2021, COVID-19: Make it the Last Pandemic, we recommended a coherent and urgent package of change. Leaders, however, have too often looked the other way and towards issues of immediate interest to their electorates. They are unfortunately gambling with our future.

Today the world is not investing in pandemic preparedness and response at anywhere near the scale or speed necessary. Despite multiple initiatives and discussions, there is still no efficient, equitable, end-to-end platform for medical countermeasures on which low- and middle-income countries can rely. Based on assessments, it’s difficult to say if countries are prepared or not for the next pandemic threat. Furthermore, tools and metrics still lack the rigour and comprehensiveness to identify and address pandemic vulnerabilities and risks. There is far too little accountability within the international system. There is a dangerous gap in trust between countries, within countries, and within communities that will allow pathogens to sail through.

There is a path that political leaders can choose, however, to transform their countries and the world into a safer place for their citizens today and for generations to come. It is a matter of building reciprocal trust, and it is in the interest of every country to do so. The unpredictability of pathogen emergence means every country must both rely on and support its global neighbours to be prepared.

All governments, of all income brackets, can apply lessons from COVID-19, invest in multisectoral capabilities, and update their plans to identify and manage the next pandemic threat. Governments can work much more closely with communities to understand and address inequities, vulnerability, and risks, and to rebuild trust.

The international community can take steps to transform international financing to support low- and middle-income countries to help bridge the gaps in domestic finances. Modern digital tools in the hands of community workers can transform disease surveillance across human, environmental, and animal health. Leaders can choose to manage outbreak and pandemic tools as part of the global commons. The World Health Organization can focus its efforts on ensuring the very best technical advice and support.

Pandemic preparedness and response are not for public health experts alone. There remains an essential role for political leaders at the highest level. Such leadership has been missing, but it can be advanced through various avenues, including the United Nations General Assembly, and specifically the upcoming Summit of the Future. We also call for a group of champion leaders to emerge and advocate to close the gaps in the international system and help to activate a response in times of crisis.

The solutions lie in political will to overcome trust deficits, leadership, and accountability. Statements from the G7 and G20 are important, but they are not enough. A pandemic agreement and strengthened IHR are not enough. The world needs leadership at the highest-level to turn statements and recommendations into systems and actions that protect people.

This isn’t a problem for future governments. It is not a theoretical exercise. It is a problem for which we have direct lived experience in the most recent of pasts and for which actions need to happen now.

Lack of preparation risks the lives and livelihoods of the 8 billion people on this planet, including the children and grandchildren of leaders who today could instead make a choice to protect them. This is not the time to gamble. Inaction is a dangerous political choice.

Keywords

PandemicTreaty

Geneva Health Files April-June 2024 [The GHF WRAP]

dlegge — Fri, 05 Jul 2024 06:40:25 +0000

Geneva Health Files April-June 2024 [The GHF WRAP]

02 July 2024

dlegge Fri, 05/07/2024 - 16:40

Author/s

Priti Patnaik

GHF

Geneva Health Files April-June 2024 [The GHF WRAP]

Special index page with links to over 35 editions of GHF, including a series of exclusive stories, guest essays, interviews, podcasts from the second quarter of 2024 between April and June, compiled by Sana Ali.

Group 1 'Treaty talks' comprises posts regarding the WG IHRs and the INB for a pandemic agreement. See in particular the posts regarding the politics of the Africa position and various reports regarding pathogen access and benefit sharing, financing, 'equity', and technology transfer.

Group 2 includes a range of posts, including comments on WHA77 and WHO financing (the 'investment round').

Group 3 includes a number of guest essays, including One Health and PABS in the draft pandemic agreement

Keywords

IHRs (International health regulations)

PandemicTreaty

FinancingWHO

Report of Global Health Law Committee to International Law Association Athens Conference, 25-28 June 2024

dlegge — Fri, 05 Jul 2024 03:07:46 +0000

Report of Global Health Law Committee to International Law Association Athens Conference, 25-28 June 2024

25 June 2024

dlegge Fri, 05/07/2024 - 13:07

Author/s

Global Health Law Committee

International Law Association

Report of Global Health Law Committee

1. The Kyoto Biennial Conference of the International Law Association was convened remotely as in December 2020 the COVID-19 pandemic precluded in-person gatherings. The Lisbon Biennial in July 2022 was among the first in-person events attended by many of its participants as the shadow of the pandemic dissipated. As the ILA prepares for its Athens Biennial in June 2024 the international community has largely returned to “normalcy” from a public health standpoint. Yet unfinished business from the COVID-19 pandemic remains as we seek to lay the groundwork for preventing and mitigating future pandemics. In a paradoxical sense, the COVID-19 pandemic opened a window of opportunity for governments and civil society to put in place institutional mechanisms to accomplish these objectives. Yet that window may not remain open for long. Planning and spending time to address low probability, high risk events – paradigmatically pandemics -- does not occupy a high government priority because returns on investment are uncertain, and political leaders are not likely to be credited by their constituencies for spending to address uncertainties. It may be that pandemics are today more likely to recur because boundaries between the natural environment and heavily populated cities have broken down, and transport has been facilitated. But budgets everywhere remain constrained, and before long the window of attention to pandemic preparedness may close. It is with that background that this report of the Global Health Law Committee largely focuses on the policies and legal instruments being debated and negotiated to prepare for and address future public health emergencies. In addition, the Committee recognizes that the wake of the Covid-19 pandemic may potentially create a window of opportunity for norm development and potential standard setting in the health field, beyond health emergencies.

2. The Committee decided to focus this Report on One Health, the Pandemic Agreement negotiations, and the IHR negotiations because each of these subjects is intricately linked to preventing, preparing for, mitigating, and treating potential future pandemics and similar public health emergencies. Also, a major feature of the COVID-19 pandemic was its immediate and longer-term impacts on the mental health of individuals and communities around the world. The effects are felt in the day-to-day life of individuals, and more generally they have influenced social attitudes and political conditions in ways that have not been favorable to public order, or to international peace and security. For this reason, Committee members decided to address the promotion and protection of mental health, focusing on the protection of mental health under international (human rights) law. This Report finally discusses the potential for new investments to address the social environments in which mental health disorders arise.

3. This Report falls into two principal parts. The first part (Sections II-IV) is devoted to policies and international instruments debated and negotiated at the World Health Organization (WHO) that are intended to prepare for and address future pandemics. This includes the One Health approach, negotiation of a WHO Pandemic Agreement (focusing on medical countermeasures), and amendments to the International Health Regulations (2005). Moving beyond pandemics, the second principal part of the Report (sections V-VI) addresses social and environmental determinants of mental health in the context of international human rights, with a concluding section addressing the relationship between international investment law and mental health. Finally, the Report briefly addresses the future work program of the Global Health Law Committee (Section VII).

Are pandemic treaty negotiations dividing the Africa group?

dlegge — Sat, 08 Jun 2024 22:44:17 +0000

Are pandemic treaty negotiations dividing the Africa group?

20 May 2024

dlegge Sun, 09/06/2024 - 08:44

Author/s

Jenny Lei Ravelo

Devex

Are pandemic treaty negotiations dividing the Africa group?

The last negotiations on the pandemic treaty revealed a split within the Africa group that some fear would compromise its bargaining position and undermine low- and middle-income countries' solidarity as they again engage in marathon talks this week to reach an agreement ahead of the 77th World Health Assembly.

According to sources close to the talks, a few African countries aligned with the European Union’s proposed text on pathogen access and benefit-sharing, or PABS — a multilateral arrangement that facilitates access to virus samples and genetic sequence data with pandemic potential, and lays out obligations on users to share the benefits with countries through WHO. The benefits include access to health products and monetary contributions.

Keywords

PandemicTreaty

The Pandemic Agreement: A Bridge to Nowhere or North Star to Access and Global Health Security?

dlegge — Sat, 08 Jun 2024 22:41:35 +0000

The Pandemic Agreement: A Bridge to Nowhere or North Star to Access and Global Health Security?

22 May 2024

dlegge Sun, 09/06/2024 - 08:41

Author/s

Petro Terblanche, Jerome Kim, Rajinder Suri & Padmashree Gehl Sampath, et al.

HPW

The Pandemic Agreement: A Bridge to Nowhere or North Star to Access and Global …

Sixteen leading scientists and manufacturers involved in vaccine development and production worldwide issue an urgent call for a pandemic accord that can be a ‘win-win for all.’ The full list of authors is available below.

Health misinformation was not invented during COVID-19 but was certainly brought to a higher, more malevolent and destructive pitch during the pandemic. That hostile crusade has since been (mis)directed at two landmark agreements, the Pandemic Prevention, Preparedness and Response Agreement (Pandemic Agreement), and amendments to the International Health Regulations (IHR), that are currently being negotiated by WHO’s 194 member states for approval at the World Health Assembly.

The overarching goal of ensuring that the world will deal more equitably with the next pandemic appears to be elusive as we near the deadline of May 2024 for the close of the negotiations.

Several social media and news outlets have claimed that the WHO is negotiating two instruments that will afford the agency far-reaching powers in case of a future pandemic.

Member-state led talks

While the WHO is the global custodian of human health, the WHO is not negotiating these agreements – the 194 member states are. Aside from being untrue, the false claims undermine the goals of the Pandemic Agreement and its ability to ensure that it remains centered around the key pillars of access, equity, and global health security.

Moreover, these false claims gainsay the grim facts of the COVID-19 pandemic and the lethal consequences that the lack of equitable access to life-saving medical countermeasures imposed on the greater part of the world’s population.

The Pandemic Agreement and the IHR amendments do not grant WHO far-reaching powers and do not compel member states to surrender national sovereign rights.

Rather, they seek to ensure that, by working together, the global community can ensure the health of all. The Pandemic Agreement is an important and empowering step in that direction.

Powerful instrument for for all people

The Pandemic Agreement is a powerful instrument for mankind and, while recognising that the WHO is the internationally-recognised lead agency, it is important to remember that WHO member states initiated these processes, remain the main players in the negotiations, and are themselves, not WHO, responsible for the outcome. The World Health Assembly (WHA), not WHO, decides on the content and adoption of the agreement.

It should be borne in mind that the Pandemic Agreement is NOT written for low- and middle-income countries, but for all countries to secure health security for all peoples – rich and poor. This is critical as pandemics do not stop at country borders, nor put all within a country’s population at similar risk.

Keywords

Disinformation

PandemicTreaty

Proposed legal nature of pandemic instrument risks health emergency regime fragmentation

dlegge — Sat, 08 Jun 2024 22:38:04 +0000

Proposed legal nature of pandemic instrument risks health emergency regime fragmentation

23 May 2024

dlegge Sun, 09/06/2024 - 08:38

Author/s

K M Gopakumar

TWN

Proposed legal nature of pandemic instrument risks health emergency regime frag…

The pandemic instrument as a treaty under Article 19 of the WHO Constitution raises concerns on the fragmentation of the health emergency regime, which the Intergovernmental Negotiating Body (INB) has not taken up for discussion.

The draft negotiating text and the draft resolution for its adoption proposes that the pandemic instrument would be adopted under Article 19 of the WHO Constitution as a treaty. Further, some Member States are moving towards the notion of a protocol for the Pathogen Access and Benefit Sharing (PABS) system and for the proposed instrument on One Health Approach.

Since treaty obligations would apply only after ratification, which is a sovereign decision, the result is that Member States could decide not to be part of the treaty or accompanying protocol. This would result in fragmented membership in various instruments and WHO Member States with different sets of obligations on health emergencies.

Legal instruments under the WHO Constitution

The WHO Constitution envisages two types of legal instruments. First, there are conventions or agreements also known as treaties. To date there have only been two instruments concluded under Article 19, i.e. the Framework Convention on Tobacco Control and the Protocol on Illegal Trade in Tobacco Products. Secondly, there are legal instruments that can be adopted under Article 21 and this was the pathway for the International Health Regulations 2005 (IHR 2005). The nature of legal obligations under both pathways is the same, i.e. instruments under Article 19 and 21 are legally binding.

Articles 19 and 20 of the WHO Constitution set the rules for treaty adoption and joining of a treaty respectively. Article 19 states: “The Health Assembly shall have authority to adopt conventions or agreements with respect to any matter within the competence of the Organization. A two-thirds vote of the Health Assembly shall be required for the adoption of such conventions or agreements, which shall come into force for each Member when accepted by it in accordance with its constitutional processes”.

Article 20 sets out the ratification process of a treaty: “Each Member undertakes that it will, within eighteen months after the adoption by the Health Assembly of a convention or agreement, take action relative to the acceptance of such convention or agreement. Each Member shall notify the Director-General of the action taken, and if it does not accept such convention or agreement within the time limit, it will furnish a statement of the reasons for non-acceptance. In case of acceptance, each Member agrees to make an annual report to the Director-General in accordance with Chapter XI”.

Thus, obligations of an Article 19 instrument would be applicable to WHO Member States only after ratification.

In contrast, the obligations of an instrument adopted under Article 21 automatically apply without any need for ratification. Member States who do not want to be a party under an Article 21 instruments will need to notify the WHO Director-General, and this is provided in Article 22: “Regulations adopted pursuant to Article 21 shall come into force for all Members after due notice has been given of their adoption by the Health Assembly except for such Members as may notify the Director-General of rejection or reservations within the period stated in the notice”.

Thus, obligations under an Article 21 instrument are applicable to all WHO Member States in the absence of an explicit communication to the Director-General to opt out.

Keywords

PandemicTreaty

Global health inequity persists in pandemic agreement talks, says AIDS Healthcare Foundation (AHF)

dlegge — Wed, 05 Jun 2024 01:31:33 +0000

Global health inequity persists in pandemic agreement talks, says AIDS Healthcare Foundation (AHF)

03 June 2024

dlegge Wed, 05/06/2024 - 11:31

Author/s

Guilherme Ferrari Faviero and Dr. Jorge Saavedra.

Brussels Times

Global health inequity persists in pandemic agreement talks, says AIDS Healthca…

After years of back-and-forth talks on how to best protect the world from the next pandemic disaster - World Health Organization Member States remain at a stalemate - with lower-income countries still lacking access to lifesaving health commodities and the ability to secure vital technologies and know-how during global public health emergencies - issues world leaders must rectify immediately.

As the 77th World Health Assembly (WHA) convened this year in Geneva, there was much anticipation as to the fate of the WHO Pandemic Agreement. For the last two years, Member States have been engaged in negotiations to create an agreement to prevent a repeat of the COVID-19 global health catastrophe - a human tragedy that is less about a virus and more about nationalist protectionism, corporate profit interests, and unacceptable inequity.

In December 2021, after the omicron variant was first identified by South Africa and Botswana, Member States voted to establish an Intergovernmental Negotiation Body (INB) to draft and negotiate a Pandemic Agreement. From the start, addressing equity has been a priority for countries, with calls for equity initially being made even among those countries responsible for many of the very inequities observed during the global COVID-19 response.

While initially seeming committed to being guided by noble objectives, European Union nations and the UK have since taken a stance of opposition against proposals aimed at breaking down intellectual property and other barriers to the equitable distribution of vaccines and other pandemic-related health products. This stance has caused an impasse in negotiations, and on the Friday before the assembly, it was announced that countries had failed to reach an agreement by its pre-established deadline of May 24. This, in spite of the fact that, as reported by legal scholars Alexandra Phelan and Lawrence O. Gostin, that “most of the draft treaty text was ‘greened’, meaning it was accepted by the parties".

During discussions on the INB, which took place at the WHA on Wednesday, representatives from Brazil pointed out that financing and equity are the key issues preventing the agreement. This isn’t surprising considering the stated position of powerful Western countries like Germany, whose Health Minister announced at the World Health Summit last year that an “agreement with ‘major limitations’ on intellectual property rights protection will ‘not’ fly for Germany and most of its European Union members.” This announcement was reported and described by Health Affairs, the leading journal of health policy research, as “a victory for the pharmaceutical industry, which has been lobbying hard to influence negotiations.” We agree.

Keywords

PandemicTreaty

WHO Member States Score a Win on IHR and for Multilateralism, Bag More Time to Conclude Pandemic Agreement

dlegge — Wed, 05 Jun 2024 01:25:51 +0000

WHO Member States Score a Win on IHR and for Multilateralism, Bag More Time to Conclude Pandemic Agreement

02 June 2024

dlegge Wed, 05/06/2024 - 11:25

Author/s

Priti Patnaik with Nishant Sirohi

GHF

WHO Member States Score a Win on IHR and for Multilateralism, Bag More Time to …

Member States of WHO secured a desperate win in reaching consensus on the amendments to the International Health Regulations, following more than two years of systematic and intense negotiations, culminating in an astonishing agreement in the final hours of the 77^th World Health Assembly. The consensus assumes greater significance in an otherwise difficult meeting of WHO member states this year, that was fraught with several political resolutions laced with rounds of voting among 194 countries.

Amendments to these technical rules, last revised in 2005 following the SARS outbreak, is the first significant change in international law in the aftermath of the COVID-19 pandemic that saw 20 million excess deaths. These rules have been in force since 1969, but have been amended and revised on several occasions. The latest round of the adoption of these amendments, have been targeted in nature, following negotiations on 300 proposals to amend these rules as suggested by scores of countries globally. This is also a big win for the United States, among others, who spearheaded the amendments’ process in 2021. The smallest of developing countries followed suit with bold and ambitious proposals to amend these rules.

In their statements after the adoption, several countries described the outcome of these negotiations as “momentous”, and as a testimony to multilateralism being alive in Geneva.

In this story, we look at how these negotiations unfolded during the last week in the midst of an ongoing Assembly. Negotiators who have been working on these discussions included both Geneva-based diplomats and capital-based experts – they spent days, and long hours into the nights, in drafting group sessions. See our earlier story, when a drafting group was established on May 29th. The following four days was a determined effort by all countries to get this over the finish line by around 4 p.m. on June 1, 2024.

For some delegations, it was a challenging process to finalize and agree on the amendments, while political and highly contentious discussions unfolded in the next room at the premises of the United Nations in Geneva. Some developing country diplomats hopped in to watch the voting on matters related to Palestine, and going back in, into the IHR drafting group sessions negotiating financing mechanisms among others. They not only survived, but also won on both accounts.

At the Assembly, countries also agreed to extend the mandate of the Intergovernmental Negotiating Body for another year. The INB was set up to establish a Pandemic Agreement.

Keywords

IHRs (International health regulations)

PandemicTreaty

MSF responds to the outcomes of PPR negotiations at WHA77

dlegge — Wed, 05 Jun 2024 00:39:24 +0000

MSF responds to the outcomes of PPR negotiations at WHA77

04 June 2024

dlegge Wed, 05/06/2024 - 10:39

Author/s

Dr Maria Guevara, MSF International Medical Secretary

MSF

MSF responds to the outcomes of PPR negotiations at WHA77

"MSF welcomes these new amendments to the IHR as an important first step towards addressing inequity in access to medical care and health products during global health emergencies. As a medical humanitarian organisation responding to emergencies globally, we are encouraged to see explicit recognition of the need to ensure access to health products during health emergencies, including in humanitarian settings.

“As the INB negotiation is extended for another year, we urge WHO member states to remember the clear lessons learned from the past health emergencies, from Ebola virus disease to COVID, follow the example of the IHR amendments, and complete the package of measures needed for a just framework for pandemic prevention, preparedness and response.

Keywords

PandemicTreaty

IHRs (International health regulations)

WHO Member States Score a Win on IHR and for Multilateralism, Bag More Time to Conclude Pandemic Agreement

dlegge — Tue, 04 Jun 2024 03:54:47 +0000

WHO Member States Score a Win on IHR and for Multilateralism, Bag More Time to Conclude Pandemic Agreement

02 June 2024

dlegge Tue, 04/06/2024 - 13:54

Author/s

Priti Patnaik

GHF

WHO Member States Score a Win on IHR and for Multilateralism, Bag More Time to …

Keywords

IHRs (International health regulations)

PandemicTreaty