WHA Concludes With Call For Strong WHO And Equitable Access To COVID-19 Treatments – But US Assault Casts Shadow Over Future WHA73 19/05/2020 • Elaine Ruth Fletcher & Svĕt Lustig Vijay Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window) Dr Tedros Adhanom Ghebreyesus at close of WHA With overwhelming support, the World Health Assembly (WHA) on Tuesday approved a resolution to combat the COVID-19 pandemic, which represents the strongest commitment yet from the global community to international cooperation in fighting the pandemic as well as ensuring access to COVID-19 treatments and future vaccines. The final text also called for an independent evaluation of WHO’s performance during the pandemic. The demand for the investigation of WHO has been included in a strident letter by US President Donald Trump to Director General Dr. Tedros Adhanom Ghebreyesus that issued a blunt ultimatum to WHO to undertake ‘substantive reforms’ – or permanently lose US funding. The letter, published earlier Tuesday by Trump on his personal Twitter account, was sharply critical not only of the organization, but of Tedros himself. Trump compared the current Director General’s response to COVID-19 to that of former WHO Director General Gro Harlem Brundtland, who “did not hesistate to criticize China for endangering global health” in the 2003 SARS epidemic, and had even issued a WHO travel advisory, recommending against travel to and from the disease epicentre. Even so, Dr Tedros seemed to be bolstered by the otherwise resounding endorsement he and the WHO had received from global leaders and member states over the past two days. Dressed casually, and posing for photos by the WHO flag, he responded with characteristic aplomb to the hailstorm of criticism by the US president, saying: “We welcome any initiative to strengthen global health security and to strengthen the WHO…I have been impressed and inspired [by the widespread adoption of the resolution as well as the call for an] independent and comprehensive evaluation of the international response”. He also noted pointedly that the evaluation is “not limited to the WHO” – but will also include responses by member states. In the closing moments of the abridged WHA73 session, to be resumed later in the year, world leaders including Ursula von der Leyen, President of the European Commission, Spain’s Pedro Sanchez and Colombia’s president Iván Duque Márquez, affirmed the need for multilateral cooperation, and its importance in the global health landscape, at closure of the two-day virtual WHA. “I call on the World Health Organization and all the member states to face this COVID-19 with a better sense of international cooperation in order to protect those who most need it,” said Márquez, speaking at the close of the two-day virtual Assembly: “International cooperation is our most immediate challenge…it should be a no-brainer”, added von der Leyen. “Now is the time to act. We need to fight and defeat coronavirus in all continents….we need multilateral approaches,” she said. She pointed to the EU-led Access to COVID-19 Tools Accelerator as one important start in the right direction. Earlier this month, the initiative raised some 7.5 billion Euros to speed development and improve equitable access to COVID-19 health technologies. Her call for international cooperation was also echoed by Spanish President Sanchez: “The only response to COVID-19 is a multilateral one. This epidemic has highlighted our vulnerability. This should be a moment for re renewing our strong commitment to the WHO.” At the same time, there is a need to “modernize the WHO” to ensure that it can “live up to the new challenges”, stressed von der Leyen. Other countries, including The Republic of Korea, Germany, France and The Netherlands, had already suggested yesterday that WHO member states also need to give the International Health Regulations, the binding convention governing health emergency responses, more teeth. Heads of state at the WHA on Monday (top-down, left-right): France’s Emmanuel Macron, Germany’s Angela Merkel, Switzerland’s Simonetta Sommaruga, Republic of Korea’s Moon Jae-in USA Questions Voluntary COVID-19 Patent Pool – Civil Society Argues ‘Voluntary’ Release of IP Is Not Enough Even though EU-led resolution on COVID-19 responds to US demands for an impartial investigation of WHO’s performance as well as a scientific inquiry into the source of the virus, the US disassociated from key sections of the resolution. US objections centered on clauses that endorsed countries’ rights to override patent laws as well as preserving health services, including for sexual and reproductive health, which the US said could be interpreted as supporting abortion. In a written statement, the US argued that the resolutions clauses endorsing countries’ use of legal World Trade Organization “TRIPS flexibilities” to override patents when there are urgent health needs was “unbalanced” and could disincentivize innovation and R&D, saying: “The United States recognizes the importance of access to affordable, safe, high-quality, and effective health products and the critical role that intellectual property plays in incentivizing the development of new and improved health products. However, as currently drafted, paragraphs 4, 8.2 and 9.8 send the wrong message to innovators who will be essential to the solutions the whole world needs.” While those objections had been expected, the US statement also questioned one of the resolution’s core provisions – an initiative to create a voluntary COVID-19 patent pool initiative to share rights to health technologies. The initiative, which has been widely endorsed by leaders of developed and developing countries – was launched by WHO along with Costa Rica and Chile only last week. “The United States interprets this reference as limited to voluntary mechanisms existing before the COVID-19 pandemic, not new or proposed “patent pooling” mechanisms created in response to the pandemic. It is critical that any such voluntary mechanisms as applied to COVID-19 related technologies be narrowly tailored in scope and duration to the medical needs of the current crisis,” said the statement. In the end, even the pharma industry seemed to be more enthusiastic about the resolution outcome. The International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), gave the measure an unqualified endorsement. “We must also ensure equitable global access to safe, quality, effective, and affordable COVID-19 diagnostics, therapeutics and vaccines – making sure no-one is left behind, said Thomas Cueni, IFPMA Director General in a news release on Tuesday. *Biopharmaceutical companies have publicly committed to, and are actively working with, governments, insurers, foundations and international organizations to make future COVID-19 products available and affordable to those that need them,” said the statement. “COVID-19 is cruelly driving home a tough lesson: facing any global health challenge, in particular of such unprecedented scale, requires solidarity and inclusive cooperation. I think there has been a recognition among the broader health community that the industry has reached out, is teaming up and is responding at amazing speed. But at the same time, efforts to ensure essential medicines, vaccines and diagnostics for patients with other life-threatening diseases, must continue.” Civil society actors, with WHO observer status, also lined up overwhelmingly to support the resolution – while warning that tougher measures would still be needed to put teeth in the high-minded declarations about equitable access to medicines. Some leading global health organizations also said that new COVID-19 innovations shouldn’t be restricted by patents at all. “[Member States must] guarantee that health tools are free of intellectual property restrictions…No new legal rights should be sought, and technology owners should either not enforce their existing IP or share it via non-exclusive licensing globally,” said a joint statement from Drugs for Neglected Diseases initiativeI (DNDi) and Médecins Sans Frontières. To ensure that health technologies are affordable, the public needs more transparency from the pharmaceutical sector, added Knowledge Ecology International in their statement – urging the WHO’s R&D Observatory to setup a global database to keep track of clinical trial costs, public sector subsidies and prices for COVID-19 health technologies: “The WHO R&D Observatory needs to have a database of all R&D related to the coronavirus, including information on the costs of trials, the funders and the public sector subsidies [as well as] prices for all relevant COVID 19 drugs, vaccines and diagnostic tests.” The South Centre’s, Carlos Correa went even further, saying it is time to rethink the R&D process so that it is “solely” focused on access rather than being driven by commercial interest. Image Credits: WHO / Seventy-third World Health Assembly, European Parliament, Ministry of the Presidency. Government of Spain, Korea.net / Korean Culture and Information Service (Jeon Han). 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