Independent Panel Co-Chairs Blast Slow Pace of Pandemic Reforms – Call for UN Summit After Next Week’s Special World Health Assembly Pandemics & Emergencies 22/11/2021 • Elaine Ruth Fletcher 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 print (Opens in new window) Former Liberian President Ellen Johnson Sirleaf (left) and Former New Zealand Prime Minister Helen Clark (right), co-chairs of The Independent Panel Six months after publication of their landmark report, Make it the Last Pandemic, the co-chairs of Independent Panel have re-entered the political fray over the slow pace of urgently needed reforms to vaccine equity, pandemic finance and countries’ legal obligations – that they say are required to end the COVID-19 pandemic and head off the next disaster. In a progress report dubbed “Losing Time: End this Pandemic and Secure the Future” former New Zealand Prime Minister Helen Clark and Liberia’s President Ellen Johnson Sirleaf issued a sharp call for the UN General Assembly to convene a summit of heads of state, following next week’s World Health Assembly special session on a pandemic treaty. The UNGA summit is needed to come up with “an ambitious and forthright declaration of the United Nations General Assembly..[to] tackle issues of equity, leadership and accountability, governance and financing,” according to their new report, launched Monday. “Two years after the first appearance of the novel coronavirus, the world still isn’t getting a lot of things right or moving fast enough,” declared former Clark, co-chair of the now disbanded “Independent Panel”, in a Chatham House briefing Monday. And unless countries can muster the will to “seize the moment”, the world risks being just as poorly prepared for the next pandemic, she warned. Clark called for the world to “put it’s feet on the accelerator to negotiate new legal instruments at the World Health Assembly next week” and to “get cracking” on a special United Nations GA summit to set out a broader “roadmap” for pandemic finance and greater vaccine equity. Ellen Johnson Sirleaf, at Chatham House event “In the past six months 90 million more people have contracted COVID-19 and more than 1.6 million people have died. Those are only the reported cases,” added Johnson Sirleaf, the report’s co-author. “Waves of disease and death continue. Resolve [on] protective measures is waning. Vaccine coverage is uneven – people in the poorest countries still have almost no access to vaccines at all. The world is losing vital time against a virus that continues .. when we don’t work urgently together. ‘Absurd situation’ – rich countries protest vaccine mandates and poor countries can’t get jabs Top left clockwise: Chatham House moderator Robert Yates, Helen Clark, UK MP David Miliband and South African special advisor Zane Dangor at report launch event. Rising street protests in Europe over new pandemic restrictions, illustrates the “comprehensive global failure” of the world to conquer the virus so far, observed United Kingdom MP David Miliband, CEO of the International Rescue Committee. “We’re in the absurd situation of countries in Europe returning to lock down because of an anti-vaccination movement, at a time where the countries where we work have vaccination rates of under 5%,” said Miliband, who also appeared at the report launch, hosted by the United Kingdom’s Chatham House think tank. Key actions needed…. now Helen Clark, co-chair, The Independent Panel In the briefing, Clark and co-chair Johnson-Sirleaf, recapped the headlines for jump-starting the sweeping reforms still needed, including: A new “legal instrument” governing states’ obligations in disease outbreak alerts and authorizing WHO to visit countries to investigate and report on outbreaks of concern – with “visa ready authorizations”; Creation of a Global Health Threats Council, operating under the joint auspices of the UNGA and G-20; Creation of a sustainable finance mechanism for a $10 billion global pandemic preparedness facility and a $100 billion emergency fund – linked to either the new Global Health Threats Council, global financial institutions like the World Bank, or both; Immediate action on vaccine equity, including faster redistribution of rich countries’ vaccine surpluses and approval of a waiver on World Trade Organization intellectual property and trade secrets rules – particularly in the absence of sufficient voluntary action to voluntarily expand vaccine manufacture. Hopes UNGA Summit and World Health Assembly special session will accelerate pace Clark expressed cautious optimism that a UN GA special session on a political “road map” might occur before the end of the year. That, along with the special World Health Assembly session on the pandemic treaty, could help accelerate the pace of action, she said. “The President of the General Assembly has made it clear that leadership to confront the COVID-19 pandemic must be at the top of the Assembly’s priorities in this year’s session,” concludes the report. “He has signalled his intention to call a high-level thematic debate on vaccine equity with leading experts and world leaders for early in 2022, with the commitment of all states at the highest level”. I’m quite optimistic that there will be a special session of the UN General Assembly,” said Clark at the Chatham House briefing. Next week’s WHA Special Session, meanwhile, will be a moment of decision on whether WHO member states move ahead on a new Pandemic Treaty – or focus on reforms to the existing International Health Regulations (IHR) that now govern WHO member states’ emergency response. Clark said she was optimistic that the WHA would indeed agree to move toward a new “legal instrument” such as a convention or a treaty – adding “just don’t take too long about it.” She said that the IHR lacks the teeth required for WHO and its member states to rapidly and clearly respond to an outbreak – let alone address longer-term issues, such as vaccine finance, supply and equity. “One of the key gaps [in the existing IHRs] is being very clear about responsibilities and member states, and powers of WHO,” she said, adding that she was seeing “traction” around the concept of a “notification protocol,” outlining “what are the responsibilities of states and how is an international organization to respond?”. “It [WHO] needs, in our Panel’s view, enough power to access the site of an outbreak immediately, no questions asked – with standing visas,” she said, pointing to the findings of the original Independent Panel report, released in May 2021. “It needs to be able to publish the information that it gets without seeking country permission. It clearly needs to be empowered to act and the precautionary fashion where you have a respiratory pathogen on the move.” While, in theory, the IHR could be revised to accommodate those concerns, “The whole IHR process doesn’t give WHO the power or the authority to act in a concerted and very decisive way. “We felt that a Framework Convention could spell out more the responsibilities of Member States and international organizations. It could fill gaps in the existing legal framework.” Building a broader legal framework for vaccine equity & finance over time Expected Vaccine Supply at End-2021 (% of Total Population): Most of sub-saharan Africa, and parts of Asia, would only reach 10-20% vaccine coverage – at most – as compared to the 40% WHO goal. Clark said that she would, however, recommend keep any new treaty or convention within a “narrower” scope at the beginning, leaving space to broaden the mandate over time. “Rather than trying to negotiate very broad, initially, I think I would focus on some of the key gaps,” she said. However, as a “Framework Convention”, the new legal instrument could be built out with “more protocols” over time to refer to issues that could never be covered by the IHR, such as vaccine distribution and equity: : “It’s possible, for example, that you could, in such a convention, refer to financing mechanisms, oversight councils, the design of the global public goods platform for supply of goods and therapeutics,” said Clark. Rejects idea that treaty could take years to approve Clark rejected the claims of some critics who have said that such a treaty could take years for a large number of states to approve and ratify. She pointed to the Convention on Early Notification of a Nuclear Accident, adopted by UN member states at a September 1986 meeting of the International Atomic Energy Agency just five months after the April 1986 Chernobyl nuclear disaster, as evidence that countries can move rapidly on treaties when they wish. The treaty was also ratified by the then-Soviet Union – the country responsible for the accident. “The old saying where there’s a will there’s a way. Post Chernobyl, still in the Cold War period, member states of the UN agreed to two new global conventions within five months of nuclear safety. And when we look at that, we think what is wrong with the international community now? Here we are with a pandemic which is a threat to the health of every human being, and they don’t act with the same alacrity.” But a splintering of the pandemic debate also has impeded progress on the wide range of issues that need to be addressed – from finance, to vaccine equity and distribution to early warning systems, she and other panel members added. Too many groups are haggling over the grammar and syntax of texts, rather than their essence. Voluntary IP Transfer – or IP Waiver ? Airfinity’s COVID Vaccines Revenue Forecasting predicts 545 million Covaxin doses to be sold to low-middle-income countries in 2022. The new report also comes out in favor of an IP waiver on vaccine IP and know-how, not only for this pandemic: “Global health cannot be left hostage to a pharmaceutical industry which buys up patents and develops them in the interest of making profits. They say that the development of a true end-to-end global public goods model remains the answer,” state the co-authors. At the briefing sessions, those recommendations were couched in reflections over the failure of voluntary actions so far. For instance, voluntary vaccine license deals that have so far been reached have been primarily bilateral arrangements, rather than through multilateral groups like the MedicinesPatentsPool – which also limits their effectiveness, said Zane Dangor, special advisor to South Africa’s Minister of International Relations and Cooperation, also appearing at the Chatham House event. “If voluntary tech transfer is not possible, then we should move with speed with discussions on the WTO IP waiver,” said Dangor said. Clark added that there should be a permanent IP waiver mechanism that automatically kicks in during a pandemic. “We have the tools to fight this pandemic & they are systematically being denied to a significant proportion of the world’s people. We need some kind of trigger, when there’s a disease outbreak at scale.” More immediately, she appealed to wealthy countries to speed up the redistribution of surplus vaccines saying: “We get pledges, but they are always ‘not this month, not next month, but next year,’ ” she pointed out, noting that meanwhile: “We have wealthy countries like the UK, which is throwing vaccines down the drain now. If they had better planning at home, they could have released the surplus doses into countries that can’t get their hands on any at all. “We have to scale up manufacturing, with manufacturing countries exerting the levers that they can on the pharma industry,” Clark added. IFPMA says real problem is not IP but ‘political will’ for dose-sharing Vaccine dose-sharing promises by rich countries against actual deliveries, as of November 2021. In a response, James Anderson, executive director of global health for the International Pharmaceutical Manufactureres and Associations, said that “political will” in high-income countries to redistribute doses faster and more equitably is the real problem. “We’ve seen a historic manufacturing scale-up. By end of this year, vaccine manufacturing output will reach 12 billion doses. By the middle of 2022, it is estimated to reach 24 billion doses,” he said. “Vaccine manufacturers are sharing their know-how: to date, 329 manufacturing and production agreements are helping scale up COVID-19 vaccines production in volumes never seen before. There are enough supplies, what’s needed is the political will to redistribute them fast and redouble the focus on dose sharing and country readiness. “We also acknowledge that much more needs to be done to ensure equitable and fair distribution and access of pandemic products around the world and are committed to playing our part… “But in so doing, we should not throw the baby out with the bathwater… We need to build on what has worked: first, immediate, unhindered pathogen sharing; second, an IP-backed innovation eco-system that enable R&D and technology transfer and voluntary licensing; third, the contributions of the leading global regulatory authorities who have streamlined their processes and allowing fast access to safe and effective COVID products.” Image Credits: @TheIndPanel, https://covid19globaltracker.org/, Airfinity, @Airfinity/BBC . 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