Unless a future pandemic ‘instrument’ is properly financed and legally binding, it will not be able to prevent health emergencies, numerous member states told the World Health Organization’s (WHO) 150th executive board meeting on Monday.

Speaking on behalf of Africa’s 47 member states, Kenya’s Dr Cleopa Mailu said there should be a “radical disruption” of the WHO’s programme budget, calling on the board to “take bold steps” to adopt recommendations that will improve the WHO’s financing place it “on a more stable footing as the lead UN agency for coordinating global health”.

The WHO secretariat has requested an increase of $480 million for the emergency programme alone, he noted.

Speaking on behalf of the European Union, France agreed that sustainable financing needs to be at the heart of strengthening the WHO. 

“We cannot ignore the chronic underfunding of the organisation, something that hampers its ability to step up to member state expectations,” said France’s Professor Jerome Salomon.

France also called for the WHO to operate with “increased efficiency through streamlined governance, accountability, and an executive board that is committed to increasing transparency and swift decision making”. 

Even Japan, which has been resistant to an increase in member states’ contributions to the WHO, stated its commitment to “strengthening sustainable financing of WHO”.

However, Japan also called for a “simultaneous in-depth conversation between member states and WHO to further strengthen its financial discipline and transparency”.

Limited changes to International Health Regulations 

In the past, some countries and civil society organisations have stressed that it would be more effective to strengthen the International Health Regulations (IHR) rather than creating a new structure.

Russia appears to favour this approach, asserting that the IHR – the only global legally binding rules that govern countries’ responses to health emergencies – “must remain the cornerstone of preparedness and response to health emergencies”.

However, the EU believes that stronger IHR will complement a new pandemic instrument. It is supporting a US-sponsored  resolution to the board that calls for limited amendments to the IHR to address “specific and clearly identified issues, challenges, including equity, technological or other developments, or gaps that could not effectively be addressed otherwise but are critical to supporting effective implementation and compliance of the IHR”.

Meanwhile, Germany welcomed the proposal from the WHO Secretariat for a Universal Periodic Review mechanism to monitor IHR implementation and compliance, describing it as a “potential game-changer”.

Negotiating a pandemic ‘instrument’

Negotiating such an international pandemic response instrument would not be easy or quick, but it was urgent and “indispensable”, Austria’s Dr Clemens Martin Auer told the board.

Austria stressed that this instrument – also called a pandemic treaty – should be “legally binding to have full impact”, and have ”strong mechanisms” to share information and technology, especially vaccines. 

But Auer stressed that, in creating such “a new global architecture, we should avoid any motion of further fragmenting the responsibilities and competencies.” 

“When it comes to deal with matters of health emergency, we don’t need additional structures, especially when we would lose inclusivity for all member states and transparency,” said Auer.

Late last year, a special session of the World Health Assembly resolved to set up an inter-governmental negotiating board (INB) to take forward these negotiations.

France’s Salomon, speaking for the EU,  said that a pandemic treaty would provide member states with a “a common roof” to organise multi-sectoral pandemic preparedness and response.

France added that the Dutch Director of International Affairs in the Ministry of Foreign Affairs would lead European negotiations at the INB. 

“The EU and its member states look forward to the establishment of the INB, and to its first meeting in February, and for the working draft to be developed and submitted before the second meeting this [European] summer,” said Salomon.

The US and Germany both supported the inclusion of civil society in pandemic instrument negotiations – something that is opposed by Russia and China.