Appeal for Pandemic Treaty, More Resources and Vaccine Equity Close World Health Assembly
Dr Tedros Adhanom Ghebreyesus, WHO Director General, giving his closing remarks at the 74th World Health Assembly.

The 74th World Health Assembly (WHA) closed on Monday with appeals for vaccine equity, more resources for the World Health Organization (WHO) and support for a “pandemic treaty” to combat future pathogens.

WHO Director General Dr Tedros Adhanom Ghebreyesus devoted much of his concluding speech to the global body’s dearth of finances and the importance of the proposed pandemic treaty to put more teeth into international health rules around outbreak responses. Member states agreed at the WHA session that the proposed treaty would be discussed in detail at a special WHA session at the end of November.

Despite member countries’ praise for the global body’s support, Tedros said bluntly:  “We cannot pay people with praise”, adding that many of their experts were on short contracts as the WHO struggled to maintain its current level of pandemic response.

“The message that a strong WHO needs to be properly financed has been amplified by all the expert reviews that reported to this Assembly,” said Tedros, adding that the WHO Working Group on Sustainable Finance was charting a way forward to address this.

“The one recommendation that I believe will do the most to strengthen both WHO and global health security is the recommendation for a treaty on pandemic preparedness and response,” said Tedros. “That could also improve the relationship between member states, and foster cooperation.”

For Tedros, such a treaty would be a “a generational commitment that outlives budgetary cycles, election cycles and media cycles”.

Pathogens have More Power than WHO – And Globe has a “Temperature”

The current pandemic had been characterised by a lack of sharing and a lack of global accountability, he added.

“At present, pathogens have greater power than WHO. They are emerging more frequently in a planet out of balance. They exploit our interconnectedness and expose our inequities and divisions,” Tedros stressed.

“A treaty would foster improved sharing, trust and accountability, and provide the solid foundation on which to build other mechanisms for global health security,” said Tedros, including research and innovation, early warning, stockpiling and production of pandemic supplies – and equitable access to vaccines, tests and treatments.

Referring to a visit Saturday to WHO by a group of health and climate activists DoctorsXR   the WHO Director General also noted how the climate crisis has become interwoven with the pandemic as another risk to humanity whose signals need to be heeded now. 

“Our human health is very much similar to Planet health,” he noted,  “As you know, in human health, 37 ℃ is healthy. If you add 2 degrees, which is 39 ℃, you’re sick. If you add another 2 ℃, then you are at 41, and in  danger. And then if you add more and it’s 37 ℃ plus 5℃, that’s too late. 

“And for the planet it’s the same thing.  So we need to take care of ourselves and our planet. And the recommendations they have made are: 1)  focus on preventive rather than curative care; 2) promote a more sober and equitable medicine; 3) develop environmentally-friendly healthy structures, and 4) focus on community based care and support.

“Five, respect the natural environment; 6) organize information and education, and 7)  involve the population and patients in strategic decisions. And in all that leadership is key and this is a message to you which they asked me to pass to all member states.”

Debates over TRIPS Waiver, Virus Origins Investigation and Pandemic Treaty End in Whispers  

The WHA had the longest agenda in its history, and adopted over 30 resolutions, including new initiatives to promote local production of medicines; prevent and reduce non-communicable diseases;  expand access to services for the treatment of diabetes, disabilities and eye care.

It also considered reports from three different bodies – the Independent Oversight and Advisory Committee (IAOC), the Independent Panel for Pandemic Preparedness and Response (IPPR), and the International Health Regulations Review Committee (IHRC) – which revealed the WHO weaknesses in dealing COVID-19 and how to address these.

Despite the roaring debates that occurred on the Assembly’s margins, member states clearly sought to end the packed 8-day long meeting on a note of accord – if not exactly consensus. 

Disagreements over an IP waiver to spur vaccine protection or the future direction of the WHO-led investigation into the SARS-CoV-2 origins did not break out again onto the plenary floor, as could have occurred in the closing hours of the assembly.  

Rather, member states seemed happy to let the IP waiver debate move back to its natural arena in the World Trade Organization forum, which is set to meet on the issue once more next Monday – although chances for progress remain dim in light of continued European opposition.  

A key resolution of this WHA, “Strengthening WHO Preparedness for and Response to Health Emergencies, received final approval on Monday without objections – even though scientific critics and member states had complained that the already nuanced text touching on the investigation into the SARS-CoV2 origins had been weakened further during the course of negotiations. 

A terse statement by one of the leading critics of the investigation so far, the United States, seemed to throw the ball back into the court of Dr Tedros once more.  

“We call for a timely, transparent, evidence-based, and expert-led Phase 2 study, including in the People’s Republic of China,” said the US statement.

“It is critical that China provides independent experts full access to complete, original data and samples relevant to understanding the source of the virus and the early stages of the pandemic. We appreciate the WHO’s stated commitment to move forward with Phase 2 of the COVID-19 origins study, and look forward to an update from Director General Tedros.”

But President Joe Biden was not taking any chances either.  As the WHA session was in full swing, Biden announced the launch of a US investigation into one key element of the controversy –  whether the virus more likely first infected humans via contact with the pathogen in a wild animal or food-borne source – or via a biosafety accident at the Wuhan Virology Institute, that was studying bat-borne coronaviruses at the time the Wuhan outbreak first began.  

Member States Describe Pandemic Challenges and Successes 

Malaysian Prime Minister Tan Sri Muhyiddin Yassin

Instead of touching on those sensitive nerves, leaders of member states addressing the closing plenary talked about the struggles that they still faced to contain the pandemic – as well as the qualified successes that some countries had seen. 

Malaysian Prime Minister Tan Sri Muhyiddin Yassin said his country was experiencing another surge in infections – but it had only secured 6% of the 53 million vaccines it needed to protect its citizens.

“Vaccine equity is still a major issue and we cannot win this war against the virus unless everyone has equal and rapid access to vaccines,” said Yassin, expressing his country’s support for the proposed TRIPS waiver of intellectual property on COVID-19 related products.

Argentina’s President Alberto Fernández said that his country was “going through very, very difficult times… the worst time of the pandemic”.

“We’ve got, say, a dozen countries who can produce vaccines and have managed not only to produce but to purchase about 90% of them. Everyone else has had to go searching for the vaccines in order to try and get sufficient quantities to vaccinate our people. Solidarity there has been fairly non-existent,” he said.

Fernández described the ongoing economic blockade of Cuba and Venezuela during the pandemic as “obscene”, and called for it to be lifted alongside the lifting of patents on vaccines. Cuba is reportedly in advanced stages of R&D into an indigenous COVID-19 vaccine which could be relevant for its Latin American neighbours unable to readily access sufficient supplies from the big producers in US, Europe, India, China or Rusia. 

Bhutan’s Success Mitigated by Vaccine Scarcity 

Bhutan’s Prime Minister, Lotay Tshering

On a brighter side, Azerbaijan President Iham Aliyer said that the country had vaccinated two million people – 20% of its population – mostly using the Sinovac vaccine, and would be removing most pandemic restrictions by 1 June. 

Buthan’s Prime Minister, Lotay Tshering, talked about how the tiny country had been able to vaccine 90% of its population thanks to AstraZeneca vaccines donated by India – and that had, in turn, kept the pandemic at bay.

But he expressed doubts about “how long” the reprieve would last, if Bhutan is unable to get people their second doses because of the huge surge seen in Indian cases since. 

Afghanistan President Mohammed Ashraf Gani was meanwhile critical of “UN agencies” which had neither been able to deliver the oxygen they had promised nor “offer us timely policy advice”.

In contrast, he said, “India showed us exceptional solidarity by giving us 650,000 vaccine doses” which had enabled the country, currently in its third wave, to vaccinate its most vulnerable people.

  • Elaine Ruth Fletcher contributed to this story.



Image Credits: WHO.

Combat the infodemic in health information and support health policy reporting from the global South. Our growing network of journalists in Africa, Asia, Geneva and New York connect the dots between regional realities and the big global debates, with evidence-based, open access news and analysis. To make a personal or organisational contribution click here on PayPal.