Members of the Intergovernmental Negotiating Body (INB) face another sleep-deprived week as talks on the World Health Organization’s (WHO) pandemic agreement resumed on Monday and run until Friday.

There are many outstanding articles and little prospect that the agreement will be completed in time for the World Health Assembly (WHA) next week, but participants hope that the broad outlines of the agreement and the way forward will have been reached by Friday.

Whatever agreement is reached needs to be tabled at the WHA, which will decide on the way forward.

There is already a proposal on the table for two key and complex aspects of the pandemic agreement –  One Health and a pathogen access and benefit-sharing (PABS) system – to be decided on by 2026.

INB co-chairs told reporters after what was supposed to be the last meeting on 10 May that member states were finally entering into the give-and-take spirit of talks after two years of little compromise.

“The closer you get to the endpoint, the more willingness there is to move. We worked very hard and deep into the night, but there’s just so much so many issues that we need to agree upon and which are sometimes very technical or political,” said INB co-chair Roland Driece.

“I think this is the last mile,” added co-chair Precious Matsoso, who said that One Health, PABS, intellectual property and human resources had preoccupied delegates.

This week’s agenda (see below) is focused on the key articles on which there is not yet agreement:

Common definitions

At least part of Monday’s talks, on definitions, will be helped by the agreements reached by the Working Group on amendments to the International Health Regulations (WGIHR). The IHR and the pandemic agreement will use the same definitions.

The WGIHR worked until the early hours of Saturday morning, agreeing “in principle on a large, ground-breaking package of amendments” to the IHR, according a media statement from  WHO.

“These amendments build on over 300 proposals made by countries in the wake of the COVID-19 pandemic. They set out to improve the ability of countries to prepare for, detect and respond to Public Health Emergencies of International Concern (PHEICs), and will be part of a package to be put forward to the World Health Assembly (WHA),” 

WGIHR members are due to meet again this week to “wrap up their work on the few remaining issues that need to be finalised”, according to WHO.

A few disagreements on technology transfer and finances prevented the end of the process, according to sources.

WGIHR co-chair Ashley Bloomfield still hopes to reach an agreement on what to present to WHA, but it’s hard to imagine when his committee will have much time as many are also on the INB.

‘Robust’ IHR amendments

“Amending the International Health Regulations reflects the critical need to bolster our collective defences against current and future public health risks, all whilst firmly adhering to the principle of national sovereignty and respecting equity,” said WGIHR co-chair, Dr Abdullah Assiri.

“We have coalesced around a robust set of amendments which will make international cooperation more effective and easier to implement.”

The IHR were first adopted by the World Health Assembly in 1969 and last revised in 2005, to manage public health outbreaks and emergencies. All 194 WHO Member States plus Liechtenstein and the Holy See are party to the IHR. 

“The International Health Regulations have served the world well for nearly 20 years but our collective experience in using this vital tool for the management of multiple public health emergencies, including the COVID-19 pandemic, has demonstrated important areas in which they could be strengthened for the benefit of all 196 State Parties,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. 

“Countries have come together around improved international mechanisms to protect every person in the world and future generations from the impact of epidemics and pandemics, with a commitment to equity and solidarity.”

Amending the IHR and developing a pandemic agreement are complementary processes.

“The IHR focuses on building countries’ capacities to detect and respond to public health events which could take on international dimensions, whilst the draft pandemic accord focuses on a coordinated international response to pandemics, with equitable access to vaccines, therapeutics and diagnostics at the centre,” according to the WHO.

Image Credits: WHO.