Tedros’ 10-Point Proposal for Reforming Global Emergency Response Gets Mixed Review 
‘Cautioning that the Secretariat not to get ahead of member states:’ Loyce Pace, US Assistant Secretary of State for Global Affairs in debate over WHO reform proposal.

A new 10-point proposal by the World Health Organization’s Director General Dr Tedros Adhanom Ghebreyesus for improving preparedness and response to health emergencies received mixed reviews from WHO member states in Monday’s opening session of this week’s Executive Board (EB) meeting, the agency’s 34-member governing body. 

It was the first substantive issue to be tackled in the eight-day long EB meeting packed with an agenda of over 50 draft proposals and resolutions on items ranging from emergency pareparedness and response to non-communicable diseases. Charged management issues, ranging from sustainable finance to the organization’s handline of recent sexual harrassment claims will also be taken up by the EB.

The Director General’s 10-point proposal on “strengthening the global architecture for health emergency preparedness, response and resilience” calls for the creation of a new WHO Global Health Emergency Council, which would aim to liaise more efficiently between WHO’s Secretariat and its Member states in health emergencies and outbreaks, and meet during the World Health Assembly. 

The proposal also calls for massively expanding the size and scope of a  WHO Contingency Fund for Emergencies (CFE) to include broad support to member states’  “including deployments through the health emergency workforce and emergency supply chain” of medical products.

And the initiative calls for scaling up a system of member state peer reviews of emergency preparedness to increase “transparency”.  

The WHO proposal synthesizes more than 300 recommendations of several independent panels that reviewed WHO and member state response to the COVID pandemic, the report stated.

Initiative raises fears of ‘duplication’, moving ahead of member state negotiations

While member states gave positive reviews to the WHO proposal’s overall aims  – ensuring more fair, equitable and transparent management of crises – they stressed that concrete reforms are already the focus of two member state fora – and that’s where the discussion should focus. Those include the Intergovernmental Negotiating Board (INB) due to issue a zero draft for a proposed pandemic treaty later this week, as well as another member state working group that will look at more targeted revisions to the circa 2005 International Health Regulations (IHR), the rules currently governing emergency response.   

Japan joins the UK, USA and China in rare accord that member states should hold reins of emergencies reform wheel at the WHO Executive Board meeting Monday.

In a moment of rare agreement between often rival nations – the United Kingdom, China and Japan all expressed hesitations over the creation of a new WHO “Global Health Emergencies Council”, proposed by Tedros, ad meeting during the annual member state World Health Assembly. 

The UK said it “echoed China’s concerns about being careful about creating new institutions and mechanisms” which might duplicate the work of other bodies. 

“I think the risk is that there are multiple mechanisms already,” the UK’s EB delegate said, asking. “Do adding new mechanisms add, or do they actually make it more complicated to navigate?”

Japan, meanwhile, asked whether it was feasible to create yet another body that convenes during the already packed week-long session of the WHA “unless we have a clear idea of what will be discussed and decided by the council.

“Who will be preparing the materials for discussion?” Japan’s EB delegate asked wondering “whether a schedule [of meetings during the WHA] is feasible since we already have Committees A and B?” He was referring to the two main WHA sub-committees in which proposals are debated and decided during the WHA session.  

Meanwhile, the USA warned against the WHO administration “getting ahead” of member states’ own negotiations over a new Pandemic Treaty, or accord. Those discussions, led by the INB, are already taking up most of the same topics that the WHO Secretariat paper covers, said Loyce Pace, US Assistant Secretary of State for Global Public Affairs.  A ‘Zero Draft’ of the pandemic treaty framework is due to be published on Wednesday.  

“We’re grateful that they have a proposal that draws attention to those negotiations. But we’re still cautioning that the Secretariat not to get ahead of member states in terms of putting forth an architecture that hasn’t yet been agreed, and that would arguably require approval from member states and buy-in from relevant international institutions so they could be operationalized,” Pace said. 

Ensuring equity as a cross-cutting principle 

Echoing Brazil Peru says ‘fairness’ needs to be the foundation of reforms.

Brazil, likewise, said that the essence of proposals brought forward in document by Tedros and the WHO adminisration is already being debated in the INB and the IHR working groups.   

“The difference is that this process has been developed in a much more transparent and inclusive way, with clear participation by non-state actors,” said the Brazilian delegate. 

“Both of these work streams are entering a critical phase this year. Now it’s the time to concentrate our effort to have meaningful debates within those two mechanisms in order to come up with innovative, game changing norms.”

He called for the WHO administration proposal to be referred to the IHR and pandemic treaty negotiating bodies “where they can be discussed and fully developed.”

Brazil also said that proposals to change the way global emergency response unfolds need to include equitable access to medical countermeasures as a cross-cutting theme, along with “respect and promotion of human rights and racial and gender equity.”

Echoing Brazil, Peru added that, “one of the pillars of global architecture when it comes to preparedness and resilience in the face of future health emergencies has to be the principle of fairness.”

Revisions to the existing International Health Regulations as well as a new pandemic accord should “allow for a universal universal access to measures such as vaccines, without any privileges or discrimination, and will face challenge questions related to R&D, intellectual property technology transfers, and expanding the manufacturing capacities at the local level …in the context of emergencies,” added the Peruvian EB delegate. 

African Group – more WHO and donor support to countries   

Equitable access to health products and more support for WHO country offices – Ethiopia speaks on behalf of the African group of 47 countries at the 152nd session of the WHO Executive Board

Meanwhile, Ethiopia, speaking on behalf of the African group of 47 states stressed that in a time when many countries in the region are facing a complex array of climate-related and infectious disease health emergencies, “less than 10% of African countries have adequate human resources with technical emergency know how to prepare, detect and respond to emergencies.” 

There is also a “large reliance on international funding due to limited capacity to mobilize sustainable and predictable resources domestically.”

She called for “stronger support of the WHO country offices in strengthening the IHR capacities,” as part of the solution as well as underlining the importance of “greater coordination across the funding landscape to ensure that existing funding flows are ….targeted to the most critical gaps at the global regional and national level. And that this role should be augmented by additional catalytic gap funding.

She also called for a greater role for African representation in the new World Bank -managed pandemic fund, and other governance mechanisms. 

“We would also appreciate a greater focus on equitable access to health products, technologies and know-how, and as such, funding and capacity incentives for states to report information to the international community to be further explored. 

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