GENEVA – A powerful lobby, including the US, Germany and New Zealand, are pushing for the amendments to the International Health Regulations (IHR) to be adopted by the close of the World Health Assembly (WHA) on Saturday. 

Weaknesses in the IHR, the only global rules guiding countries’ conduct in international public health emergencies, were exposed during the pandemic, prompting a two-year process to amend them.

Agreement is close, with some outstanding issues particularly on definitions, according to the report on the IHR negotiations to the WHA by World Health Organization (WHO) Director-General Dr Tedros Adhanom Ghebreyesus.

“My appeal here is let us focus on the IHR so we have this success as this is already providing much better protection for the world,” said Germany’s Health Minister Karl Lauterbach. 

Strong positive signal

The European Union (EU) echoed this sentiment, describing progress on IHR amendments as “remarkable”.

“The adoption of these amendments within the very short timeframe of only two years will send a very positive signal to the outside world about the ability of the WHO and its membership to take concrete action to improve the global health architecture,” said the EU.

“Such adoption will also send very positive signal for the future of the INB [Intergovernmental Negotiating Body] process.”

The INB was charged with negotiating a pandemic agreement but member states have failed to reach agreement by the WHA deadline. The most recent pandemic agreement draft shows significant areas of disagreement remain.

The EU acknowledged that some IHR amendments still need to be resolved and urged all partners to “redouble efforts” to finalise the work and adopt the changes by 1 June.

Dr Ashley Bloomfield, co-chair of the Working Group on amendments to the IHR, told the WHA that the committee is “very close to completing an agreed package of amendments”.

“There is both momentum and an aspiration among states parties to complete the task,” said Bloomfield. “Adopting a package of IHR amendments during this assembly would be a significant milestone and achievement and we believe in a very important stepping stone to successfully concluding the pandemic agreement negotiations later.”

France, Indonesia, Kenya, New Zealand and Saudi Arabia have prepared a resolution to adopt the IHR amendments in anticipation of agreement being reached in the next few days.

Pandemic agreement process unclear

It is unclear whether the African region will support completing the IHR amendments this week if its demand for the speedy conclusion of the pandemic agreement by the end of this year is not accepted.

At a packed WHA meeting of Committee A on Tuesday afternoon, there was intense discussion and some disagreements over the way forward for the INB process on a pandemic agreement.

First off, there were two resolutions on the floor, one from the 47 WHO African member states and another from a group of countries that have often played a conciliatory role in talks – Australia, Brunei, Canada, Norway and Pakistan.

Both spoke to the time frames for further talks, while the second resolution called for a new structure to take forward the pandemic agreement negotiations.

Expressing disappointment on behalf of the African region that a pandemic agreement was not agreed on, South Africa’s Ambassador Mxolisi Nkosi called for negotiations to be completed by the end of this year, followed by a special WHA.

Botswana expressed its support for the speedy resolution of the IHR during the session, but Kenya – on behalf of the Africa region – linked the IHR amendments and the pandemic agreement, and simply said the region was ready to reach consensus.

However, US Ambassador Pamela Hamamoto called for an extension of “one to two years”, explaining that “fundamental differences remain on core issues central to the agreement”.

She described these differences as “complex technical issues that require extensive deliberation and carefully crafted workable solutions, inspired by a common vision and supported by all member states”.

Ironically, if Donald Trump wins the US presidential election at the end of the year, his administration is unlikely to support the pandemic negotiations – or even the WHO.

The WHA’s Committee A resolved that a single drafting group co-chaired by one INB member and one WGIHR member, will convene on Wednesday morning. It will be open to all member states and its task will be to consider all three draft resolutions and propose a process for adopting the IHR amendments and the timing, format and process to conclude the pandemic agreement.

These proposals will have to be submitted to the WHA as the mandates for both the WGIHR and the INB have expired.