The final reading of the Political Declaration for the United Nations High-Level Meeting on Pandemic Prevention, Preparedness and Response (PPPR) is scheduled for Tuesday in New York – and while the revised text has a few more practical clauses than the bland zero-draft, it remains more aspirational than actionable.

The draft Political Declaration, which has been shared with Health Policy Watch, puts “equitable, people-centered and community-based” primary health care at the centre of countries’ pandemic mitigation.

There are five sections to the “call to action”: equity, global governance, leadership and accountability, health, and financing and investment.

In terms of equity, the declaration commits to strengthening “research and development capacity in developing countries” funded by “greater official development assistance”, surge financing and other “innovative financing”.

Strongest language for medical supply

The strongest language in the declaration calls on member states to “ensure the supply and distribution of sustainable, fair, equitable, effective, efficient, quality, safe, affordable and essential medicines, including generics, vaccines, diagnostics and other health technologies and innovation”.

Some of the “how” to achieve this involves the transfer of technology and know-how “within the framework of relevant multilateral agreements”; voluntary licensing – although confined to cases where public funding has been invested in research and development;  and strengthening “local and regional capacities for the manufacturing, regulation and procurement”.

Emergency trade measures designed to tackle pandemics should be “targeted, proportionate, transparent, temporary”. In addition, they should not “create barriers to trade or disrupt global and regional supply chains”. 

India’s decision to refuse to allow locally manufactured generic COVID-19 vaccines to leave its borders at the height of the pandemic – effectively stopping the only vaccine supply COVID-19 vaccine access platform COVAX had lined up for developing countries – would be antithetical to these clauses.

Manufacturing capacities should be “diversified” across regions and ‘facilitate the movement of medical and public health goods, especially during pandemics and other health emergencies among and within countries”.

The declaration also stresses the need to address the current global pandemics of HIV, tuberculosis and malaria, as well as tackling antimicrobial resistance – a potential pandemic source.  

One contentious clause 

The declaration will be adopted at the High-Level Meeting on 20 September which is aimed at “political mobilisation” for PPPR, but the draft is being finalised in two days of informal consultations on Monday and Tuesday. After Tuesday, the declaration goes into “silence procedure” – that is no more discussion – under the HLM. 

By Monday, the one clause that was still contentious called for “the importance of refraining from promulgating and applying any unilateral economic, financial or trade measures not in accordance with international law and the Charter of the United Nations that impede the full achievement of universal health coverage, particularly in developing countries”.

China, Russia, Pakistan, Cuba and others support this clause but the US, European Union and others want it removed.

The HLM will be “aligned and informed” by the ongoing World Health Organization (WHO) negotiations on the pandemic accord and the changes to the International Health Regulations (IHR), according to the declaration.

Another pandemic HLM will be convened in 2026 “to undertake a comprehensive review of the implementation of the present declaration” – a far cry from the establishment of an international oversight body proposed by the Independent Panel.

Meanwhile, Monday saw the conclusion of the joint plenary meeting of the WHO Intergovernmental Negotiating Body (INB) negotiating a pandemic accord, and the Working Group on the International Health Regulations (WGIHR), which is amending the globally binding regulations relating to public health emergencies.

The WGIHR continues meeting for the remainder of the week, as the two negotiation processes accelerate ahead of the looking summer vacation in the northern hemisphere.

Image Credits: UN Photo/Manuel Elias.