US Eager to Move Ahead with Pandemic Accord that Promotes Equity but not ‘Transactional’ Linkage between Data and Benefit-Sharing
Pamela Hamamoto, lead US negotiator on the WHO pandemic accord, in Geneva this week.

The United States, once a reluctant partner in the initiative for a new global pandemic accord, is now keen to move ahead in negotiations over an agreement. The accord would expedite more rapid global data sharing and response to looming threats as well as ensuring greater equity in access to medicines and treatments, said the lead US negotiator of the instrument, Pamela Hamamoto on Friday.

But Washington would like to avoid what she described as “transactional” language directly linking the two issues, as some developing nations have suggested.  Nations like South Africa, for instance, cite bitter experiences with rapid, transparent sharing of genetic data on new SARS2 variants, which did nothing to improve the country’s access to badly-needed COVID medicines or vaccines.

“Overall, the concept of equity, as I said, is very important. And it is certainly something that the United States is committed to to helping work on that and improve… the availability of medical countermeasures broadly speaking, going forward,” Hamamoto said. But in terms of a direct “linkage between the access and benefit sharing… I actually don’t necessarily think that that linkage is that helpful,” she said.

“We’re also very interested in you know, as are others, in the rapid transparent sharing of data,” she said, adding, “what I hope is that… the sort of transactional nature of that concept doesn’t hamper us in being aspirational in our thinking, how we approach this and move forward.”

Hamamoto was speaking in Geneva Friday along with Loyce Pace, US Assistant Secretary for Global Affairs, after a week of closed-door meetings with WHO officials and other WHO member states ahead of a third round of member state negotiations on a ‘conceptual’ zero draft text for the treaty due to start next week.

First ‘zero draft’ circulated in late November

Loyce Pace, Assistant Secretary for Global Affairs, US Department of Health and Human Services, in Geneva this week.

This initial ‘zero draft’ text of a proposed pandemic accord was circulated among member states in late November.

The draft calls for for “early, safe, transparent and rapid sharing of samples and genetic sequence data of pathogens” – a measure supported by the pharmaceutical industry – but simultaneously calls for “the fair and equitable sharing of benefits” – which the private sector and many developed countries along with the US have resisted, saying that too tight a linkage between any country’s agreement to share pathogen data and benefits reaped could slow down pandemic response.

The draft also makes a strong case for more emphasis on regional production of vaccines and other pandemic-related products as well as ‘strategic stockpiles’ of pandemic response supplies.

Speaking on that point, Pace and Hamamoto both underlined that the US is supportive of efforts to regionalize production of pandemic countermeasures.

“We’re very committed to leaning into overall concepts of equity and transparency,” Hamamoto said. “making sure that we’re better prepared for the surveillance, detection and rapid response to future outbreaks. More comprehensive data and sample sharing on a fast timeframe as well rapid, rapid response .. and more equitable access to medical countermeasures, possibly through regional and local manufacturing.”

Current text is hanging too much on the Christmas tree

However both women warned that the current text, including many member state proposals for amendments and additions, will need considerable refinement to get the approval of the US and other member states.

“There are so many ornanments we’re trying to put on the Christmas tree,” said Pace. “And that is understandable, and yet there are various work streams that will emerge, where there can be a higher and better use for some areas than others.”

Added Hamamoto, “I think it’s just there’s just too much in there that is, is maybe not at the right level, like a more tactical playbook… as opposed to, you know, international agreements.

“What we’re focused on next week is to really move it towards something that’s appropriately scoped to begin,” she said.

“What it represents now is a collection of all the inputs that the Bureau has received so far for member states and external stakeholders as well,” she noted, referring to the small member state group guiding the process.

“And everything has just been collected, sorted to a certain extent into some specific chapters…. But there’s a lot of work that still needs to be done around scope around structure around governance. And so in a nutshell, there’s a lot that needs to change before we were going to be able to sign on to it, as is the same for a lot of Member States, probably most.”

Negotiations over revisions to International Health Regulations happening in parallel

Negotiations over revisions to the WHO’s International Health Regulations are also proceeding in parallel.  It was the US which tabled a series of proposed amendments to the IHR at the May World Health Assembly as matter for negotiations, finally winning the agreement of the member state body to engage in a parallel process to revise the 2005 WHO agreement on procedures for responding to outbreak and emergency threats.

Assembly Approves Process to Update International Health Regulations on Pandemic Response

Revising the IHR is deemed to be a quicker fix to some of the shortcomings in global pandemic response as once any revisions are approved, they would take effect immediately. A new international convention or accord would have to be ratified state by state.

However agreement on those revisions, and alignment with the new pandemic accord, will also be a complex process, she admitted.

“Obviously, there’s a lot cooking in that space, with so many member states and frankly, amendments being brought to the table,” Pace said. “That’s a good thing because I think we weren’t sure, frankly, earlier this year, to what degree the member states would be interested in engaging in that [IHR] process. And so I know a lot of being done to look through those various proposals and align them with the work that Ambassador Hamamoto is leading on the front end.”

Hints at adjustments in negotiating schedule – but not endpoint

Standing ovation at 2021 special World Health Assembly session that decides to negotiate a new pandemic accord.

Hamamoto also suggested that some of the mid-term milestones that have been set in the negotiating schedule for the pandemic accord over the coming two years, might have to be adjusted in order to accommodate the complexity of the process.

According to the current timeline, a firm ‘zero draft’ text is supposed to be ready to put before WHA member states for the full-fledged start of negotiations by February 2023.

However, Hamamoto said that she was in no way suggesting that member states should prolong deliberations over the text beyond the May 2024 date that was agreed to by WHO member states exactly a year ago, as the date by which a final draft text should be brought before the World Health Assembly.

“You know, the pretty broadly held view is that we need to make sure that the process is set up right so that we feel that we can that we have the space to do our work, and make sure we get this right and so we don’t blow this opportunity to put together an accord that is going to be meaningful and implementable,” Hamamoto said.  “But May 2024 is the planned and hoped-for end-date and I’m not suggesting going beyond that.  However, the time line along the way is ambitious.  And we do also have these parallel processes, so we just want to make sure in theese early stages, what is being called the zero draft, that we get that right.”

Image Credits: E Fletcher/Health Policy Watch , E Fletcher/Health Policy Watch.

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