United States Publicly Expresses Support for Director General Tedros in Second Term at WHO’s Helm
Loyce Pace, US Health and Human Services Assistant Secretary for Global Affairs at a briefing at the US Mission in Geneva on Wednesday, 23 February.

The United States will support Dr Tedros Adhanom Ghebreyesus in a second term as head of the World Health Organization – a move that is largely symbolic insofar as Tedros is running unopposed in the elections, scheduled for the 75th World Health Assembly, 22-28 May. 

Although over a dozen countries in Europe and elsewhere lined up as co-sponsors of Tedros’ bid for re-election last autumn, Loyce Pace, US Health and Human Services Assistant Secretary for Global Affairs, made what are probably the first overt expressions of support for Tedros’ candidacy, in a briefing with journalists on Wednesday. 

“It’s been really helpful to be able to work so closely with him,” Pace said in a conversation with a small group of journalists at the US Mission to the UN Geneva during a visit to city, where she was meeting with WHO, member states and other global health officials. 

‘Skim off’ most critical reforms on pandemic response with IHR rule revisions

Pace also spoke about the new US proposal to reform the International Health Regulations that govern WHO and member state responses to disease outbreaks – in a resolution that Washington wants to put before the upcoming WHA session.

The reforms were detailed in an exclusive report by Health Policy Watch published Wednesday. They would create clear criteria and timelines for countries to assess and report emerging disease threats to WHO, and WHO to other member states – within a matter of days.

Pace said the reform of the IHR was “really looking at how we can approach targeted amendments” to improve pandemic response – while longer-term negotiations over a broader pandemic convention or other multilateral agreement get underway.

“And so, so we really tried to just skim off what we thought would be the most critical enhancements that could be made…whether we’re talking about improved alert systems or, or other components, and some of the issues that are maybe tougher to tackle than others,” she said.

Greater opportunity to work in ‘partnership’ in DG’s second term

On the re-election of the WHO Director-General, Pace added, “In his first term, I think Tedros has always signaled his responsiveness to feedback from all member states. And we’ve seen that to be true in this administration, over the past year, certainly. So that’s encouraging.”

But she underlined that “Term Number 2 – that will overlap … with more time working with the Biden administration. And so that presents yet another opportunity to really think deeply and look closely at what we we do together moving forward.”

Indeed, Tedros first three years as WHO director general were rocky ones for WHO-US relations. Then US President Donald Trump, never a fan of the UN system, grew increasingly antagonistic to WHO and its DG as the COVID pandemic spread – accusing both of being China-leaning, before announcing that the US would pull out of the organization altogether in July 2020.

On January 21, 2021, just after being inaugurated, new President Joe Biden revoked Trump’s moves. In a video appearance at a WHO governing board meeting the same day,  Biden’s chief medical advisor Anthony Fauci greeted Tedros warmly as a trusted colleague and “dear friend“.  

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More transparency ?

However, behind the scenes, the Biden administration, Pace included, have not not been without their criticism of WHO and Tedros.

US officials have said that WHO needs to become more transparent about its budget planning and financial management – before Washingon would agree to a European initiative to increase fixed member state contributions along the lines of a German proposal – aimed at creating more budget stabiity for the world’s global health agency.

In her comments Wednesday Pace alluded only indirectly to such tensions, saying:

“I have no doubt that that openness on his part, on behalf of his team, will change.

“Given that the US is back so robustly and ready and willing to engage, I see even greater opportunity to work in partnership with him on that,” she added, without elaborating. 

Support for WTO waiver  – as negotiations resume in earnest 

Pace also reaffirmed the US support for a temporary waiver on intellectual property rights on COVID vaccines, as negotiations over the log-jammed measure resumed this week in the World Trade Organization.  

In October of 2020, India and South Africa brought forward a resolution to waive the WTO agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) for COVID vaccines – saying this would help jump-start more production and reduce prices for low- and middle income countries. But European Union opponents have blocked approval of the waiver for months, tabling counter measures for more limited technical changes to IP rules in a polarizing debate. 

Now, however, there are signs that the two sides are resuming talks in earnest with the aim of reaching agreement for the WTO’s 12th Ministerial Conference (MC12). The WHO MC12, postponed last November due to the pandemic, is now set for the week of 13 June in Geneva.

On Tuesday, following a meeting of the WTO’s TRIPS Council, Geneva-based trade officials said that talks had been “difficult but are moving in the right direction,” quoting WTO Deputy Director-General Anabel González. 

Bilateral dialogue between ministers and senior officials of the opposing WTO member blocs have intensified in the past weeks and days, and González has hopes that with some additional dedicated work a compromise could be reached soon, the officials reported. 

European Commissioner Ursula von der Leyen also said that she believed a “bridge” could be created between the positions on the waiver issue – after South Africa’s Cyril Ramaphosa called out Europe for blocking the initiative at the European Union-African Union Summit last week.  

Said Pace of the TRIPS waiver: “It’s something that we continue to speak to. You’re well aware also of our stance on the TRIPS waiver and our support of a TRIPS waiver for vaccines.”

But she added that:  “The President also has called for voluntary tech transfer. And that came through, hopefully, clearly in the summit he convened last year.” 

Scaling up regional vaccine manufacture and distribution

Pace also spoke of the need to scale up regional manufacturing of vaccines – as well as overcoming bottlenecks to actual vaccine distribuition.

 “And I mean by that, I mean shots in arms. You can talk about distribution, but it really has to make it to the end user, if you will, it’s something that we saw first-hand in our own country,” said Pace, referring to vaccine hesitancy and supply chain breaks that have characterized the US vaccine rollout.

Pace said the United States has been investing in South Africa, India, Senegal, and elsewhere, to try and spur investments in vaccines and other medical products to fight COVID.

Short-term, she also said that delivery of promised vaccine donations is “critical”, although not enough on its own. 

 “So obviously, we’ve shared 450 million vaccines with the world to date. And we’ve made a commitment to share over a billion. But it’s not just about sharing,” said Pace.

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