Some WHA Members Want Existing Health Rules Strengthened as New Pandemic Treaty Negotiations Will Take Time
WHA collage
Collage of delegates presenting Member State positions at the WHA special session on Tuesday.

While the vast majority of World Health Organization (WHO) member states expressed support for a negotiated pandemic “instrument” at Tuesday’s World Health Assembly special session (WHASS), many also urged the strengthening of the International Health Regulations (IHR) – currently the only existing legal framework to address pandemics.

Singapore, Thailand, Zambia, and Colombia were among those that supported the strengthening of the IHR alongside a new pandemic instrument.

Colombia said that a pandemic instrument could be linked to the IHR, and called for the IHR to be strengthened “through amendments and effective bodies, which will allow better implementation mechanisms”.

Zambia called for “focused adjustments to the identified weaknesses’ alongside the development of a new legally binding international instrument”. 

However, Dr Ahmed Al-Mandhari, director of the WHO Eastern Mediterranean Region (EMRO), said that while the IHR were important, they were not sufficient to address future pandemics.

Meanwhile, the Netherlands cautioned that a legally binding pandemic treaty was not a “panacea” for pandemics and that much more needed to be done to prevent pandemics. 

For Japan, universal healthcare has to be a key principle of any pandemic treaty to ensure “no one is left behind”.

Fiji drew attention to the fact that there is “no comprehensive framework within the WHO that governs pathogens, including emerging diseases of zoonotic origin”, and called for this to be addressed alongside numerous calls for a “One Health” approach to future pandemics.

India, on behalf of the South East Asia region, called for any new instrument to address the development and distribution of medicines, “research and development, intellectual property, technology transfer, and scaling of local and regional manufacturing capacities during emergencies”.

Risk of lengthy negotiations

The agreement to set up an intergovernmental negotiating body to strengthen pandemic prevention, preparedness and response” has been co-sponsored by 114 of the 194 members.

However, the new instrument – variously called a treaty, convention and agreement – is likely to take at least 18 months of negotiations to come into existence. The best-case scenario for a “pandemic treaty” agreement is by mid- 2023.

Thiru Balasubramaniam, Knowledge Ecology International’s (KEI) Geneva representative, acknowledged that the proposed negotiations “are not a quick fix to the current pandemic, but they offer a much more comprehensive and potentially useful response going forward, including for the next pandemics”. 

But a report prepared by the WHA working group presented to the assembly by Tedros, acknowledged the possibility of drawn-out negotiations.

“The risks include lengthy time frames for negotiating new instruments or deadlock due to negotiation, as well as insufficient resource and time commitments resulting from intergovernmental negotiations,” the report acknowledged.

Balasubramaniam said that the negotiators “will be looking to see how they can address the many policy failures that have accompanied the current pandemic responses, and to create a better global framework for cooperation, including the sharing of technology and the financing of measures to prepare for and respond to pandemics”. 

“The initial plan is to negotiate the details in a two-year time-span, commencing in March 2022 and ending in May 2024. The WHA decision cites Article 19 of the WHO constitution, a rare and important effort to attain the highest legal status to an agreement,” he added.

Civil society appeals for solidarity

Addressing the WHA on Monday, WHO Director-General Dr Tedros Adhanom Ghebreyesus said that the governance of global health security was “complex, fragmented and has failed to ensure effective collective action and equitable access to vaccines and other tools”.

A wide range of civil society observers addressed Tuesday’s session, and most appealed for a well-funded, nimble body that was based on solidarity and equity.

The International Federation of Red Cross and Red Crescent said the COVID-19 response had been “hugely impaired by gaps in global cooperation and inequities”, and any new  treaty must include “a firm commitment to equity, including equitable access to health services, and care and resources such as “vaccines, data, diagnostics, treatment and PPE”.

Dr Seth Berkley, CEO of the global vaccine facility, Gavi, appealed for more attention to be paid to strengthening countries’ routine immunisation programmes and primary healthcare systems.

Berkeley outlined a five-point approach, including a “truly global response, as infectious diseases need to be simultaneously controlled all across the world” and “agile contingency financing”.

Reminding the WHA that at least 115,000 health workers had died of COVID-19, the International Council of Nurses stressed that any instrument had to ensure the protection of workers in the sector.

Medecins Sans Frontieres and the South Centre stressed a community-based approach to addressing pandemics that involved the people most affected.

The WHA concludes on Wednesday when it is expected to endorse the decision to negotiate a new instrument.


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