A wide range of groups including civil society, academic and health groups have been identified as stakeholders that are able to interact with the World Health Organization’s (WHO) Intergovernmental Negotiating Body (INB) on a pandemic preparedness instrument.

The WHO published the list last week but stressed that it was a “living document with further possibilities for updates as deemed appropriate by the INB”. 

Earlier, an op-ed published by Health Policy Watch warned against the “pervasive influence” of pharmaceutical groups and businesses in pandemic preparedness.

“The proposed modalities for engagement for relevant stakeholders do not in fact propose any safeguards against corporate political interference in the pandemic treaty and its making. In fact, they pave the way for an ever-increasing range of entities to gain a foothold of status with the organization – beyond the pharma and agribusiness interests, like CropLife International, already in recognized WHO relations,” noted Nicoletta Dentico and Ashka Naik.

The International Chamber of Commerce, AdvaMed, the world’s largest medical technology association and Biotechnology Innovation Organization, the world’s largest biotech trade association are among the newly listed entities.  

Environmental actors

In a positive development, the dearth of environmental and One Health groups has been partly rectified in the current list with the inclusion of the Wildlife Conservation Society and the One Health High Level Expert Panel.

Wildlife Conservation Society’s Christine Franklin confirmed that her organisation had been recognised after initially struggling to engage with the INB.

“In the preparations for negotiation of a possible global instrument on pandemic prevention and preparedness there has been remarkably little attention given to true pandemic prevention,” Dr Nigel Sizer, executive director of Preventing Pandemics at the Source, told Health Policy Watch in an earlier interview.

“We know where most pandemics come from and we know how to reduce the risk of zoonotic spillover of the viruses that cause them,” he added. 

“Governments in general and health agencies, in particular, should embrace these approaches, including One Health efforts.  They should also work much more closely with environmental agencies to address spillover risk from tropical deforestation, wildlife exploitation and trade, and intensive animal agriculture. The public health return on investment in such activities would be enormous.”

In light of the monkeypox outbreak and COVID-19, Sizer said that the WHO and other key actors should do more to address ecosystem risks that increase “spillover risks” of pathogen leap from animal to human populations: 

“Such actions include shutting down or strictly regulating wildlife trade and markets, stopping deforestation and forest degradation, and providing better health to communities in emerging infectious disease hotspots, as well as strengthened veterinary care and biosecurity in animal husbandry,” according to Sizer, an internationally known conservationist. 

Reactive not proactive list

However, the list of entities seems based largely on those that have applied to give presentations at INB meetings rather than a representative group of all non-state and UN-affiliated actors that should be in the room to negotiate a future pandemic treaty.

Entities already in official relations with WHO are also considered “relevant stakeholders”. Official relations status not only allows civil society groups the privilege of expounding on their positions at the annual World Health Assembly, it gives them access to lengthy and detailed informal member state consultations and intergovernmental negotiating sessions that are closed to the general public and the media. 

Some 220 civil society actors hold that coveted status, mostly mainstream medical and health societies as well as pharma groups, but also agro-business foundations, such as CropLife International, as well as the outliers like the World Plumbing Council. 

Additional reporting by Elaine Fletcher.