A single oversight and compliance body may be set up to oversee both the new pandemic agreement and the amended International Health Regulations (IHR), according to  Dr Ashley Bloomfield, the co-chair of the Working Group on Amendments to the International Health Regulations (WGIHR).

Bloomfield was responding to a question about whether his group had discussed independent monitoring from Dame Barbara Stocking, chair of the Panel for a Global Public Health Convention, at the start of the WGIHR’s sixth meeting on Thursday.

Several civil society groups have called for independent oversight of the implementation of the pandemic agreement currently being negotiated by the intergovernmental negotiating body (INB) and the amended IHR.

Stocking reiterated the need for “independent assessment in both the IHR and any new treaty” because of a lack of trust between countries, as well as between citizens and governments.

“Having independent assessment is a really important way of actually making sure that there is trust in what is being done, and what is being said to be done,” said Stocking.

“We’re very aware of the importance of this issue of compliance, oversight and monitoring, including what independent monitoring might look like,” responded Bloomfield, who said that the WGIHR and the INB were first considering existing monitoring arrangements such as the independent oversight and advisory committee set up by the WHO Director-General.

Bloomfield added that the issue was featured in a new article in the IHR (Article 53) and well as in Article 54.

“Likewise, there are relevant provisions in the draft INB agreement that were discussed over the last few days,” said Bloomfield, who attended this week’s INB meeting as an observer.

“All these matters are ones that we will be considering within our individual processes, but I can say that there are already informal discussions happening about how a future oversight and compliance arrangement would be constructed that takes into account both processes.” 

He later added that there was considerable overlap between the two groups on financing and there could be a joint process on that too.

Civil society concerns

Meanwhile, other civil society organisations also raised their concerns at the open plenary of the WGIHR. 

The World Trade Organization (WTO) offered its technical expertise and experience to the WGIHR on proposed amendments that “address topics with trade-related elements” such as open supply chains, trade restrictions, unnecessary interference with international traffic and trade, the transfer of technology and know-how and to develop and diversify manufacturing capacity. 

“We have a shared interest in promoting synergies and coherence across our organisations and our legal instruments. To this end, we would welcome the opportunity to collaborate with the WHO on the development and implementation of an international pandemic response as mandated by our ministers last year,” said the WTO.

Jamie Love of Knowledge Ecology International reminded the group that the WHO had adopted a resolution at the World Health Assembly in 2019 (WHA78) “on improving the transparency of markets for medicines, vaccines and other health products”. 

“Among the measures we hope can be reflected in future revisions of the IHR are measures to implement the transparency obligations in WHA78, including but not limited to those relating to the transparency of prices and units sold for countermeasures, and the transparency and collection of data on R&D subsidies, patent landscapes, and the outcomes and costs and subsidies relating to relevant clinical trials on countermeasures,” said Love.

Noting that cancer treatment was disrupted during pandemics, the European Society of Medical Oncology urged member states to “support amendments to the IHR which would build, develop and maintain health systems capacities at secondary and tertiary care levels to avoid leaving millions of patients with cancer behind in times of health emergencies”. 

Mohga Kamal-Yanni for Oxfam and the People’s Vaccine Alliance appealed for  “practical measures to operationalize equity of access to pandemic-related products”.

Grega Kumer of the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA)  called for three measures to “modernise” the IHR: “One, raising the alarm early by ensuring the rapid sharing of outbreak information and immediate access to pathogens and genetic data. 

“Two, enabling the innovative ecosystem including protection incentives on IP to reinforce the pipeline for needed medical countermeasures, and third, fostering multi-stakeholder partnerships and dialogue, including with private sector, to ensure balanced and implementable approaches.”

WGIHR progress

Meanwhile, WGIHR Co-Chair Dr Abdullah Assiri reported that two inter-sessional activities have been held since the group’s last meeting in mid-November. 

“The first was an informal consultation on Article 44 and 44 A, Annex One and 10,” said Assiri. 

“The second was the joint INB-WGIHR briefing on the public health alert system [known as the public health emergency of international concern], the pandemic continuum, including definitions, criteria and the process for determining each.”

The Bureaus of the INB and the WGIHR have also held two joint meetings. The first (25 October), discussed financing mechanisms and preparations for the joint INB-WGIHR briefing. The second (6 December) continued discussions on “key areas of overlap between the two processes, particularly financing, surveillance and prevention, including One Health, capacity building and know-how”, said Assiri.

Bloomfield described Wednesday’s joint meeting with the INB Bureau as “very helpful” in enabling the two bodies to “really think further about how we progress with the work, and where there are overlaps between our two processes”. 

“I’ve certainly found it useful to be in the room during the INB meeting over the last three days and other members of our Bureau were also able to listen into those discussions as well.”

INB update

The INB ended later than anticipated on Wednesday night so its public report-back was perfunctory. 

However, INB co-chair Roland Driece reported on Wednesday that the body had established four drafting subgroups: one on prevention, surveillance, preparedness, readiness, and One Health (Articles 4, 5 and 6 of the negotiation text);  the second on sustainable production and technology transfer (Articles 10 and 11 and possibly 13); the third on access and benefit sharing (Article 12) and the fourth subgroup on financing and capacity building (Articles 19 and 20). 

These drafting subgroups held inter-sessional meetings in November and early December, and the drafting group completed a review of the proposal for negotiation text. The next INB meeting is scheduled for 19 February to 1 March 2024. 

Meanwhile, Bloomfield noted that financing is “an area where there is clearly a lot of overlap and common interest between our two processes”.

“So we will be canvassing [member states’] views on how we might progress that area of financing in a joined-up way to make sure that we coordinate and are coherent across the two processes,” said Bloomfield.