World Health Assembly Appears Set to Move Ahead on Pandemic Treaty Negotiations – With Very Different Views About Outcomes
WHA special session meets in Geneva in a first-ever hybrid format since the start of the COVID-19 pandemic – with about three dozen of the WHO’s 194 member states sending in-person representatives.

In a first face-to-face meeting in Geneva since the start of the COVID-19 pandemic, the World Health Organization’s 194 member states appeared set to adopt a landmark decision to negotiate a new treaty or framework convention governing pandemic response, dubbed “Our World Together”, and with over 100 countries now declaring co-sponsorship.  

But from the start of talks at Monday’s World Health Assembly (WHA) Special Session, it was clear that countries still have very different ideas of how this new legal instrument will take shape – and the role it would play alongside the 2005-era International Health Regulations – that now govern pandemic response, but which critics say has been too weak, ineffective, incomplete, and out-of-date for the current crisis. 

Notably, among the dozens of countries that took the floor both in person and remotely at the hybrid session, China sounded the most “treaty hesitant” affirming that “China supports amending the international health legal system with the IHR at its core.”

Speaking from Beijing, China’s WHA representative Shen Hongbing stressed that there was a “”wide divergence of views on how to move forward on a concrete path.” 

But he said that the country would agree to revisions to “integrate universality, equity, one health and whole of government approaches into the amendments of the IHR.”

He added that the IHR would remain “the most critical legal document in global health governance for the present and in the near future.” 

Indeed, as any new treaty instrument would only come before the WHA for approval in 2024, according to the draft decision, it will not be an immediate solution to the COVID-19 pandemic – but rather a preparation for the next one. 

United States sounding bullish

Colin McIff, co-chair of the Working Group on Emergency Preparedness and Response that met over the past six months, concluding with a recommendation to move ahead with negotiations over a pandemic treaty,

In comparison, the United States, which had been treaty skeptic until very recently, was now sounding almost bullish on the potential advantages a new treaty could offer – light of the failings of the existing IHR legal framework.  

Colin McIff,  deputy director of the office of global affairs in the US Department of Health and Human Services and co-chair along with Indonesia the “Bureau” of six countries that guided a months-long review of IHR needs and gaps, cited a long litany of weaknesses in the existing IHR rules. Those range from a lack of “networks, mechanisms and incentives for sharing pathogens’ genetic information, to “proper incentives and benefits to support more equitable health emergency preparedness and response,” he said. 

Other gaps identified in the review by the WHA Working Group on WHO emergency preparedness and response “that could be addressed by a new instrument” included the lack of compliance with, and accountability to IHR obligations, McIff said noting that: “The IHR has a dispute resolution provision, it remains unused to date.” 

European’s also see more stable WHO as treaty outcome 

Jens Spahn, outgoing German Health Minister

Lack of sustainable finance for WHO was yet another shortcoming cited by McIff and a number of other WHA representatives, including Germany’s outgoing Health Minister, Jens Spahn.  

Along with European Council President Charles Michel, Germany’s Spahn has been one of the most active supporters of a pandemic treaty from the early days of proposals made by Chilean president Pinera. 

In what he described as one of his last public appearances before the formal departure of outgoing German Chancellor Angela Merkel, Spahn acknowledged the many obstacles that still lie ahead to winning broad WHA approval on the shape of a new treaty instrument – and whether the new treaty, or convention, would wind up becoming the superstructure umbrella or merely a weak complement of the existing IHRs.

“True, there are still some questions remaining regarding such a legally-binding instrument under Art. 19 of WHO’s Constitution.  However it is clear the benefits significantly outweigh all potential disadvantages,” said Spahn. 

A new WHA Executive Board standing committee on health emergencies?

Olivier Véran, France’s Minister of Health and Social Solidarity

During the day-long debates,  Austria and France also called for the establishment of a health emergencies standing committee of WHA Executive Board member states. Such an EB committee could be activated immediately in the case of a WHO declaration of a global health emergency, they said. 

Said France’s Minister of Health and Social Solidarity, Oliver Véran, the initiative to create a standing committee, which would come before the next EB meeting in January, aims to: “strengthen governance on health emergencies.”   

Such an EB Committee could in fact help facilitate closer WHO and WHA coordination over rapidly emerging disease threats – ensuring better communication and coordination – along with earlier informal dialogue between member states.

That kind of dialogue was found to be seriously wanting in the early days of the COVID pandemic, by a number of review boards. And in fact, the WHA Executive Board, which is charged with providing close member state oversight of WHO, was not convened for months following WHO’s declaration of an international Public Health Emergency (PHEIC).   

Africa supports treaty and denounces travel restrictions imposed on southern Africa in wake of Omicron variant discovery

African nations swung as a bloc behind the treaty initiative – but also denounced the widespread travel bans and restrictions imposed on South Africa and other southern African nations as a result of the recent identification of the Omicron variant.

While WHO has repeatedly decried the use of travel restrictions as an ineffective means of limiting infection spread, most countries have ignored that advice – as well as the IHR rules that similarly call for countries to avoid travel bans as a means of infection control. Blanket travel restrictions are “not based on science, they smack of racism and xenophonia and must end immediately if other countries are to be encouraged to follow South Africa’s example” in rapidly reporting COVID variants like said Ghana’s delegate to the WHA session. 

Botswana, whose scientists collaborated with South Africa in the discovery of the variant, stressed that travel restrictions had been imposed by Europe and the United States “solely due to our agility and transparency in reporting the COVID19 variant.

Those moves are particularly unfair, asserted Botswana’s delegate at the WHA, since COVID infection rates had been declining in Botswana over the past three months, 80% of variant infections were imported and “all patients reporting mild to moderate symptoms”. 

The ironies are even more pronounced, since African countries have faced an uphill battle to access and pay for sufficient volumes of vaccines to curtail infection spread – which is the fundamental cause of variants. In countries like Zambia, only 4% of the population is fully vaccinated. And while vaccination rates in Botswana and South Africa are now approaching 28-37%, that is still far below rates in Europe, Asia and the Americas.


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