Countries to discuss the need for a pandemic treaty; WHO suggests “enlightened self-interest” to rich countries
Newsletter Edition #71 [The Weekly Primer]
Originally published July 13th, 2021 on Geneva Health Files.
For an international organization that depends on a small group of donors for much of its financing, WHO’s DG Tedros Adhanom Ghebreyesus and his team, have shown candor in consistently calling out high-income countries which have been impeding the access to vaccines during this pandemic. Tedros has also challenged pharma giants Pfizer, Moderna and others to share technology to widen production of COVID-19 vaccines.
In the latest weekly briefing on Monday, top WHO officials, repeatedly emphasized the lack of sufficient evidence on the need booster shots that some countries are considering, clearly at the expense of the most vulnerable populations across the world who have not had access to COVID-19 vaccines. Check out this evocative speech Tedros made, full of imagery of firefighters facing a furnace without adequate protection. (“Deaths are rising again”, how often have we heard this unfortunate message from WHO in the last year and a half.)
With deaths from COVID-19 topping 4 million, WHO is finding it hard to reconcile the two-track pandemic that this health emergency had become, even as its richer member states think that “this is no longer our problem”. Tedros called for countries to act with “enlightened self-interest” hinting at both faster economic recovery and global health security.
This brings us to the discussions on a potential legal instrument to address future pandemics. Member states will kick-start discussions in an inter-governmental working group beginning this week.
Meanwhile, biggest donor countries of WHO, are also those who are opposing the TRIPS Waiver negotiations that continue this week.
Geneva embodies this dichotomy. We capture these complex positions to look at issues collectively. Check out our exclusive story from last Friday: Countries wrestle with regulatory data, trade secrets and tech transfer: TRIPS Waiver discussions at WTO. Without a doubt, we are witnessing history as countries negotiate and try to change the narrative on what should be accessible and why. Sign up now to keep up with our dedicated and comprehensive coverage on this, and more.
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I. POLICY UPDATES
- First Meeting Of The Working Group On Strengthening WHO Preparedness And Response To Health Emergencies: 15–16 July
- Backed by a WHO Resolution WHA74.7, the Member States Working Group on Strengthening WHO Preparedness and Response to Health Emergencies, will meet this week to examine the needs for an international legal instrument to address future pandemics. These efforts will reportedly be led by a Bureau with representation from France, the U.S., Botswana, Singapore, Iraq and Indonesia.
- The group will prioritize “the assessment of the benefits of developing a WHO convention, agreement or other international instrument on pandemic preparedness and response.” It is tasked with preparing a report to be considered at the special session of the World Health Assembly in November 2021.
- The working group is also expected to review the recommendations of the three committees (the Independent Panel for Pandemic Preparedness and Response, the IHR Review Committee and the Independent Oversight and Advisory Committee for the WHO Health Emergencies Programme). These committees had mostly suggested the need for a new pandemic treaty. The group will also take into account “the work of other relevant bodies, organizations, non-State actors and any other relevant information.”
- The report from the working group will have “proposed actions for the WHO Secretariat, Member States, and non-State actors” that will be considered by the the 150th Executive session followed by the Seventy-fifth World Health Assembly next year, according to a provisional agenda of the meeting.
- Sources familiar with the discussions tell us that the working group will have two different groups — one to deliberate on the potential legal instrument, and the other on strengthening WHO. It is understood that Indonesia will lead on the treaty discussions in association with representative from a developed country, within the working group.
- During the World Health Assembly in May this year, a number of countries were opposed to the idea of a treaty, notably, the US, Brazil, Russia among others. It is learned that India has also expressed reservations on this. The role of these countries will determine whether WHO member states can reach a consensus on the need, and the type of legal instrument to address future pandemics.
- The key questions for developing countries to consider will include what they will be expected to sign up for, in return for what they will be expected to give, global health law experts told us. In our earlier stories, we have documented how some countries see this as a top down approach spear-headed by a few developed countries.
- A range of countries comprising some developed and developing countries see the need for a pandemic treaty in order to capitalize on the momentum generated in the response to COVID-19. These countries are keen on taking advantage of the narrow window of opportunity to put in place safeguards to enhance global health security.
- We had also reported earlier, the emerging role of other actors such as The Graduate Institute in Geneva in forging these discussions. Last week The South Centre and The Graduate Institute “exchanged views” on the discussions around pandemic response and preparedness.
- Also see this new report: Proposal for a WHO treaty on pandemics raises concerns by Third World Network.
- Recently we were criticized on twitter, for pointing out that there were opponents to the treaty idea. We were also asked why we were not contributing to consensus on these discussions. We will, of course, continue to report on these issues in the manner that we have done — to show what we see. (Shooting the messenger is not a great idea!)
- We have filed more than half a dozen stories on these discussions since January 2021. Check out our archives.
WHO recommends interleukin-6 receptor blockers, therapeutics for patients who are severely or critically ill with COVID-19, “especially when administered alongside corticosteroids”, according to a statement last week. “These are the first drugs found to be effective against COVID-19 since corticosteroids were recommended by WHO in September 2020,” WHO said.
“The inequitable distribution of vaccines means that people in low- and middle-income countries are most susceptible to severe forms of COVID-19. So, the greatest need for these drugs is in countries that currently have the least access. We must urgently change this.”
To increase access and affordability of these life-saving products, WHO calls on manufacturers to reduce prices and make supplies available to low- and middle-income countries, especially where COVID-19 is surging.
WHO also encourages companies to agree to transparent, non-exclusive voluntary licensing agreements using the C-TAP platform and the Medicines Patent Pool, or to waive exclusivity rights.
In addition, WHO has launched an expression of interest for prequalification of manufacturers of interleukin-6 receptor blockers. Prequalification of innovator and biosimilar products aims to expand the availability of quality-assured products and to increase access through market competition and reduce prices to meet urgent public health needs.
See Tedros statement on this.
Statement from Roche here.
“Roche’s non assertation of patents should be applicable to all countries — and not just to low- and middle-income countries — so that wherever biological production capacity exists, alternative producers can speed up development and production of biosimilars;
Roche should disclose the full details of all remaining secondary patents and any pending patent applications and withdraw them to provide full freedom to operate and legal certainty for biosimilar producers; and
Ensure quick and independent production and supply of tocilizumab by additional manufacturers, Roche should opt for open, transparent and unrestricted transfer of master cell lines, share its regulatory dossier and any other manufacturing information, which is critical for immediate scale-up of production by other manufacturers.
Roche must also lower the price of this drug to make it affordable and accessible for everyone who needs it.”
- Gavi signs agreements with Sinopharm and Sinovac for immediate supply to COVAX: Press Release
- Urgent Action Needed to Address a Worsening ‘Two-Track’ Recovery: IMF Boss
- WHO issues new recommendations on human genome editing for the advancement of public health: Press release
II. WHAT WE FOUND INTERESTING
My colleague Rithika has pulled this together for you:
- COVID vaccines to reach poorest countries in 2023 — despite recent pledges: Nature
- All talk, no jabs: the reality of global vaccine diplomacy: The Telegraph
- When Lifesaving Vaccines Become Profit Machines for Drugmakers: Bloomberg
- Amid fresh virus surge, Africa sets out to save itself on vaccines procurement: Politico
- COVID infections imperil Indonesia’s vaccinated health workers, and hospitals: Reuters
- Can we stretch existing Covid vaccines to inoculate more people? Experts are divided: STAT
- How effective are coronavirus vaccines against the Delta variant?: Financial Times
- A Royal Mark Up: How an Emirati Sheikh Resells Millions of Russian Vaccines to the Developing World: The Moscow Times
- Why aren’t diseases like HIV and malaria, which still kill millions of people a year, called pandemics?: STAT
- Gates Foundation makes contingency plans for break-up: Financial Times
- The political awakening of Melinda French Gates: Financial Times
- An acceptable level of deaths?: Nuffield Council on Bioethics
FROM THE JOURNALS/REPORTS
- Averting Future Vaccine Injustice: The New England Journal of Medicine
- What’s yours is ours: waiving intellectual property protections for COVID-19 vaccines: BMJ Journal of Medical Ethics
- Decolonising global health: where are the Southern voices?: BMJ Global Health
- Decolonising global health: beyond ‘reformative’ roadmaps and towards decolonial thought: BMJ Global Health
III. WHAT WE ARE WATCHING:
- WHO: Working group on strengthening WHO preparedness and response to health emergencies 15–16 July
- WTO: TRIPS Council Informal meeting on the TRIPS Waiver: 14 July
- Lessons On Global Health Cooperation From Covid-19: Germany’s Perspective — A Graduate Institute Event — 14 July