TWN Info Service on Health Issues (Apr24/10)
30 April 2024
Third World Network

WHO: Resumed INB negotiations in Working Group & informal discussion to push for consensus

Geneva, 30 April (TWN) – The resumed meeting of the Intergovernmental Negotiating Body (INB) on the pandemic instrument has initiated negotiations in a working group and other informal discussion to push for consensus.

A working group was constituted to discuss Articles 4 and 5 i.e. on pandemic prevention and surveillance. Further, Germany has convened an informal meeting to discuss issues around Article 7 dealing with health and care workforce. 

The resumed session started without an open plenary and directly took up Articles 4 and 5 for discussions in the formal drafting group, where all Member States participate.

Co -Chair Mr. Roland Driece in his opening remarks described the process of the INB Bureau to arrive at consensus on the current draft text. He said that the idea is to go through the provisions of the text and get feedback from Member States but they would not be allowed to insert or change texts in the Bureau’s text from the floor of the drafting group. Instead, if there are issues that need to be discussed with respect to the text of each provision, those could be raised in the drafting group and then informal consultations or working groups would be mandated to try to deal with those issues.  

The countries that made comments included Ethiopia for the Africa Group, Bangladesh, Pakistan, Brazil, the European Union (EU), the United States (US), Norway, Malaysia, the United Kingdom (UK).

Brazil and Pakistan in general said that they could accept the Bureau’s proposals for Articles  4 and 5 although they would have some textual suggestions.

The US said that the Bureau’s text could be a basis but that the text needs to be further worked on.

The UK said that the Bureau’s text is not acceptable, needing further work to make clearer the relationship between the pandemic instrument and the  One Health instrument to come out of the Intergovernmental Working Group to be set up under the World Health Assembly resolution to adopt the pandemic instrument. Norway supported the UK.

The EU said that Articles 4 and 5 need further work on to make it more operational and clearer.

The Africa Group, Bangladesh and Malaysia also raised concerns on Articles 4 and 5. Some developing country Member States questioned whether text on One Health was actually needed to be included in the pandemic instrument.

Russia suggested instead of One Health Approach, a multisectoral approach could be mentioned.

Comments from Member States lead to decision to establish the Working Group to negotiate Articles 4 and 5.

Working Group discussions

The newly established Working Group had two sessions on the first day (Monday). During the first session (2.00 - 5.30 pm) Member States proposed various amendments to Articles 4 and 5. During the daily briefing for Non-State actors (NSA) Co-Chair Roland who chaired the working group meeting, described the state of play of  amendment proposals.

First, there are amendment proposals for linking the implementation of Articles 4 and 5 with the availability of finance and technical assistance. Discussions also occurred on the placement of finance and technical assistance. While the proponents of linkage insisted on mentioning the linkage proposal within Articles 4 and 5 others proposed to place the provision on finance and technical assistance in Articles 19 (international cooperation and support for implementation) and 20 (sustainable financing).

Second, on the proposal to merge Articles 4 and 5 into a single article there was not enough support for this and it may be dropped.

Third, many Member States opposed the proposal in paragraph 4 of Article 5 to develop full a comprehensive legal instrument on One Health. Article 5.4 states: “The modalities, terms and conditions and operational dimensions of a One Health approach shall be further defined in an instrument that takes into consideration the provisions of the International Health Regulations (2005) and will be operational by 31 May 2026”.

Member States said that One Health is a broad agenda, of which many aspects especially issues related to animal health and environment fall outside the mandate of WHO. The Co-chair during the briefing cited the Framework Convention on Tobacco Control to counter this argument stating that many aspects of the Convention is outside WHO’s mandate.

Though the Co-chair stated that there is text-based negotiations within the Working Group many Member States told TWN that textual proposals were reflected on the screen but there were no negotiations. After completing the collection of the textual suggestions, the Bureau produced the following text for the consideration of the Working Group. 

Bureau’s new text

“Article 4. Pandemic prevention and surveillance

1.                  The Parties shall take steps, individually and through international collaboration, in bilateral, regional and multilateral settings, to progressively strengthen pandemic prevention and surveillance capacities, consistent with the International Health Regulations (2005), and taking into account national and regional circumstances.

2.                  Each Party shall, consistent with its capacities, develop, strengthen, implement, monitor, periodically update and review comprehensive multisectoral national pandemic prevention and surveillance plans, programmes and actions, that support effective implementation of the International Health Regulations (2005), and that cover, inter alia:

(a)                    Collaborative surveillance and risk assessment; (Definition of “Collaborative surveillance” to be added to article 1 as follows: “Collaborative surveillance” means the systematic strengthening of capacity and collaboration among diverse stakeholders, both within and beyond the health sector, with the ultimate goal of enhancing public health intelligence and improving evidence for decision-making);

(b)                    community-based early detection and control measures;

(c)                    water, sanitation and hygiene;

(d)                    routine immunization;

(e)                    infection prevention and control;

(f)                      zoonotic spill over and spillback prevention;

(g)                    laboratory biological risk management in order to prevent the accidental exposure to, the misuse of or the inadvertent release of pathogens;

(h)                    vector-borne disease surveillance and prevention;

(i)                      antimicrobial resistance to address the pandemic-related risks associated with the emergence and spread of pathogens that are resistant to antimicrobial agents;

(j)                      emerging and re-emerging infectious diseases; and

(k)                    environmental, climatic, social, anthropogenic and economic factors that increase the risk of pandemics.

3.                  The Conference of the Parties may adopt, as necessary, guidelines, recommendations and other non-binding measures, including in relation to pandemic prevention capacities, to support the implementation of this Article.”

The proposed text removed the earlier obligation to cooperate with one another in bilateral, regional and multilateral settings to take steps for such cooperation. Second, the areas mentioned for surveillance in paragraph 2 is increased from 9 to 11. Third, the Bureau’s text proposes a definition of community surveillance which even calls for stakeholder engagement. These stakeholders could include foreign or international actors compromising national interests. There is nothing in the text which indicates the collaboration is limited to national level, even though the chapeau refers to a national plan.  

It fully ignored the proposal to link implementation with the availability of financial and technical advice and recommended that particular considerations may be given to the implementation of Articles 4 and 5 in Articles 19 and 20.

The proposed text ignored many proposals from developing countries. For instance, Bangladesh called out on the process and questioned why the developing county proposals for financial and technological support are not retained, at the very least in brackets. Malaysia, Namibia, Uganda, Tanzania pointed out that their textual proposals are not reflected in the revised text.

Colombia requested for mention that actions on environmental and anthropogenic factors are to be in accordance with applicable international agreements, while China requested to remove the same.  

“Article 5. One Health approach for Pandemic Prevention, Preparedness and Response

1.                  The Parties shall promote a multisectoral One Health approach for pandemic prevention, preparedness and response, recognizing the interconnection among people, animals and the environment, taking into account national circumstances. To this end, Each Party shall, in accordance with its national context, take appropriate measures to:

(a)                    Implement and regularly review relevant national policies and strategies that reflect a One Health approach as it relates to pandemic prevention, preparedness and response;

(b)                    Promote the effective and meaningful engagement of communities in the development and implementation of policies, strategies and measures to prevent, detect and respond to outbreaks; and

(c)                    Promote or establish One Health joint training and continuing education programmes for human, animal, and environmental health workforces to build relevant and complementary skills, capacities and capabilities.

2.                  The Parties shall take measures, as appropriate, aimed at identifying and addressing the drivers of the emergence and re-emergence of diseases at the human-animal-environment interface.

3.                  The modalities, terms and conditions and operational dimensions of a prevention and One Health approach to Pandemic Prevention, Preparedness and Response shall be further defined in an instrument that takes into consideration the provisions of the International Health Regulations (2005) and shall be presented for consideration to the Conference of the Parties.”

There is no major change in the proposed new text except for the removal of the timeline for development of the modalities, terms and conditions and operational dimensions of a prevention and One Health. Further the instrument containing modalities, terms and conditions and operational dimensions will now be submitted to the Conference of Parties ofledged the pandemic instrument. The draft Bureau’s draft negotiating text was silent on this and mentioned a deadline for the operation of modalities, terms of reference etc.

The Bureau’s new text rejected the demand for linking the availability of finance and technical assistance for the implementation of Articles 4 and 5.  It only made a mere reference to Articles 4 and 5 in Articles 19 and 20, which does not guarantee any such assistance. 

Paragraph 2 of Article 19 now states: “Particular consideration shall be given to the specific needs and special circumstances of developing country Parties, including by providing sustainable, sufficient and predictable means of implementation of this Agreement, in particular for articles 4, 5”.

Paragraph 1 of Article 20 also added reference to Article 4 and 5. It states: “The Parties shall strengthen sustainable and predictable financing, in an inclusive and transparent manner, for implementation of this Agreement, including by providing sustainable, sufficient and predictable means of implementation, in particular for articles 4, 5, […], and the International Health Regulations (2005)”.

TWN learned that developing countries conveyed their disappointment to the Bureau for unilaterally removing their proposals. A developing country delegate said that the Bureau’s text does not reflect the issues raised by developing countries both in the drafting group and in the Working Group.

An evening communication from the Bureau states that the revised text of Articles 4 and 5 from the Working Group process and Article 7 from the informal sessions will be placed for the consideration of the Drafting Group.

While the Working Group was convened in the afternoon the Drafting Group finished the initial discussions on Articles 6, 7 and 9. The Bureau is to revise Article 6. Meanwhile there is no clarity still on the next steps on Article 9.