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TWN
Info Service on Health Issues (Apr23/02) 14 April 2023, Geneva (Nithin Ramakrishnan) – The fifth session of the Intergovernmental Negotiating Body (INB5) on the new pandemic instrument has fixed 22 April 2023 as the deadline for the submission of written textual proposals by Member States on the Zero Draft. The Zero Draft for a new WHO Convention, Agreement or International Instrument on Pandemic Prevention, Preparedness and Response (WHO CA+), was circulated in February 2023 and first discussed at INB4, held from 27 February to 3 March. INB5, which continued the discussions from INB4, is now suspended and the drafting group would meet again between from 15 to18 June. INB5 was held last week from 3 to 6 April at the WHO Headquarters in Geneva in a hybrid mode. The whole session was closed, except for the brief opening and closing plenary sessions, leaving the civil society observers to depend on secondary information and journalist sources to know about the negotiations. The INB5 meeting also adopted a progress report of the discussions to be submitted to the 76th Session of the World Health Assembly (WHA76) in May. Earlier, INB4 had decided to give Member States time to submit text proposals to the Zero Draft by 14 April. Although the deadline is now extended till 22 April, several Member States consider this as insufficient time to prepare text proposals. According to the INB5 report shown on the screen during its session, the INB Bureau will release a compilation of all text proposals along with a “Bureau’s Text” for the consideration of the continuation of the drafting group in June 2023. The Bureau’s text is expected to be released by 22 May. However, it is not clear whether this “Bureau’s Text” will be considered as the “First Draft” as mentioned in the modalities. Member States did not want to commit to anything on the modalities regarding how the Bureau’s text will be considered during the drafting group meeting in June or in the INB6 that will be in July. Accordingly, a new modality for the drafting group discussion in June will be proposed end of May or first week of June, and Member States may consider the status of the “Bureau’s Text” while further deciding on the modalities. The Bureau will also organize a briefing session ahead of the drafting group meeting in June. There appears to be an attempt by the Bureau and WHO Secretariat to not have another round of written text submissions, to fast-track the negotiations, facilitating adoption of the new pandemic instrument by May 2024. While this is acceptable to a few developed countries and some others who place importance on concluding the new instrument by May 2024, others who prioritise the substantive content of the new instrument, especially operationalizing equity, believe that it is important to have another round of written submissions if the Bureau’s text does not capture the inputs provided during INB4 and INB5. Some Member States also believe that an early decision on the meaning and scope of the term “pandemic” is required to settle on the negotiating text. It is practically impossible to arrive at any form of agreement, including on what needs to be negotiated, without such an understanding. According to a developing country delegate, “It would be ideal to have a final round of text submissions after this decision is taken”. Lack of clarity over the meaning of pandemic During INB5, the European Union circulated a new set of text proposals that expanded the scope of the WHO CA+, from being a pandemic instrument to essentially a “One Health Surveillance” instrument. The EU in order to cover this expansion of scope has proposed to include a definition on “pandemic situation”, which could practically cover all types of infectious diseases happening “often world wide”. The proposed definition reads: “Pandemic situation” means a manifestation of a disease, irrespective of origin or source, that is spreading or is likely to spread over a wide geographical area, often worldwide, that is affecting or is likely to affect a large number of persons, and is creating or is likely to create a severe social disruption and economic loss.” This newly proposed definition has two implications. First, it can help build a large-scale interconnected surveillance infrastructure for “bio-surveillance”, that will establish a regular and continuous flow of biological resources and associated genetic information from developing countries to developed countries. Secondly, it could potentially limit international assistance to developing countries in terms of medical products and technologies only for a very limited set of diseases such as COVID-19. The notion of “pandemic situation” is quite different from the conception of pandemic which was more of an infectious disease transmissible from human to human, perhaps after a zoonotic spill-over or otherwise. The EU had circulated its proposal and released it via its webpage. This proposal has added more than 25 pages of proposed legal text into the Zero Draft. However, the EU proposal received very little attention in the drafting group discussions during INB5. It is clear that developing countries will need more time to study the EU proposals, and they will have to conduct inter-ministerial discussions on the new proposals before agreeing to make them a part of negotiating text. In this context, it is also important to note how Member States’ textual proposals will be incorporated into the Bureau’s text or any other document that would form the basis of negotiations. Attempts to compromise participatory and transparent process Compared to the parallel process on amendments to the International Health Regulations 2005 (WGIHR), which gave around 6 months’ time to prepare written text proposals, INB5 has only given 2.5 months to the Member States. Several developing country delegates informally expressed concerns that there has been very little time to study the whole new legal text creating obligations on Member States. Referring to the numerous proposals in the WGIHR submitted by developing countries, one delegate said, “I think, the developed countries have learnt from the WGIHR process that if given time developing countries can come together to develop creative proposals and this, they want to avoid in INB”. Unusually for inter-governmental negotiations, there was a proposal from Norway and a few other Member States to invite experts to work on and synthesise the text submissions made by Member States during INB5 in order to develop a negotiating text. However, quite a few developing countries opposed the proposal. “They wanted to create something like the IHR Review Committee, to constrain the developing country proposals which are transformative in nature,” according to a negotiator after INB5 who spoke on condition of anonymity. Although a few other developing countries initially supported the proposal coming from Norway, which had EU backing, after strong resistance from others they withdrew their support. Further, there is a growing discontent within small delegations on the WHO processes and the haste with which they are handled. Genuine requests for extension on deadlines are opposed with unnecessary resistance by certain states. Short-circuiting of the process is often justified in the INB negotiations by citing the need for adopting the new pandemic instrument by May 2024. One of the tacit agreements in the WHO was that WGIHR and INB will take place during those days on which small delegations or their health attachés can pay undivided attention to the text-based negotiations. This rule has been flouted twice already. WGIHR2 was conducted in parallel with the Fifth Global Ministerial Summit on Patient Safety 2023 and INB5 was conducted in parallel with the Fifth Global Forum on Human Resources for Health. Such global summits often take the attention of small delegations and their international health department officials, and hence compromises their engagement with WGIHR and INB. The new deadline for submitting written text to the INB is 22 April 2023 the very next day of the 3rd Session of the WGIHR. This pressurises Member States to further divide their attention between WGIHR and INB in the third week of April.+
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