TWN Info Service on Health Issues (Dec23/01)
4 December 2023
Third World Network

WHO: INB 7 resumes amidst report on coercion; unfair process

Geneva, 4 December (TWN) – The seventh session of the Intergovernmental Negotiating Body (INB) on the pandemic instrument starts today amidst a report on coercion and concerns over an unfair process.

INB7 has been scheduled to be held in two sessions. The first session took place on 6-10 November at the WHO headquarters in Geneva. That session created sub-groups to discuss the following clusters of articles: Articles 19 and 20; Articles 4, 5 and 6; Article 12 and two meetings of the subgroup on Articles 10, 11 and 13.

The work of the resumed session is as follows:

·    4 December: Articles 19 and 20; Articles 4, 5 and 6; Articles 10 and 11; and possibly Article 13;

·    5 December: Article 12;

·    December 6: Articles 14 to 18 and Chapter 3.

(See below for the major discussion points in the resumed INB7 session.)

Report of Coercion

According to a report published in the Geneva Health Files, one of the top negotiators of the Africa Group, a Namibian foreign ministry official, was recalled to the capital at short notice.

However, the Namibian foreign ministry clarified that the transfer is routine after the completion of 4 years in Geneva and the concerned official was posted in 2019.  A delegate of an African country told TWN that the concerned official received an extension after the completion of 4 years in August 2023 with an understanding that he would remain in Geneva until the completion of the negotiation or the end of 2024, whichever is earlier. The delegate described the sudden moving order as not only a surprise but also not a routine transfer.

The report alluded to political pressure from the United States and the European Union. It revealed that there were diplomatic communications received by a few developing countries, including Namibia, from the US and the EU on the pandemic instrument negotiations. One developing country delegate said these communications are targeted to only a few countries and not all countries received them. Such communications are sent only in special circumstances and are often used as a tool to exert political pressure.

The report also revealed that developed countries are known to have used various types of non-military coercive tactics to influence the outcome of various international negotiations.

Unfair Process

As mentioned above the two days of the INB7 resumed session is dedicated to sub-group discussions. The sub-group discussions are effectively a negotiation to build consensus to include proposals from Member States in the negotiating text. Thus the sub-group discussion is forcing Member States to dilute their proposals even before the start of the negotiations and the INB Bureau has communicated that the amendment proposals from Member States will not be included in the negotiating text without cross regional support.

The communication from the Bureau's Co-Chairs state that: "There is a huge task for the vice chairs and cofacilitators during the subgroup meetings, to bring the Member States together and to come up with concrete legal text proposals with substantial cross-regional support of the INB, in order to improve the NT (negotiating text)".

The Bureau asserts that "The NT is our default text and only if across the board there is support for alterations, these will be incorporated".

It is important to note that the draft negotiating text prepared by the Bureau has not yet been endorsed by the INB as a negotiating text. Further, if the negotiating text is treated as the default text and does not allow any proposals for amendment to be reflected in the negotiating text then there is no possibility of fair negotiations. If the amendment proposals are kept out of the negotiating text it frustrates the process.

However, some observers view it as tactics by the Secretariat and the Bureau to pressurise developing countries to agree on the surveillance agenda without addressing the concerns on equity, especially equitable access to health products required for pandemic preparedness and response.

Major Discussion Points in the Resumed INB7 session

This week’s INB agenda will discuss the major points below.

Article 19 and 20: Need for common but differentiated responsibilities (CBDR) and accountable financial mechanism

The Drafting Sub-group on Articles 19 and 20, chaired by Ambassador Tovar da Silva Nunes of Brazil will meet today (4 December) at 9.00 am CET, with Canada, Malaysia and South Africa as the co-facilitators.

The major discussion point on Article 19 is whether the language of the provision should reflect the differentiated obligations of the developed countries. The current text does not specify such obligations. There is also a need to safeguard the policy space of developing countries from the undue influence of donors of financial or technological resources.

Under Article 20, developing countries continue to call for a new financial mechanism under the WHO that is accountable to the Conference of Parties of the pandemic instrument, while developed countries want to refer to existing funds that are managed by other international financial institutions such as the World Bank. Developing countries argue that the problem with such funds is that they follow a top-down model that imposes financing priorities and conditionalities, ignoring real capacity needs of the recipient developing countries and their national circumstances. This is because States Parties to WHO instruments do not exercise any policy guidance over such external funds. For example, the Pandemic Fund of the World Bank continues to prioritise enhancing surveillance capacities, even as the recipient countries lack response capacities such as infection prevention and control or access to medicines etc.

Articles 9 to 13: The Need for Ensuring Diversification of Production of Health Products

Article 9 of the Bureau’s proposed Draft Negotiating Text deals with Research and Development, and Article 10 deals with sustainable production, while Article 11 addresses transfer of technology and know-how. These are further augmented with Article 12 which seek to establish a Pathogen Access and Benefit Sharing Mechanism, and Article 13 addressing supply chain and logistics management. Articles 10, 11 and 13 will be discussed by the Drafting Sub-group chaired by Ambassador Amr Ramadan of Egypt at 5.00 pm CET, also on 4 December. The meeting will be co-facilitated by the Philippines and the US.

Article 12 is scheduled separately for 5 December, at 9.00 am CET, and this Drafting Sub-group will be chaired by Dr. Viroj Tangcharoensathien of Thailand. The co-facilitators are Ethiopia, Australia and Norway. There is no discussion on Article 9 in the drafting sub-groups.

The major debating point in these Articles is that whether they really create any legally binding obligation on parties to ensure diversification of production of pandemic-related products such as medicines, vaccines or diagnostics. Developing countries seek to create institutional mechanisms like a Global Production and Distribution Mechanism, Technology Access Pool, and arrangements like designated production facilities etc. for reducing the transactional nature of transfer of technologies and sharing of pandemic related products thorough pre-determined agreements and arrangements in these mechanisms.

However, developed countries who want to protect the status quo monopolies of their pharmaceutical companies, continue to oppose and dilute such proposals. They want to reduce the entire issue of equitable access to pandemic-related products to a simple matter of procurement management. This is despite the major shortfalls experienced in the real supplies of health products during the COVID-19 Pandemic.

Articles 4 to 6 and 8: Real Preparedness traded Off for Enhancing Surveillance

In the Bureau’s proposed Draft Negotiating Text, Article 4 deals with Pandemic Prevention and Public Health Surveillance, Article 5 with One Health, Article 6 is on Preparedness, Readiness and Resilience and Article 8 deals with Preparedness Monitoring and Functional Reviews.

The Drafting Sub-group on Articles 4, 5 and 6 is also scheduled for 4 December at 1.30 pm CET, and will be chaired by Ambassador Honsei Kozo of Japan. The meeting of the sub-group will be co-facilitated by India, Tanzania and the United Kingdom.

The major concern in these Articles faced by the developing countries is the overemphasis on surveillance and information sharing obligations in the name of pandemic prevention and preparedness. There are at least four types of surveillance mentioned between Articles 4 and 6 such as integrated surveillance, collaborative surveillance, one health surveillance and antimicrobial resistance surveillance. There is, however, very limited clarity on what these obligations on surveillance means and the scope of such obligations. This allows the funding agencies and other international donors to keep on requiring developing countries to expand their surveillance capacities, sometimes even beyond what is necessary.

On the other hand, there are no clear obligations addressing social, economic and environmental determinants of health, promoting universal health care, enhancing access to vaccines and immunization schemes etc. which would have served as real prevention of pandemics. There is also very limited understanding of how the proposals on One Health will affect the real public health priorities of developing countries. Therefore, these provisions lack effective safeguards protecting the interests and priorities of developing countries.

Similarly, Article 8 on preparedness monitoring seeks to build on existing arrangements of monitoring and evaluation and subject countries to expert and peer reviews. However, there is no clarity on who will determine the monitoring and evaluation frameworks and their components. Currently such frameworks are developed by technical expert groups and the WHO Secretariat. This has to change, and there should be a real intergovernmental process in developing these frameworks; otherwise, capacity needs of developing countries such as local capacities for production of pandemic-related products, or expansion of primary health care facilities will remain out of focus in the monitoring and evaluating exercises.+