TWN Info Service on Health Issues (Mar24/01)
1 March 2024
Third World Network

WHO: Developing countries call for deliverable provisions on access and benefit sharing, equity in pandemic instrument

Geneva, 1 March (TWN) – Developing countries called for deliverable provisions on an access and benefit sharing mechanism and equity in their opening statements during the plenary of the 8th meeting of the Intergovernmental Negotiating Body (INB), which took place on 19 February.   
The 8th meeting of the INB is taking place at the WHO Headquarters in Geneva from 19 February to 2 March in a hybrid mode.

The remarks of developing countries are even more relevant in light of continued resistance from developed countries to address both the above-mentioned issues. Unlike the developing countries, the developed countries want to stress on the issue of one health surveillance and argue more on technical issues like feasibility and practical realities of deadlines in the negotiation mandate, among others.

Ethiopia on behalf of the Africa Group comprising 47 member states reiterated their position that for “equity to remain as a principle, indicator and outcome of the Instrument, there is need for concrete and tangible proposals and “future proofing” our health systems”.

Further, the Africa Group expressed great concern that “Article 12 on Pathogen Access and Benefit Sharing that will translate the provisions into meaningful impact at all levels including the community, lags behind and there is no agreed text yet. We see this article and its linkages to other articles as the backbone of the whole instrument”.

The Africa Group also stressed the need for sustainable and diversified local production along with transfer of technology and know-how to, and research and development capacities for developing countries. The statement termed both these elements as critical for ensuring equitable access during a pandemic.

The Group of Equity, a cross regional coalition of 29 developing countries demanding equity in the International Health Regulations (IHR) and the new pandemic instrument stated that only through collective efforts and putting lives above profit through overriding commercial interest can equitable public health response be achieved.

It also stated the need for financial resources, stressing that “there is a dire need to mobilize more resources in the spirit of international cooperation and solidarity. It would be unjust to burden the countries with such additional responsibilities when most of them have not been capable to fully vaccinate their people against the COVID-19 pandemic”.

The Group of Equity urged for the following four things:

First, the need for an ABS (access and benefit sharing) system at the core of the pandemic instrument. Only through ABS can a level playing field between developed and developing countries be envisaged and a more equitable health response can be ensured.

Second, transfer of technology and know-how as well as support for local and regional manufacturing of pandemic related products.

Third, sustainable financing of the instrument, which takes into account the different levels of development of Member States.

Fourth, on governance, the need to establish a clear, transparent and accountable governance system that ensures the smooth engagement of relevant entities and various mechanisms established under this instrument.

The Group of Equity also suggested that the WHO Secretariat provide a glossary of terms since the Special Session of the World Health Assembly 2021 to be used as a basis for the travaux preparatoires (official negotiations record) of the pandemic instrument in order to have a tool for interpretation.

India on behalf of the Southeast Asia Region (SEARO) called up on Member States to not forget the centrality of principles of equity and hoped to translate the concepts into actionable provisions within the instrument. It reiterated the principles of “equity, solidarity, CBDR (common but differentiated responsibilities), and transparency” and emphasised that “We now hope to translate these concepts into actionable and accountable provisions within the text.”

The statement also placed a suggestion to the Chair to set up a committee to record the negotiating history of the instrument. Further the statement stated that the need for a clear enunciation of the role of developed countries to achieve equity within the pandemic instrument framework.

The statement reiterated that “equity should be core of our discussions. We should bear in mind, that increasing obligations for developing countries, some of which are still struggling, and have not still been able to vaccinate their people even now, would be something which none of us would want”.

Further, it also stressed the need to preserve the centrality of WHO and the need to strengthen WHO for better implementation, monitoring and accountability of the pandemic instrument. 

SEARO also expressed their concern over references to various non-negotiated guidelines in the draft negotiating text, which would make these guidelines binding on parties to the pandemic instrument. It states: “… about collective obligations and responsibilities, references to any non-negotiated standards and guidelines, would only be counter-intuitive”.

Bangladesh recalled the WHO Executive Board Decision 150(3), which sets the scope of the IHR 2005 amendments (the parallel negotiation process to INB) and includes equity as an element to be addressed as part of the amendments. The statement suggested the following to move forward in the INB:

·         to put public health at the centre of the treaty; 

·         to keep aside north-south polarity-based considerations;

·         to deliver on equity to build around predictable financing, diversification of production of vaccines, therapeutics, diagnostics etc. and leadership of WHO in its relations with other institutions;

·         to develop a PABS (pandemic access and benefit sharing) System applicable for both pandemic and non-pandemic situations; 

·         to clearly outline the role of developed countries with requisite qualifier throughout the entire treaty to operationalize equity;

·         to link up existing WHO’s processes with the fundamental concepts of the treaty to reduce administrative and financial overhead and thus to ascertain participation of all WHO States Parties.

Eswatini stressed that equity is at the centre of the pandemic instrument and also stated the importance of taking into account the concept of common but differentiated responsibilities. The statement then laid down three areas of concrete action viz. access and benefit sharing (ABS), technology transfer, diversified production and sustainable financing.

On ABS it called for the establishment of an ABS system covering pathogens of pandemic and PHEIC potential. Thus, it called for an ABS system that includes both the IHR and pandemic instrument.

(PHEIC is public health emergency of international concern, the term used in IHR 2005. There is currently no international legal instrument with the term “pandemic”.)

On technology transfer, Eswatini called for the establishment of a Technology Access Pool and said that a coordinated system of production facilities across regions need to be established under the pandemic instrument.

The statement also stressed the need to establish a financial mechanism accountable to the governing body of the pandemic instrument. Eswatini expressed concern on the proposed provision in Article 20 of the draft negotiating text, which envisaged the fund established under the pandemic instrument as a supplementary fund, meaning as the last resort to obtain funds for the instrument’s implementation. According to Eswatini it would “imply external funding agencies will determine the trajectory and progress of implementation”.

Brazil called upon the WHO Member States to use the political momentum to decide on important issues that have been forgotten, i.e. equity and solidarity.  Brazil requested Member States to be practical and cautioned against repeating mistakes of the COVID-19 pandemic response.

The main challenges experienced during the COVID-19 Pandemic, according to Brazil, were the lack of geographically diversified and sustainable local production of medical countermeasures, access to such medical countermeasures (especially vaccines), difficulties and challenges faced by the health workforce and the burden they have to extend, and lack of a clear regime regarding access to pathogens and benefit sharing. These gaps must be addressed meaningfully by the INB.

China supported the statement of the Group of Equity, stating that it appreciates the incorporation of the principle of common but differentiated responsibilities and respective capacities in the pandemic instrument and wanted to reflect the principle in various provisions of the agreement.

China further called for a unified (a fully integrated) access and benefit sharing that respect national sovereignty and ownership of States over biological resources and materials.

South Africa pointed out that “the instrument we are negotiating is trying to correct the inequities that have existed over a long time between developed and developing countries”.

It said that it is not surprised, therefore, that those who have benefited over time have found some difficulties in appreciating the concept of equity and have also found difficulty to let go of the benefits or accept proposed changes that are paramount for the realization of equity.

South Africa reminded the delegations of all key equity-related provisions facilitating diversification of production for the attainment of equitable access to health products and reiterated the need for making them operational through a legally binding instrument.

Mexico, on behalf of Member States of the Americas reiterated commitment to both INB and the Working Group on Amendments to IHR 2005. They stressed on the deadline for concluding negotiations and reiterated that equity should be achieved thorough both INB and the Working Group. They called for including provisions on timely and equitable access to health products, more geographically diversified production capacities, effective prevention and surveillance capacities, resilient health systems, fair and equitable timely sharing of pathogens and benefits through a multilateral system.

The United States indicated that it is fully committed to the process to conclude a successful agreement by the World Health Assembly (in May 2024). It also stated that the agreement should be ambitious but also practical, operationally feasible and implementable.

Reflecting upon the long-standing commitment towards equity and global health, the U.S. said that it is exploring where there can be flexibilities and required other Member States to do so, such that INB concludes an agreement by May 2024. The U.S. wanted to involve stakeholders, particularly in the Article 12 subgroup discussion on pathogen access and benefit sharing system and said that this engagement of the stakeholders is important to arrive at a feasible and implementable agreement.

The European Union said that it would work with all Member States pragmatically in good faith towards a successful outcome by way of the adoption of a meaningful and balanced pandemic agreement in May.

According to the E.U. a sound and successful agreement has to improve prevention preparedness and response by making a concrete difference on the ground. Further, it has to be balanced by way of addressing the full pandemic prevention and response cycle.  In their view, “this requires a concrete, comprehensive and meaningful set of provisions also in the area on prevention, preparedness and one health to make the world a safer place for all of us”.

This means that focus on response capacities (of importance for developing countries) is of very limited interest to the E.U.

The United Kingdom said that the INB has only a few months and there should be a meaningful outcome in May 2024. It wanted to invite stakeholders to the meetings and to listen to them as experts in order to achieve the May 2024 deadline. This will improve feasibility, effectiveness sustainability of the obligation being proposed, according to the U.K. +