TWN Info Service on Health Issue (May24/10)
16 May 2024
Third World Network

WHO: Switzerland rejects proposals for equity in International Health Regulations

Geneva, 16 May (TWN) – Switzerland rejects outright equity-related amendment proposals in the International Health Regulations 2005.

Switzerland in its written submission to the Bureau of the Working Group on Amendments to International Health Regulations (WGIHR) stated: “We would like to request the deletion of all other mentions of health products in the Proposed Bureau’s text, namely in Articles 15, 16, 17, 18, 43, 44, Annex 1.”

The only other country that supports such a blanket deletion of the proposals relating to equitable access to health products is Israel.

The WGIHR has circulated the consolidated text of the IHR amendment proposals, which include the Bureau’s proposals on equitable access to health products and finance. These proposals will be negotiated during the resumed 8^th session of the WGIHR, which is taking place on 16-17 May at the WHO Headquarters in a hybrid mode.

It is learnt that other developed countries such as the European Union, the United States, Japan, Australia and Canada are trying to work through the Bureau’s proposals on the issue, even though they are also making efforts to dilute the Bureau’s already diluted proposals on equity. The Bureau has made proposals relating to equity without retaining several important amendment proposals placed by developing countries.

Switzerland requests the Bureau to keep two short paragraphs in Article 13 which refers to public health response and equitable access to health products and remove all other references to health products as proposed by the Bureau. The proposed two paragraphs from Switzerland are as follows:

“WHO shall support States Parties and coordinate response activities during public health emergencies of international concern, including pandemic emergencies. This support may include, as necessary, coordinating with mechanisms and networks that facilitate equitable allocation and distribution of relevant health products.”

“Pursuant to paragraph 5 of this Article, and paragraph 1 of Article 44 of these Regulations, States Parties shall undertake to collaborate with, and assist each other, as appropriate, to support WHO-coordinated response activities. This support may include, as appropriate, the facilitation of access to relevant health products, in accordance with applicable international law, including through WHO-coordinated mechanisms.”

These two paragraphs are proposed in lieu of the Bureau’s proposals for paragraphs 7 to 9, which read as follows:

“7. WHO shall support States Parties and coordinate response activities during public health emergencies of international concern, including pandemic emergencies, after their determination pursuant to Article 12 of these Regulations.

8. WHO shall facilitate equitable access by States Parties to relevant health products after the determination of a public health emergency of international concern, including a pandemic emergency. To that effect, the Director-General shall:

(a) conduct, and periodically review and update, assessments of the public health needs, as well as of the availability and accessibility, including affordability, of relevant health products for the public health response; publish such assessments; and consider the available assessments while issuing, modifying, extending or terminating temporary recommendations pursuant to Articles 15, 17, 18, and 49 of these Regulations;

(b) make use of existing WHO-coordinated mechanisms, or facilitate their establishment as needed, and coordinate, as appropriate, with other allocation and distribution mechanisms and networks that facilitate equitable and unobstructed access to relevant health products based on public health needs;

(c) collaborate with relevant stakeholders to support States Parties, upon their request, in scaling-up and diversifying, as appropriate and in accordance with relevant international law, the production of relevant health products;

(d) share with a State Party, upon its request, the product dossier related to a specific relevant health product, as provided to WHO by the manufacturer for approval and where the manufacturer has consented, within 30 days of receiving such request, for the purpose of facilitating regulatory evaluation and authorization by the State Party.

(e) support States Parties, upon their request, and, as appropriate, in collaboration with relevant stakeholders pursuant to sub-paragraph (c) of this paragraph, to strengthen local production; achieve quality assurance for the evaluation and regulatory approval of locally manufactured relevant health products; and facilitate the [voluntary] transfer of technology, know-how and expertise [on mutually agreed terms], including for research and development purposes.

9. Pursuant to paragraph 5 of this Article and paragraph 1 of Article 44 of these Regulations, States Parties shall undertake to collaborate with, and assist each other, to the extent possible, and, upon request of other States Parties or WHO, support WHO-coordinated response activities, including facilitating equitable access to relevant health products, in accordance with applicable law. To that effect, States Parties shall:

(a) support WHO in implementing actions outlined in this Article;

(b) engage with and encourage relevant stakeholders operating in their respective jurisdictions, to facilitate equitable access to relevant health products for responding to a public health emergency of international concern, including a pandemic emergency;

(c) publish, as appropriate, relevant terms of government-funded research and development agreements for relevant health products related to promoting equitable access to such products during a public health emergency of international concern, including a pandemic emergency.”

It must be noted that Bureau’s proposal is in itself a dilution of the Africa Group and Bangladesh proposal for a new Article 13A which specifically deals with access to health products, technologies and know-how. There is no more proposal for Article 13A, which initially had eight key paragraphs.

The proposal on intellectual property law exemptions as proposed by the Africa Group and Bangladesh has disappeared from the negotiating table, unless some States bring it back to the discussions.

Regarding technology transfer and sharing of know-how the Bangladesh proposals on timely development and sharing of pharmacopoeia monographs as well as sharing of biological starting materials are not taken into account.

Countries like the U.S. and those from the E.U. are already pushing for voluntary and mutually agreed terms clauses regarding technology transfer. The U.S. reportedly has attempted to threaten the negotiators in the WGIHR that if voluntary and mutually agreed terms have to be removed from the IHR 2005, then technology transfer should also be removed from IHR 2005.

Further proposals for effective pathogen access and benefit sharing now seems to be parked in the negotiations for the WHO pandemic agreement. In short, there is no provision for consideration at the WGIHR which would promote diversification of production in different regions and thereby ensure equitable access promptly or predictably.

It is unfortunate to note that the colonial and euro-centric international law narratives still cloud the current negotiations. For example, when States Parties are obligated to respond to offers of assistance or collaboration from WHO, there is no corresponding obligation on the States Parties to respond to requests for assistance from WHO. It is even more unfortunate that although the current amendment proposal for new IHR authorities is all colour coded green, except for one sentence in Article 4, there is no corresponding obligation on the WHO contact point to provide a response to requests for surveillance.

(The green colour code means there is an in-principle consensus on the text.)

It is at this stage that Switzerland is proposing the blanket deletions for IHR 2005 amendments, wherever “relevant health products” is mentioned and Israel is backing the same. These proposals from Switzerland, if accepted, means the WGIHR would be going against the WHO’s Executive Board (EB) Decision 150.3, which provides the clear mandate to address equity issues in the IHR.

EB 150.3 states: “ Such amendments should be limited in scope and address specific and clearly identified issues, challenges, including equity, technological or other developments, or gaps that could not effectively be addressed otherwise but are critical to supporting effective implementation and compliance of the International Health Regulations (2005), and their universal application for the protection of all people of the world from the international spread of disease in an equitable manner”.