TWN Info Service on Health Issues (Jul24/01)
16 July 2024
Third World Network

WHO: Proposed INB10 work plan seeks to rush negotiations, compromising equity

Geneva, 16 July 2024 (TWN) – The proposed work plan to be considered and adopted during the 10th meeting of the Intergovernmental Negotiating Body (INB10) on the pandemic instrument seeks to continue negotiations in a rushed manner, compromising the prospects of equity in the instrument.

The proposed work plan along with a tentative meeting schedule and updates to the current method of work was circulated by the INB Bureau on 11 July 2024. Member States in the INB will discuss the work plan, schedule and the updates during on 16 - 17 July at the WHO Headquarters in Geneva. INB10 will be conducted in an hybrid mode.

Earlier in June 2024, the 77th Session of the World Health Assembly (WHA77) had decided to extend the mandate of the INB for another year, i.e. up to WHA78.

Decision WHA77/20 extended the mandate of the INB “to draft and negotiate a WHO convention, agreement or other international instrument on pandemic prevention, preparedness and response to finish its work as soon as possible, and submit its outcome for consideration by the Seventy-eighth World Health Assembly in 2025, or earlier by a special session of the World Health Assembly if possible in 2024”.

The proposed work plan now aims to conclude the work of INB10 by December 2024 and call for a special session of the WHA to consider the adoption of the outcome document.

The 11th meeting of the INB is proposed to be conducted on 9 - 20 September 2024, and the 12th meeting on 4 - 15 November. Interestingly, the proposed work plan is requesting INB to consider 15 November as the deadline for calling the WHA Special Session.

However, the work plan also provides options for possible dates for INB meetings beyond the 15 November deadline to further negotiate if necessary. These meetings in total have only 10 days scheduled before WHA78, i.e. between 2 - 6 December 2024, and 24 - 28 February 2025.

The INB negotiations are frontloaded, with a view to continuing the same rushed manner of negotiations observed up to the WHA77 last May. This approach involves proposals to defer key equity elements to future instruments to be adopted only after the pandemic instrument itself comes into force. The concerns relating to this approach, in particular of fragmenting the international health law regime, was earlier reported by Third World Network (TWN).

The proposed work plan seeks to build on an ostensible progress that has been achieved by the INB, and the initial agreement reached on many provisions of the proposed pandemic Instrument and focuses on the remaining elements. It suggests that: “The INB will continue its negotiations on the text of the proposal for the WHO Pandemic Agreement contained in the Appendix to document A77/10, building upon the provisional agreement on the text highlighted in green, and focusing on text for which initial convergence was reached and is highlighted in yellow, as well as on all outstanding elements, in a prioritised manner”.

While such an approach would be perceived as appropriate in usual circumstances, the unusual situation and conditions, prior to the WHA77, in which WHO Member States negotiated the pandemic instrument in INB under pressure, call for much greater flexibility going forward with INB negotiations.

It must be noted that the texts were highlighted “green” and “yellow” prior to WHA77 under significant pressure in parallel small groups, where several small delegations could not effectively intervene. Meetings of the INB alongside meetings of the Working Group on Amendments to the International Health Regulations 2005 (WGIHR) were conducted almost in a marathon manner during the months of April and May 2024, compromising small delegations’ capacities to focus on the various aspects of the draft under consideration in INB.

Member States were also put under pressure to consider adopting additional instruments on Pathogen Access and Benefit Sharing and on One Health Approach, in April and May, in order to conclude negotiations by May 2024. The proposals were introduced not to develop consensus on these issues, but to park the divergence in these critical issues into future instruments. These proposals currently remain on the INB table, even though the INB now has one full additional year to negotiate further.

Member States could be pressured not to deviate from these proposals, citing the need to conclude before 15 November, meaning equity will remain elusive, even if a special WHA session adopts the pandemic instrument in December 2024.

Furthermore, the proposed work plan does not provide enough policy space for WHO Member States to examine the draft pandemic instrument in light of the changed circumstances following the WHA77, particularly the adoption of amendments to the International Health Regulations (IHR) 2005.

The WGIHR has adopted amendments to IHR 2005 setting the legal framework for achieving equity in health emergency preparedness and response, including for access to health products and technologies during pandemic emergencies.

The pandemic instrument currently under discussion in the INB must be considered as a supplementary instrument for augmenting pandemic prevention, preparedness and response efforts under Article 57 of IHR 2005, read with appropriate provisions under the Constitution of WHO in order to avoid fragmentation of this legal framework for equity. The legal provisions of the pandemic instrument should thus ensure “IHR plus equity” in the pandemic instrument.

However, it is doubtful whether the updated method of work in the proposed work plan allows time and space for achieving this. The proposed work plan seeks to continue with simultaneous conduct of parallel sessions for drafting under various names such as “informal meetings” and “working group meetings”. It also allows the INB Bureau to conduct “smaller informal meetings” apart from the working groups that already divide the drafting group.

Furthermore, it seeks to open drafting sessions to relevant stakeholders, without taking into account the power asymmetry between developing country stakeholders and big pharma representatives from the global north. All these would put developing country negotiators in a further disadvantaged position, jeopardising equity.