Can the WHO Special Assembly on Nov.29-Dec. 1 produce a binding instrument useful to prevent the “Next Pandemic”?
(Notes on the WHO-sponsored “pandemic treaty” that will be discussed Nov. 29-December 1, 2021, WHO Special Assembly) : Here’s what to expect
Based on the most recent Resolutions of the World Health Assembly: an expected outcome is a resolution “Strengthening WHO Preparedness” etc. , and at best, a resolution on aspirational statements on the WHO One Health approach, which contains aspirational statements on land management, deforestation, wildlife trade regulation but no binding provisions nor specific enforcement mechanisms on these.
DO NOT EXPECT ANY COMPREHENSIVE INSTRUMENT ON PREVENTING A SIMILAR PANDEMIC OF ZOONOTIC TRANSMISSION.
US, China, Russia, etc. did not sign the preparatory resolutions, and are cold to a WHO-sponsored pandemic treaty — the US presidential spokesperson in a separate briefing stressing that it might detract from the worldwide effort to contain the present pandemic, while the Russian delegate in a separate occasion being more frank by saying that there has to be an assessment first of why existing international instruments, including those granting WHO mandates, were not enough to prevent the present pandemic, and determining why there should be an overhaul of all these — but not without first containing the present pandemic.
Quoted below is the only “working paper” published online (in the form of resolutions) on the Nov. 29-Dec. 1 WHO Special Assembly upon which the above prognosis was based.
Strengthening WHO preparedness for and
response to health emergencies
The Seventy-fourth World Health Assembly,
1. DECIDES:
(1) to request the Member States Working Group on Strengthening WHO Preparedness and Response to Health Emergencies to prioritize the assessment of the benefits of developing a WHO convention, agreement or other international instrument on pandemic preparedness and response and to provide a report to be considered at the special session of the Health Assembly referred to in paragraph OP1.2 of this decision;
(2) to request the Director General to convene a special session of the World Health Assembly in November 2021, and to include on the agenda of the special session only one item dedicated to considering the benefits of developing a WHO convention, agreement or other international instrument on pandemic preparedness and response with a view towards the establishment of an intergovernmental process to draft and negotiate such convention, agreement or other international instrument on pandemic preparedness and response, taking into account the report of the Working Group on Strengthening WHO Preparedness and Response to Health Emergencies referred to in paragraph OP1.1;
(3) to request the Executive Board at its 149th session to determine, in accordance with Rule 2 of the Rules of Procedure of the Health Assembly, that the special session of the Health Assembly referred to in paragraph OP1.2 of this decision will be held from 29 November 2021 to 1 December 2021 at WHO headquarters, either in person or virtually, if limitations to physical meetings preclude the holding of the special session in person;
(4) to suspend, in accordance with Rule 122 of the Rules of Procedure of the Health Assembly, and with respect to the above-referenced Special Session, the requirement of Rule 2 of the Rules of Procedure of the World Health Assembly under which the Director-General is to convene a special session of the Health Assembly within 90 days of the receipt of the request therefor.
Strengthening WHO preparedness for and response to health emergencies
The Seventy-fourth World Health Assembly,
x x x
OP7. URGES Member States:
1 (1) to increase and improve efforts to build, strengthen and maintain the capacities required under the International Health Regulations (2005) and continue to report annually to the Health Assembly on the implementation of the International Health Regulations (2005), using as appropriate, available tools included in the International Health Regulations (2005) monitoring and evaluation framework;
(2) to strengthen core public health capacities and workforce for indicator-based and early[1]warning surveillance, based, inter alia, on disease-specific surveillance, syndromic surveillance, event-based surveillance of health-related behaviour, surveillance data relating to animal and environmental health enabling detection of public health events requiring rapid assessment, notification and public health response, in order to ensure that all relevant events are rapidly detected and controlled;
(3) to adopt an all-hazard, multisectoral, coordinated approach in preparedness for health emergencies, recognizing the links between human, animal and environmental health and the need for a One Health approach;
(4) to increase their capacity to detect new threats including through laboratory techniques, such as genomic sequencing;
(5) to notify WHO of public health events within their respective territories according to relevant provisions of the International Health Regulations (2005), including any events that may cause a public health emergency of international concern, as well as any health measures implemented in response to those events; and continue to communicate to WHO timely, accurate and sufficiently detailed public health information and laboratory results available to them on these events, as well as on the difficulties faced and support needed in responding to these events;
(6) to share with their population and the global community reliable and comprehensive information on health emergencies and the public health responses to be taken by local, national, regional and international public health authorities, and take measures to strengthen health literacy and to counter misinformation, disinformation and stigmatization, including by providing access to other sources of fact- and science-based information;
(7) to strengthen cooperation to create mechanisms for communication, coordination and articulation of programmes and policies on health issues, considered of shared interest, between
(Footnote 1 And regional integration organizations as appropriate.)
linked border localities, to adequately respond to risks and public health emergencies of international concern;
(8) to work towards achieving strong and resilient health systems and universal health coverage, as an essential foundation for effective preparedness and response to public health emergencies, and adopt an equitable approach to preparedness and response activities, including to mitigate the risk that health emergencies exacerbate existing inequalities in access to services, including for immunization and nutrition, chronic infectious diseases and noncommunicable diseases, mental health, maternal and child health, sexual and reproductive health care services, rehabilitation and long-term care services;
(9) to take steps to ensure that the response to health emergencies and pandemics does not exacerbate other global health challenges, including the ongoing necessity to address issues such as lack of access to health services and medicines, the burden of neglected diseases, and the necessity to preserve the efficacy of antimicrobials, particularly antibacterials, including through appropriate stewardship, prudent use and sustainable access;
(10) to cooperate to facilitate cross-border travel of persons for essential purposes during a health emergency and avoid unnecessary interference with trade without undermining efforts to prevent the spread of the causative pathogen, in accordance with the International Health Regulations (2005);
(11) to support stronger coordination with relevant multilateral organizations to improve understanding and mechanisms to address travel and trade considerations, including on how best to de-link travel from trade restrictions during public health emergencies of international concern, pursuant to the International Health Regulations (2005), with the goal of maximizing the effectiveness of public health measures while minimizing negative economic impacts, including by facilitating the manufacturing and movement of critical medical supplies essential to the public health response;
(12) to take steps to prevent, within their respective legal frameworks and contexts, speculation and undue stockpiling that may hinder access to safe, effective and affordable essential medicines, vaccines, medical equipment and other health products, as may be required to effectively address health emergencies;
(13) to keep transport networks and supply chains open in order to facilitate timely, equitable and affordable access to essential, safe, affordable, quality and effective medical products, especially for landlocked developing countries and small island developing States;
(14) to support and work on enhancing regional and international cooperation mechanisms to ensure universal, timely and equitable access to, and fair distribution of, quality, safe, efficacious and affordable essential health technologies and products, including their components and precursors during global health emergencies;
(15) to promote enhanced response to future pandemics based on the lessons learned from the COVID-19 pandemic and other public health emergencies of international concern, taking into account all the obstacles that impeded the effective response to, and treatment of, the disease as well as the need for all countries to have unhindered access to vaccines and essential health products;
(16) to strengthen WHO’s capacity to rapidly and appropriately assess disease outbreaks that may potentially constitute a public health emergency of international concern as early as possible, in close coordination and consultation with Member States, and to systematically communicate the results of such assessments to Member States;
(17) to seek to ensure the adequate, flexible, sustainable and predictable financing of WHO’s Programme budget including the WHO Health Emergencies Programme as well as the Contingency Fund for Emergencies and follow up on the recommendations of the Working Group on Sustainable Financing;
OP8. CALLS ON international actors, partners, civil society and the private sector:
(1) to support all countries, upon their request, in implementing their multisectoral national action plans, in strengthening their health systems to respond to health emergencies, and in maintaining the safe provision of all other essential public health functions and services
(2) to strengthen partnerships, global coordination and cooperation in response to infectious diseases based on lessons learned from COVID-19 and previous public health emergencies of international concernand fostering a One Health, whole-of-society and health systems strengthening approach, including between WHO and relevant multilateral organizations, including the signatory agencies of the Global Action Plan for Healthy Lives and Well-Being for all;
(3) to address – where relevant, in coordination with Member States – the proliferation of disinformation and misinformation particularly in the digital sphere, as well as the proliferation of malicious cyber-activities that undermine the public health response; and to support the timely provision of clear, objective and science-based data and information to the public;
OP9. REQUESTS the Director-General, as soon as practicably possible and in consultation with Members States:
(1) to strengthen the global, regional, national and subnational pandemic preparedness system, support implementation by States Parties of the International Health Regulations (2005) and of core capacities required under the International Health Regulations (2005), provide clear guidance regarding requirements for States Parties under the International Health Regulations (2005), build and strengthen tailor-made support and tools for States Parties through regional and country offices and continue working collectively and collaboratively with partners and States Parties to bridge identified gaps in core capacities required under the International Health Regulations (2005), including through international cooperation, when requested;
(2) to make recommendations to Member States to build a more robust, transparent, consistent, scientific, evidence-based and cohesive International Health Regulations (2005) monitoring and evaluation framework that enables accurate assessment and reporting on national capacities in consultation with States Parties as well as actions to improve International Health Regulations (2005) implementation;
(Footnote 2 And regional economic integration organizations as appropriate.)
(3) to develop a detailed concept note to be included in the report by the Director-General to the Seventy-fifth World Health Assembly for the consideration of Member States as they determine next steps on the voluntary pilot phase of the Universal Health and Preparedness Review mechanism, based on the principles of transparency and inclusiveness, and on how it builds on existing International Health Regulations (2005monitoring and evaluation framework components with the aim to assess, improve and strengthen accountability, cooperation, trust and solidarity around overall preparedness;
(4) to lead an evidence-based process, in consultation with Member States, relevant United Nations and other international organizations and other stakeholders, as appropriate, and taking into account the recommendations of the IHR Review Committee:
(i) to develop practical guidance for the implementation of the International Health Regulations (2005) to prevent, protect against, detect, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks and which do not unduly impede cross-border movement of people and supplies for essential purposes;
(ii) to prepare a report on the options, implications, benefits, possible consequences and potential risks of de-linking travel from trade restrictions during public health emergencies of international concern determined pursuant to the International Health Regulations (2005), with the goal of maximizing the effectiveness of public health measures while minimizing their economic impacts;
(iii) to develop recommendations, taking into consideration national circumstances, on the appropriate implementation of travel restrictions, including guidance to assist countries to facilitate the return of citizens and permanent residents to their territories and, vice versa, facilitate the departure from and transit through their territory of nationals and permanent residents of third countries;
(iv) to develop guidance on situations that may occur in the context of international conveyances, seafaring and aviation during public health emergencies, such as outbreaks on international cruise ships, including the division of roles and responsibilities of the various actors concerned when responding to such situations;
v bis) to review and report on States Parties’ experience with dispute settlement under Article 56 of the International Health Regulations (2005);
(5) to develop strategies and tools for managing the impact of health emergencies on gender equality, health systems and health service delivery, including by comprehensively increasing the resilience and capacity of health systems, in particular the health workforce, in the provision of essential public health functions and quality essential health services including those for strong routine immunization, mental health and psychosocial support, trauma recovery, sexual and reproductive health and maternal, newborn and child health during health emergencies with a view to achieving universal health coverage;
(6) to consider establishing risk communication strategies, adaptable to states and regions, including to facilitate specific local capacity-building, mobilize financial and technical resources
(Footnote 3 And regional economic integration organizations as appropriate.)
and, eventually, assist countries in elaborating goal-directed development plans, including performance indicators, as a key feature of public health systems’ responsiveness;
(7) to develop a global framework to generate, monitor, compare and evaluate research and policies on public health and social interventions and assess their broader impact to harness global knowledge and expertise and to translate evidence into effective health emergency and preparedness policies;
(8) to review and strengthen or reform, as applicable, existing tripartite reporting mechanisms, such as the Global Early Warning System for Major Animal Diseases (GLEWS) improving communication and information exchange across existing surveillance networks across the One Health sectors;
(9) to build on and strengthen the existing cooperation among WHO, FAO, OIE and UNEP to develop options, for consideration by their respective governing bodies, including establishing a common strategy on One Health, including a joint workplan on One Health to improve prevention, monitoring, detection, control and containment of zoonotic disease outbreaks;
(10) to report on efforts to accumulate expertise on and raise visibility of One Health issues with a specific view to zoonoses, including from wildlife, through the work of the “One Health High[1]Level Expert Panel”;
(11) to propose options to increase the transparency on the appointment, membership and deliberations of the IHR Emergency Committee including a more robust, transparent and inclusive risk assessment process, as well as detailed reporting of its proceedings, in particular in relation to its recommendations on declarations of, and suggested response measures to, public health emergencies of international concern, including options for the engagement of Member States with it;
(12) to make concrete suggestions for potential intermediate and regional levels of alert, complementary to a public health emergency of international concern, with clear criteria and practical implications for countries;
(13) to support countries, upon their request, in strengthening capacities to report on the information required under the International Health Regulations (2005), in particular under Articles 6–10, including the simplification and unification of reporting processes by States Parties and strongly encourage compliance with the International Health Regulations (2005), including reporting and sharing of information at the earliest possible stage of an outbreak of epidemic or pandemic potential in line with Article 44 requiring States Parties to collaborate with each other, to the extent possible, in the detection and assessment of, and response to, events as provided under the Regulations;
(14) to make proposals on the use of digital technologies, by WHO and International Health Regulations (2005) States Parties and, as appropriate, other stakeholders, to upgrade and modernize communication on health emergency preparedness and response, including for the improved implementation of International Health Regulations (2005) obligations, through the development of an interoperability framework for secure global digital health information exchange, and support measures to counter the spread of stigmatization, misinformation and disinformation;
(15) to work together with Member States, the medical and scientific community, and laboratory and surveillance networks, to promote early, safe, transparent and rapid sharing of samples and genetic sequence data of pathogens of pandemic and epidemic, or other high-risk, potential, taking into account relevant national and international laws, regulations, obligations and frameworks, including, as appropriate, the International Health Regulations (2005), the Convention on Biological Diversity and the Nagoya Protocol on Access to Genetic Resources and the Fair and Equitable Sharing of Benefits Arising from their Utilization and the Pandemic Influenza Preparedness Framework and the importance of ensuring rapid access to human pathogens for public health preparedness and response purposes;
(16) to support countries, upon request, in developing and implementing national response plans to health emergencies, by developing, disseminating and updating normative products and technical guidance, learning tools, data and scientific evidence for public health responses, to provide accurate, timely and evidence-based information;
(17) to perform fully and effectively the functions entrusted to it under the International Health Regulations (2005), in particular through strategic health operations that provide swift support to countries in detection and assessment of, and response to, public health emergencies;
(18) to ensure that the advice and support provided by WHO to Member States to improve pandemic preparedness and response to public health emergencies takes into consideration different national circumstances and focuses, inter alia, on strengthening health systems;
(19) in collaboration with Member States,1 other international organizations, civil society and the private sector, and based on lessons learned from the COVID-19 response and prior health emergencies, including experience in operationalizing the Access to COVID-19 Tools Accelerator and the COVID-19 supply chain system, to propose strategies to enable rapid research, development, production and global equitable distribution of quality, safe, effective and affordable medical and other countermeasures and commodities at national, regional and global levels to respond to future health emergencies;
(20) to strengthen WHO’s normative role, including by strengthening the technical capacity of the WHO Health Emergencies Programme, the Chief Scientist’s Office, as appropriate and the data and analytics and delivery team, and further leveraging WHO collaborating centres and expert networks in order to enable WHO to rapidly disseminate high-quality, scientific, evidence[1]based timely, technical guidance that is practically applicable and tailored for country-level settings, and to make global expertise available to Member States, through all levels of WHO, including the WHO Academy;
(21) to strengthen global, regional and country preparedness and response capabilities and capacities for health emergencies by enhancing engagement of relevant stakeholders at all levels;
(22) to support efforts led by Member States to improve the transparency and effectiveness of United Nations system efforts on pandemic preparedness and response and work with the United Nations Secretary-General and all multilateral partners to enhance system-wide coherence;
(Footnoe 4 And regional economic integration organizations as appropriate.)
(23) to strengthen the WHO Health Emergencies Programme’s capacity to prepare for and respond to both acute and protracted humanitarian crises and health emergencies, including steps to reinforce WHO’s leadership and coordination of the Inter-Agency Standing Committee Health Cluster and its complementarity to other humanitarian actors, taking into account the recommendations of the Independent Oversight and Advisory Committee for the WHO Health Emergencies Programme;
(24) to strengthen WHO’s communications to Member States in advance of and during public health emergencies, including through governing bodies meetings, the use of Member State briefings, and complementary communications as appropriate to Member States’ national focal points;
(25) to strengthen effective, representative and transparent governance, communication and oversight mechanisms, including by strengthening engagement with the Executive Board, that enable Member States to provide informed guidance to WHO’s work, especially during health emergencies, and ensuring participation of Member States at different levels and structures of international health protection;
(26) to strengthen WHO’s efforts to prevent and address sexual exploitation and abuse and sexual harassment, including in humanitarian emergencies when sexual exploitation and abuse and sexual harassment may be at greater risk of occurring;
(27) to review and, as appropriate clarify, in consultation with Member States, the roles, nomination procedures and mandates of the Independent Oversight and Advisory Committee for the WHO Health Emergencies Programme, the Global Preparedness Monitoring Board and other relevant entities dealing with WHO emergency preparedness and response;
(28) to continue efforts to respond to recommendations of the IOAC and integrate them as appropriate into the systems, structures, planning, working methods and organizational culture of the WHO Health Emergencies Programme and WHO more broadly, including into the gender and geographical balance approach;
(29) to extend the mandate of the Independent Oversight and Advisory Committee for the WHO Health Emergencies Programme to 2023 and consider steps to further strengthen its mandate based on the review;
(30) to support the work of the Working Group on Sustainable Financing for WHO, established by the Executive Board at its 148th session, as an integral element of the process of strengthening WHO, and at the same time, increase the financial transparency and accountability at all levels of the Organization and based on the outcomes of its work:
(i) increase efforts to broaden the donor base, including through the WHO Solidarity Fund and the WHO Foundation, while ensuring transparency and accountability and full Member States’ oversight of the process;
(ii) assess the role and strategy of the Contingency Fund for Emergencies, and consider implementing a sustainable financing and replenishment mechanism for it in coordination with the relevant funding mechanisms, including the World Bank’s Pandemic Emergency Financing Facility, in responding to health emergencies;
(31) to support the Member States Working Group on Strengthening WHO preparedness and response to health emergencies, by:
(i) convening its first meeting no later than 17 September 2021, announcing the date of that first meeting no later than 30 July 2021 and convening it thereafter at the request of the Member States Working Group Bureau as frequently as necessary;
(ii) providing complete, relevant and timely information to the Working Group for its discussions;
(iii) allocating the necessary resources for the Working Group to carry out its mandate, and provide information on anticipated cost and source of funding;
(32) to present a report on the implementation of this resolution to the Seventy-fifth World Health Assembly through the Executive Board at its 150th session.
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