Press Release – Equity Remains A Major Hurdle To Consensus At The WGIHR This Week

The seventh meeting of the Working Group on Amendments to the International Health Regulations (2005) took place 5th – 9th February 2024 in Geneva, Switzerland.

The opening session of the 7th meeting of the WGIHR took place on 5th February 2024 and was an open session that was publicly webcast. The entire session can be watched here.

OPENING SESSION

The session was opened with introductory comments by the Co-Chairs, Dr Assiri Abdullah and Dr Ashley Bloomfield. Dr Mike Ryan spoke on behalf of the Director General, Dr Tedros Adhanom Ghebreyesus (who was travelling to Brazil).

Key points of the Opening Session (numbers shown in brackets are time stamps of the quoted speech)

(11:40) Dr Ashley Bloomfield

“It will be important for both this process and the INB process that we make good progress this week. It will be important for us, of course, but also for those who are watching our work to see that we are able to achieve the results within the deadline we’ve been given and to report to the WHA in May.  

The second comment I wanted to make is that I’m sure in many of your countries or jurisdictions, like ours in New Zealand, there is a quite well coordinated campaign to try and undermine this process and the INB process and, indeed, to try to undermine the work of the WHO so it’s important, in our work, that we provide confidence both in the importance of the work and the fact that it is a member state led process and that sovereignty of countries is not threatened by this process but the sovereignty of each country can be enhanced by us all working together collectively. And I think we need to keep that in mind this week and we will be working hard and this is an issue we raised with the executive board last month when we spoke with them. We will be working hard to make sure there is public profile for this work and that it does address the mis and dis information that is being targeted at our process.”

It is worth noting that the deadline Dr Bloomfield refers to in his opening remarks has already been missed in breach of international law (whatever that means). Article 55.2 of the IHR provides, “The text of any proposed amendment shall be communicated to all States Parties by the Director-General at least four months before the Health Assembly at which it is proposed for consideration.” The 77th World Health Assembly (WHA) commences on 27th May 2024, therefore the deadline for the text of proposed amendments to be delivered to the Director-General was 27th January 2024 yet the WGIHR continue to negotiate the proposed amendments. It therefore should not be about “good progress” as the WGIHR should not be in a position to negotiate for a further 10 days (there is an 8th meeting of the WGIHR scheduled for 22nd to 26th April 2024).

As UK Citizen has previously pointed out, the sovereignty of countries is not threatened by this process in the sense that international law binds countries not people – only domestic law can be enforced against the people via implementing legislation. Dr Bloomfield is therefore correct on his statement. In the UK, however, such implementing law is already in place as was indicted by Andrew Stephenson CBE MP, Minster of State, “The UK already had in place many of the appropriate national structures to meet their core capacity requirements under the IHR. However, domestic legislation was required to enable the UK to meet some of its obligations/requirements under the IHR. The implementing legislation for the IHR is comprised of two keys pieces. These are the Public Health (Control of Disease) Act 1984 and The Health Protection Agency (Amendment) Regulations”. Consequently, anything agreed by unelected, unaccountable and largely unknown UK diplomats during the WGIHR process will find its way into domestic law thereby infringing on the freedoms and rights of the people. It is therefore vital that we lobby MPs to ensure the amendments to the IHR, which have nothing to do with promoting the health of the people, are rejected at the WHA in May 2024 (even then there will be work to do, domestically, if we are to prevent a repeat of the tyrannical policies employed by the UK government during the Covid-19 ‘pandemic”).

Dr Bloomfield is keen to convince the people that the WGIHR process is a “member state led” process, but is it? UK Citizen suggests that most people would take that to mean that elected representatives, of the UK, are present at the WGIHR meetings. This is not the case. Rather, it is unelected, unaccountable, largely unknown bureaucrats who have a seat at the table – they are effectively agreeing what will be rubber stamped by the UK in May.

It is ironic that Dr Bloomfield assures us he will make sure the work of the WGIHR will be given “public profile” when the vast majority of the WGIHR meetings have taken place in secret. It is worth remembering too that the WGIHR have not publicly released an update to the proposed amendments since December 2022 despite numerous meetings having taken place since then and, although Dr Assiri Abdullah admits the proposed amendments by the Bureau were made available to the member states of the WGIHR prior to the start of this, the 7th meeting, it is a pity that we the people did not get to see them.

UK Citizen and many others have been calling for transparency of the process from the outset. Had the IHR and the proposed amendments been given such a “public profile” throughout the process, we are confident that the people’s pushback would be far greater. Perhaps Dr Bloomfield should contact the BBC.

After the adoption of the agenda (A/WGHR/7/1) and the programme of work (A/WGIHR/7/2) as well as a brief update on the inter-sessional sessions, Dr Assiri Abdullah stated that “equity must be the driving force for change” and opened the meeting to the member states.

(25:50) Malaysia

On behalf of the Group for Equity, Malaysia reiterated their requirement that the negotiations focus on the operationalisation of equity and, in particular, on Articles 13, 13A, 44, 44A and Annexes 1 and 10.

“Presently, the current proposed texts have been inadequate.”

“All Articles should be treated on an equal footing.”

(29:15) Eswatini

Commenting for and on behalf of the forty-seven member states of the African region and Egypt, Eswatini expressed disappointment on the slow progress on equity related provisions.

“We therefore wish to express our great concern regarding the slow progress made in discussing equity related proposals including Article 13, 13A, 44, and 44A in comparison to other simpler and less impactful amendments. We therefore request that the Bureau prioritises these amendments and allocates sufficient time at this session in order to progress with these Articles as noted in the programme of work.”

(33:04) Bangladesh

Bangladesh aligned with Malaysia and Eswatini stating, “Co-Chairs, you have noticed that developing countries have sincerely engaged in all proposals submitted by the developed countries. Reciprocity to that is not a demand rather a course that once motivated us to conceive the idea of amending the IHR 2005. We are confident that the developed countries have the capacity to deliver on them and towards that we all need to demonstrate our real intent and commitment as per EB150(3).”

(37:33) Zambia 

Zambia aligned with Eswatini, “For Zambia, the need for equity as a guiding principle for the revised IHR cannot be over-emphasised.”

“…our health care system continues to be overstretched despite numerous efforts to improve and rebuild after the effects of the Covid-19 pandemic. This is on the backdrop of a high and unsustainable debt burden. We therefore look forward to a revised IHR that takes into account the different levels of development of member states – one that has clear capacity building financing mechanisms that we can count as means to assist countries like ours improve our surveillance systems and capabilities to prevent and respond to health concerns thereby enabling us to contribute to make our world a safer place to our people and the people of the world.”

(39:33) Japan

The comments by Japan were very interesting in light of Dr Bloomfield’s promise to give the IHR process a “public profile” thus, “Japan is proposing to the Bureau and the WGIHR to consider the publication of the Bureau text as a document to show progress of the working group discussion since September 2022.”

What better way to raise the “public profile” of the proposed amendments to the IHR than making the “Bureau’s text” public?

(40:50) India

Equity was central to India’s comments and they want to see a “paradigm shift from a response orientation to prevention and preparedness.”

(41:52) Russian Federation

Russia pointed out that agreement is still required on many points and went on to state, “We’d like to point out the Director-General’s letter that four countries have NOT joined amendments adopted two years ago at the WHA. We respect every country’s position. The point is, that for one single amendment, for one amendment alone, four countries have made reservations. To avoid such a situation on a whole series of amendments we are addressing now, maybe we have to think about stages for a final agreement. How can we avoid having this stand-off situation for a whole range of amendments?” 

The floor was then opened to relevant stakeholders.

(45:58) Third World Network

They requested transparency in the process and for equity to be legally binding thus, “some of the developed countries proposed the IHR to include equitable access to health products and the Bureau themselves has proposed a few text amendments where the scope of the IHR 2005 in this regard is recognised. We thank you for this progress. At the same time, we request the Bureau to kindly publish the text proposals to the member states in the interest of transparency”.

“We stand here until now with not a single provision which creates a legal obligation to service equity in access to health products.”

(48:35) International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) 

IFPMA (representing the biopharmaceutical industry) stated, “The immediate sharing of Cov-2 pathogen data was core to the unprecedented speed of the Covid-19 response, which enabled the development of an effective vaccine in a record 236 days. We must preserve what worked well and ensure rapid access to public health data in pandemic situations”. 

This is representative of the Big Pharma position – they demand the sharing of data regarding pathogens and genomic sequences but are not so keen to give others access to their intellectual property.

(50:26) Oxfam

Once again Oxfam called out the detrimental policy of prioritising commercial interests over the health of the people and they continue to demand equity be at the core of the amendments.

“We urge you to quickly adopt concrete measures to ensure timely, equitable access to medical technologies in order to protect all populations.”

“Business as usual of monopoly on medical technology clearly failed. The definition of insanity is doing the same thing and expecting different outcomes.”

“This means that all member states prioritise public health of all people before commercial interests. Therefore, all member states should commit to fair allocation of medical products relevant to health crisis according to health needs, not ability to pay. Enabling local production in the Global South through commitment to sharing knowledge and technology, removing IP barriers and investing in manufacturing. Implementing conditionality on public funding for R&D and on purchasing agreements that mandate sharing technology and know-how with researchers, developers and producers in the Global South and removing IP barriers. Sharing pathogens must be combined with sharing the benefits resulting from sharing the pathogens, otherwise it’s illogical and immoral.”

The last sentence above illustrates how Oxfam’s position is directly opposed to that of IFPMA.

“To protect the people from COVID, and potential pandemics, countries in the Global North implemented and proposed policies that they object to here. They must stop the double standards and, instead, make concessions to ensure that all populations are protected irrespective of where they live.”

(56:00) South Centre 

South Centre reinstated the centrality of equity thus,“It is critical that these proposals on equity, in particular Articles 13, 13A, 44 and 44A are prioritised and treated on an equal footing with the other amendment proposals.”

Dr Abdullah concluded the open part of this session and moved into closed session.

Summary of the Opening Session

• The opening session was poorly attended.
• There were no statements made by countries from the Global North (including the UK).
• There remains substantial division between the Member States and agreement remains elusive on many of the Articles.
• Demands for equity remain central to the negotiations – something that has not changed since the outset of the WGIHR process.

CLOSING SESSION

The 7th meeting of the WGIHR was scheduled to close on 9th February, however, it was agreed that a dedicated session should be held to discuss the Bureau’s text proposals on Articles 13A, 44A and other Articles addressing equity that were not covered during the week. Consequently, it was agreed to suspend WGIHR7 and hold a resumed session ahead of WGIHR8 at some time between 4th and 15th March 2024.

Dr Ashley Bloomfield, Co-Chair of the WGIHR, chaired the session. It was extremely tedious – the procedural report of the week was projected on the screen, as is custom, for the parties to read through and ensure it captured the discussions of the week. The report is considered an “interim” report as a consequence of the suspended session. The interim report was agreed but will take a few days before the final interim report will be published.

Dr Ashley Bloomfield handed the floor to Dr Mike Ryan (standing in for the Director-General).

Dr Mike Ryan commented, “…While you’ve been doing this this week in the interests of the future health and workability of an amended IHR, the elves have been in the basement processing 37,000 signals of potential epidemics, triaging 80 of those signals for follow up of Member States, confirming 14 events around the world, circulating vaccine derived polio, measles, avian flu, [… ], [… ], XTR, TB, diphtheria, swine flu, […] virus, […] fever, western equine encephalitis, yellow fever, […] Cov-2 and a Lassa fever outbreak. All happening in real time. In the last week we have carried out 5 systematic rapid risk assessment under IHR, published 5 items to the EIS website portal for our Member States with 2 more coming online today. And we’ve published 6 disease outbreak news to the public domain. That’s the core of the IHR. That’s what IHR is about. It’s working with our Member States through them increasing you working with your colleagues to increase that capability for the world to work together to detect, confirm, to share real time information about emerging events and ensure those events get collective response, that assistance reaches Member States who need particular support and that the work and the facts are available to everyone at all times.

It’s a very precious process. One that has, you know, taken decades to develop in WHO’s mandate, but also with the last revision of IHR. So just to say what you’re discussing here may sometimes seem like wordsmithing or not having a necessarily immediate impact on the world. It will because it will define the next 10 years of global surveillance and of collective security when it comes to health emergencies and, in particular, high impact epidemics. So, while you, the shoemakers make the shoes, we’ll be in the basement doing the work of the elves that are needed to work with your institutions at national level. Remember, all of this is happening with your national public health authorities, your national institutes of health, your national [ ] partners, your cluster partners, WHO collaborating centres, the EIS focal point for the IHR. This is a collective process. It provides a safety net. It provides protection for all our communities. You’ve treated this process with tremendous care and professionalism. I just would urge you again, as the DG has, get this done by May and give us back the IHR in better shape than it’s ever been and we’ll be forever grateful. Thank you.”

Dr Ashley Bloomfield closed the meeting with, “So I’ll close things off if I may. As I was saying, to be really clear so it’s on the public record and I’m happy to be quoted by Elon Musk or anyone on X, this is a Member State led process. There is no hidden agenda. It is in control of the governance bodies of the WHO which is all Member States. What we have to do is thank the WHO because the agenda it has, the one we give it, is to serve all Member States, all peoples of the world in improving and protecting their health. As we’ve heard from Dr Ryan this afternoon, it’s a task they take very, very seriously and deliver with extreme hard work, dedication and we should be grateful for that every day.” 

It seems that Dr Ryan and Dr Bloomfield need to get on the same page. UK Citizen is with Dr Ryan – the IHR is not about health rather all about surveillance.

Perhaps rather than asking Elon Musk to share the fact that the WGIHR is a “Member State led process”, Dr Bloomfield should provide Elon with the latest Bureau’s text which can then be shared with the world. You know…in the interests of “transparency”.

Summary of the Closing Session

The WGIHR did not make the progress they had hoped to this week hence the additional session dedicated to equity. Equity remains a major hurdle to consensus.

Next Steps