Today the International Health Regulations emergency committee on monkeypox is meeting again to determine if it’s now a public health emergency of international concern. According to WHO, there are now more than 14,500 reported cases of monkeypox from more than 70 countries and territories and five deaths all in Africa. WHO worries that some of the most affected countries have less access to lifesaving tools, such as diagnostics and vaccines, to respond to the outbreak — reflecting a similar challenge of the COVID-19 pandemic response.
Experts hope that a new pandemic instrument will resolve such issues in the future, especially as the world sees more disease outbreaks. But decisions on the instrument feel a long way off.
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This week, WHO member states started discussing a working draft of a potential pandemic instrument, and many were in favor of pursuing a legally binding one. But they have yet to make a final choice on which particular article in the WHO constitution to pursue, Jenny reports.
Wednesday saw a closed session of the intergovernmental negotiating body, which has been tasked with drafting and negotiating a WHO convention, agreement, or other international instrument on pandemic prevention, preparedness, and response. Several member states expressed support for a legally binding instrument to be adopted under article 19 of the WHO constitution — which allows for adoption of treaties and agreements on any matter within WHO’s competence. “In other words, there is virtually no issue relating to health that an Article 19 treaty cannot cover,” said Lawrence Gostin, a professor at Georgetown University and founding O'Neill chair in global health law.
But some member states, including the United States, want to keep article 21 — which limits binding agreements to just a few topics, such as quarantine and safety standards — as an option, while others think it’s too early to decide. Only Russia stated a preference for article 23, which focuses on recommendations that are not legally binding.
This morning, states have agreed on a text for the INB report that says that “the instrument should be legally binding” but also contain “non-legally binding elements” and that while article 19 of the WHO constitution “is the most comprehensive provision under which the instrument should be adopted,” article 21 will also be considered.
In any case, INB’s leadership has repeatedly stated that no decisions are being made this week. The current working draft of a pandemic instrument will continue to see further changes in the months ahead before the negotiation phase.
Read: Majority of WHO member states want legally binding pandemic instrument
Background reading: What is a public health emergency? Monkeypox outbreak raises questions
Healthy distance
Last weekend, the African Union executive council approved a revised statute of the Africa Centres for Disease Control and Prevention — making official its transformation from a specialized technical institution of the African Union to an autonomous public health agency. This gives Africa CDC more independence and increases its flexibility in responding to health emergencies, our colleague Sara Jerving reports. Sara broke the story back in June that WHO’s regional office for Africa had objected to these changes since they would overlap with some functions WHO already performs.
The revised statute extends those powers to the organization and contains edits meant to increase Africa CDC’s financial sustainability, such as the establishment of an Africa epidemic fund.
During a press briefing Thursday, Africa CDC Acting Director Dr. Ahmed Ogwell Ouma said he hopes the new autonomous powers will be fully operational by the end of the year. Africa CDC will be dependent on the AU Commission’s systems in the short term, but plans to establish its own support systems, such as human resources, finance, administration, and procurement to be more independent.
He called it “a huge milestone in global health security, not just for Africa,” giving the continent direct ownership of its own health care agenda.
What’s next: How Africa CDC's newly approved autonomy can actually happen
ICYMI: African Union passed statute giving Africa CDC more independence (Pro)
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Rwanda vision
Rwanda was chosen to host the Africa Union’s newest health organization: the African Medicines Agency. It’s the AU’s second cross-continental health agency, alongside the Ethiopia-based Africa CDC.
The choice of Rwanda, out of a pool of eight candidate countries, has cemented its position as the go-to for all things health on the continent. At the end of June, biotech company BioNTech broke ground on the construction of a messenger RNA vaccine manufacturing facility in the country. The African Development Bank also recently announced Rwanda as the site of the new African Pharmaceutical Technology Foundation.
Read: Rwanda chosen to host the African Medicines Agency
AfDB: $3B investment for African health manufacturing (Pro)
Gavi’s expanding map
Lebanon and Venezuela are now eligible for support from Gavi for their immunization programs, Jenny reported exclusively for Devex this week.
Last month, Gavi’s board approved a proposal to include countries reclassified by the World Bank as lower-middle-income — which now includes Lebanon, due to its economic collapse — through 2024. While there’s not enough data for the bank to determine Venezuela’s income classification, Gavi agreed to include the country to help address its current immunization challenges.
Exclusive: Lebanon, Venezuela now eligible for Gavi support
What we’re reading
USAID’s Atul Gawande warns that the agency’s COVID-19 response has run out of money. [The Hill]
Botswana’s HIV mother-to-child transmission rates have fallen from 40% in 1999 to below 1% in 2021, though the adult prevalence rate is still 20%. [The Guardian]
Contraception is legal and yet inaccessible for many women in rural India. [PARI]
Sara Jerving contributed to this edition of Devex CheckUp.
About the authors
Jenny Lei Ravelo@JennyLeiRavelo
Jenny Lei Ravelo is a Devex Senior Reporter based in Manila. She covers global health, with a particular focus on the World Health Organization, and other development and humanitarian aid trends in Asia Pacific. Prior to Devex, she wrote for ABS-CBN, one of the largest broadcasting networks in the Philippines, and was a copy editor for various international scientific journals. She received her journalism degree from the University of Santo Tomas.
Amruta Byatnalamrutabyatnal
Amruta Byatnal is a Senior Editor at Devex where she edits coverage on global development, humanitarian crises and international aid. She writes Devex CheckUp, a weekly newsletter on the latest developments in global health. Previously, she worked for News Deeply in the United States, and The Hindu in India. She is a graduate of Cornell University where she studied international development. She is currently based in New Delhi.
