'Do not be afraid to tell uncomfortable truths,' Germany tells COVID-19 evaluation panels

MANILA — Countries that participated in Tuesday’s special session of the World Health Organization’s executive board voiced their support for the work of the committees set up to review and provide recommendations on the global response to COVID-19, but some said evaluations need to ensure different perspectives, including those of small island states, are taken into account. Co-chaired by former President of Liberia Ellen Johnson Sirleaf and former Prime Minister of New Zealand Helen Clark, the Independent Panel for Pandemic Preparedness and Response was formed in July to independently evaluate the world’s coronavirus response. On Tuesday, the panel updated its member states on what it has accomplished to date, from the selection of panel members, the development of its terms of reference, and the panel’s planned methods of working in reviewing the response. The latter included desk reviews, expert hearings or discussions on particular issues, in-depth interviews, and web surveys. The panel will also engage with other review mechanisms such as with the International Health Regulations Review Committee and the Independent Oversight and Advisory Committee, which carries out an annual review of the WHO’s health emergencies program. The panel aims to use lessons learned from COVID-19 to strengthen future pandemic preparedness and response. “These recommendations could help with course correction as the pandemic continues, whilst also contributing to better preparedness for the next potential pandemic,” Clark said. Clark invited member states to share their experiences of the pandemic and provide suggestions for the panel’s work. Most member states voiced their support for the work of the panel and the other review committees, while underscoring the need for them to maintain independence and impartiality. Germany encouraged the committees to be bold and not hesitate to challenge member states in their recommendations. “The EU appeals to you. In your evaluations, do not be afraid to tell uncomfortable truths. In your recommendations, do not be afraid to challenge … us member states, to question current modes of operation, and to show boldness and vision,” the German representative said, speaking on behalf of the European Union member states. Some member states made severe mistakes early on in the pandemic, when the world had limited understanding of the disease, Austria’s representative said. There is no need for finger pointing, he added, but he underscored the importance of examining whether measures such as lockdowns and movement restrictions of people and goods “are in any means proportional to the epidemic development.” The many evaluations underway should provide insights on how governments and WHO can react more effectively to the next global crisis, the representative added. “These recommendations could help with course correction as the pandemic continues, whilst also contributing to better preparedness for the next potential pandemic.” --— Helen Clark, co-chair, Independent Panel for Pandemic Preparedness and Response Some raised concerns on the IPPR’s composition, and the risk that perspectives and experiences of low- and middle-income countries, as well as small island states, including those in the Pacific, not to be taken into account. Russia, for instance, pointed out that “one whole geographical region” is not represented. It did not identify the region at the session, but a statement posted on the website of Russia's permanent mission to the United Nations in Geneva by Alexandra Dronova, deputy minister of health of the Russia Federation, talks about the absence of representatives of Central Asia and Eastern Europe in the panel. “If you consider the fact that this region represents a very significant proportion of the world's population, that is a serious imbalance,” the representative said. The United Kingdom recommended the panel consult a scientific advisory group to ensure the panel’s findings and recommendations are “grounded in the latest and the best scientific evidence.” Others reminded the panel to consult with member states, as indicated in the World Health Assembly resolution that called for its creation. The United States requested an advance briefing of the IPPR’s progress report ahead of the resumed session of the 73rd World Health Assembly on Nov. 9-14, and an advance briefing of its interim report ahead of the WHO Executive Board’s meeting in January 2021. The IPPR is scheduled to meet again on Oct. 20-21. Co-chair Johnson-Sirleaf said the panel shares member states’ call for a “practical, robust, contextualized and implementable report.” Changes to the International Health Regulations Several member states proposed there be an intermediate level of alert for outbreaks — rather than a single alert mechanism that comes in the form of a public health emergency of international concern, under the IHR — and a discussion for how to increase member states’ accountability on health emergency preparedness. The IHR form an internationally binding treaty that outlines WHO’s and member states’ obligations in a public health emergency, and has received calls for review and revision in the course of the pandemic. Thailand also proposed the creation of a conflict resolution instrument for multilateral disputes, similar to Article 56 under the IHR. Article 56 states that disputes between state parties in the interpretation or application of the IHR — for instance a country not reporting an unusual or unexplained health event — can choose to settle it through negotiation or other peaceful means. If this fails to resolve the issue, a state can seek the help of the WHO director-general for arbitration, or seek dispute settlement mechanisms of other intergovernmental organizations.