US ‘not reluctant’ as WHA agrees to negotiate pandemic accord

The World Health Assembly concluded Wednesday with no objections to a decision to establish an intergovernmental negotiating body to negotiate a new accord for pandemic preparedness and response.

The adopted decision, which had already reached consensus in informal negotiations prior to the start of the WHA special session Monday, sets the first meeting of the negotiating body before March 1, 2022, and a second meeting before August of the same year. The negotiating body is to submit a progress report on the work at the 76th WHA in 2023.

“That may seem like a long process, and it is. But we should not be naive in thinking that reaching a global accord on pandemics will be easy,” WHO Director-General Tedros Adhanom Ghebreyesus said during a press briefing Wednesday. It took the Framework Convention on Tobacco Control a decade to come into force, he said.

“Of course, we hope that this process will not take nearly that long. But there are still differences of opinion about what a new accord could or should not contain,” he added.

That means it’s still unclear if countries will end up with a legally binding treaty, even if a large number of countries during the three-day session expressed support for one. The United States, which observers said have been opposed to a treaty wording, commented on its position on the matter.

“We're not reluctant,” U.S. Department of Health and Human Services’ Xavier Becerra said during a press briefing Wednesday, in response to a question on why the U.S. has been reluctant about the word “treaty.”

“What we want to make sure is that we get something real, that we get something that [means] everyone can move on, and that we do it now,” he said.

Assistant Secretary for Global Affairs Loyce Pace, meanwhile, said they will learn more about what path to take once substantive discussions take place, and have a clearer understanding of “what we should be holding ourselves accountable [for] and ensure that we actually follow through.”

“I think what no one wants [is] to show up and make empty promises to the world. We really do want to deliver,” she said.

What countries want

A large number of countries want a new instrument to address issues of inequity in access to medical countermeasures, particularly vaccines, as well as issues of information and pathogen sharing during a crisis. Many of them stressed the need for equity as a key principle guiding the negotiation of a new instrument.

Some countries said a new instrument should also include legally binding commitments to the sharing of technology and strengthening local and regional manufacturing capacity, as well as in strengthening a One Health approach to mitigate the risks of zoonotic diseases, taking into account environmental and animal health.

Some also highlighted the waiver of the Agreement on Trade-Related Aspects of Intellectual Property Rights, with Pakistan calling on countries that have been opposing it at the World Trade Organization to “revisit their positions” and align with the future instrument.

That a new instrument should strengthen and complement, and not replace, the International Health Regulations was agreed by a majority of countries which said they remain an important legal framework for preparedness and response.

A Russian official said that “any proposals to carry out targeted amendments to the IHR must be well-founded and discussed” and warned that “the new instrument must not serve as a pretext for modification, weakening, or duplication of existing mechanisms and agreements, including the IHR.”

Countries also said the negotiation process needs to be transparent and inclusive.

During the discussions, a number of member states, such as Haiti and Belize, mentioned the exclusion of Taiwan in the session. A representative from Palestine — not a member state, but an observer to the WHA — also expressed its “regret” for not being able to participate in deliberations on the decision.

During the sessions, the threat of the new COVID-19 variant of concern omicron has also played into countries’ push for a new instrument and what it should entail. South Africa called for the immediate lifting of the travel bans imposed on several southern African countries and expressed hope that a new legally binding international instrument on pandemic prevention preparedness and response will address such travel issues, which many African countries said are unjustified and discriminatory.

WHA achievements and shortcomings

Suerie Moon, co-director of the Global Health Centre at the Graduate Institute of International and Development Studies in Geneva, described the WHA decision as “historic,” even if there remains a lack of clarity on what type of instrument countries will pursue, and the content of such an instrument, which will be the subject of multiyear negotiations.

“What is more clear is how widely supported is the need for new, stronger international rules to address the risk of pandemics -- countries across many political divides came together to support this,” she said in an email.

“Overall, I would say this is a historic day, and we have taken a firm step forward. It will be a long and winding road ahead, but at least we have taken the first step,” she added.

But some observers, who have already raised concerns on a push toward a pandemic treaty, are underwhelmed by the results. Thomas Schwarz, executive secretary of Medicus Mundi International Network, described it as being “merely/mostly ceremonial,” given that the decision to set up a negotiating body was already negotiated beforehand.

Geneva Global Health Hub Co-Chair Nicoletta Dentico, meanwhile, said that countries have failed to honestly assess their shortcomings in adhering to the existing agreements.

“It is clear that the pandemic is a result of ... multiple failures and not a fact of nature,” she said in an email. “In the last 3 days, WHASS has not been able to achieve an honest assessment of the reasons why governments have all, in different ways, violated the rules that they had agreed on already to deal with health emergencies, including viral outbreaks.”