In the wake of the damage wrought by the COVID-19 pandemic, the World Health Organization’s World Health Assembly established a Working Group on Strengthening WHO Preparedness and Response to Health Emergencies (WGPR) in May 2021 with the following mandate:
to consider the findings and recommendations of the Independent Panel for Pandemic Preparedness and Response, the IHR Review Committee and the Independent Oversight and Advisory Committee for the WHO Health Emergencies Programme, taking into account relevant work of WHO, including that stemming from resolution WHA73.1 (2020) and decision EB148(12) (2020), as well as the work of other relevant bodies, organizations, non-State actors and any other relevant information.
WHO convened the first meeting of the WGPR from 15 July 2021 to 16 July 2021. The WGPR established a bureau (as mandated by resolution WHA74.7) with the following co-chairs: Colin McIff (United States of America) and Ambassador Grata Endah Werdaningtyas (Indonesia) and the following vice-chairs: Dr. Ala Alwan (Iraq), Dr. Malebogo Kebabonye (Botswana), Dr Lyn James (Singapore), and Ambassador François Rivasseau (France). In preparation for the second meeting of the WGPR (1 September 2021 to 3 September 2021), the WHO Secretariat prepared the following document, Preliminary findings from COVID-19-related recommendation mapping, as policy options for member states to consider.
Section III of the secretariat’s document “provides a high-level mapping of 131 recommendations found in four source documents published by:-the Independent Panel for Pandemic Preparedness and Response;-the Independent Oversight and Advisory Committee for the WHO Health Emergencies Programme;-the Review Committee on the Functioning of the International Health Regulations (2005) during the COVID-19 Response;and-the Global Preparedness and Monitoring Board.” Of the 131 recommendations harvested from the IPPPR, IOAC, and the IHR Review Committee, WHO identified 30 recommendations “that may effectively/optimally be implemented through new WHO international agreement(s)/instrument(s)”. Some of these recommendations include:
- the establishment of a pandemic framework convention under Article 19 of the WHO Constitution;
- sustainable financing for pandemic preparedness and response;
- the timely sharing of materials, including genomic sequencing data;
- equitable and timely access to medical countermeasures;
- effective and scalable supply chains for the rapid development and deployment of medical countermeasures;
- scalable and funded research and development for timely and innovative manufacturing of medical countermeasures and their regulation;
- timely technology transfer, sharing of know-how and/or voluntary licensing; and
- the empowerment of communities, strengthening of civil society and upholding of human rights principles.
In May 2021, James Love, Director of Knowledge Ecology International provided the following perspectives on a potential WHO Pandemic Treaty at a side event, The Pandemic Preparedness Treaty: Unlocking intellectual property, knowledge and know-how for the public good, convened by Health Action International, Knowledge Ecology International, and Medicines Law & Policy.
1. Government R&D Contracts
The treaty can enable more robust global rights to inventions, data and know-how, for counter measures. This should, at a minimum, go to the provisions in funding agreements.
The 2020 COVID-19 R&D funding contracts involved billions of dollars in direct funding and subsidies for R&D and advance purchase agreements that de-risked the development of vaccines and therapeutics, as well as other technologies such as diagnostic tests. Governments had retained some, often limited, rights in some, but not all, of the contracts, but a better, more coordinated approach would have seen more robust rights that could have been used to make technologies global public goods, enabling the scaling of more decentralized production and lower prices.
2. Buyouts of Know-how
Governments could commit, in advance, to create a fund to buy the rights in inventions and data know-how and access to biological resources that governments or UN agencies do not control, but which would be more useful in a pandemic if available as a global public good. This is a cost-effective but so far under used intervention to address the need to scale manufacturing. Such buyouts would work best with collaboration on paying for the buyouts. (more here)
3. Funding R&D
Higher income governments could commit to make minimum contributions to fund R&D, with robust global rights, to address future global health challenges. Discussions about creating soft or hard norms for minimum funding for priority R&D have taken place at the WHO over the last two decades. This can be the opportunity to take a first step.
4. CTAP – PTAP, or just TAP
Reboot and transform C-TAP, the COVID-19 Technology Access Pool, into a Pandemic Technology Access Pool, P-TAP, or just TAP, to create a forward looking pool for rights in inventions, data, know-how and biologic resources, not just for COVID-19, but for any future global emergency.
The treaty should address the public interest in transparency: transparency of R&D contracts, patent landscapes and licenses, prices, trial outcomes, manufacturing costs, efficacy of diagnostic tests, the costs of clinical trials and the role of government R&D funding and subsidies, and the existing and potential manufacturing capacity for different technologies.
The next meetings of WHO’s WGPR will take place from 4 October 2021 to 6 October 2021 and 1 November 2021 to 3 November 2021. This will be followed by a special session of the World Health Assembly to consider developing a WHO convention, agreement or other international instrument on pandemic preparedness and response which will take place from 29 November 2021 to 1 December 2021.
Currently, the WHO secretariat has proposed a document entitled, “Proposed modalities of engagement for relevant stakeholders“. Under these modalities, the United Nations and other intergovernmental organizations in effective relations with WHO (Annex A) are invited to attend open sessions of the Working Group, have the right to speak at open sessions of meetings of the Working Group, at the Chair’s request, and are invited to provide inputs to the Working Group (via an electronic portal, an open “hearing”, and/or a segment of a session). Entities under Annex A include:
1. United Nations
2. African Development Bank and African Development Fund
3. Commission of the African Union
4. Food and Agriculture Organization of the United Nations
5. Islamic Development Bank
6. International Fund for Agricultural Development
7. International Labour Organization
8. League of Arab States
9. International Organisation of la Francophonie
10. World Organisation for Animal Health
11. International Atomic Energy Agency
12. Pan American Health Organization
13. International Committee of Military Medicine
14. South Centre
15. United Nations Educational, Scientific and Cultural Organization
16. United Nations Industrial Development Organization
17. Universal Postal Union
18. World Intellectual Property Organization
19. World Meteorological Organization
The following observers listed under Annex B are invited to attend open sessions of the Working Group, have the right to speak at open sessions of meetings of the Working Group, at the Chair’s request, and are invited to provide inputs to the Working Group (via an electronic portal, an open “hearing”, and/or a segment of a session). Entities under Annex B include
1. Holy See
3. Gavi, the Vaccine Alliance
4. Order of Malta
5. International Committee of the Red Cross
6. International Federation of Red Cross and Red Crescent Societies
7. Inter-Parliamentary Union
8. Global Fund to Fight AIDS, Tuberculosis and Malaria
Non-state actors in official relations with WHO are not permitted to attend open sessions of the Working Group nor speak at open sessions of the Working Group. Non-state actors are invited to provide inputs to the Working Group (via an electronic portal, an open “hearing”, and/or a segment of a session).
The Secretariat has also determined that other stakeholders, as decided by the Working Group, invited to (1) attend open sessions of meetings of the Working Group, (2)speak at open sessions of meetings of the Working Group, at the Chair’s request, and (3) provide inputs to the Working Group (via an electronic portal, an open “hearing”, and/or a segment of a session. Entities listed under Annex D include:
Access to COVID-19 Tools (ACT) Accelerator
International Air Transport Association
International Civil Aviation Organization
International Federation of Pharmaceutical Manufacturers and Associations
International Maritime Organization
International Monetary Fund
International Organization for Migration
International Shipping Federation
Joint United Nations Programme on HIV/AIDS
Medicines Patent Pool
Médecins Sans Frontières International
United Nations Children’s Fund
United Nations Environment Programme, including the Convention on Biological Diversity
World Bank Group
World Food Programme
World Trade Organization