How committed is the world to a stronger WHO?
The World Health Assembly (WHA), the main decision-making body of the world’s largest health agency, the World Health Organization (WHO), meets in person from May 22n/a in Geneva. He has one week to better prepare the world for the next pandemic.
This content was published on May 22, 2022 – 10:00
“If there were a new pandemic threat this year, next year or the year after, we would be largely where we were in December 2019,” said Helen Clark, former co-chair of the Panel. independent for pandemic preparedness and preparedness. Response (IPPPR), said during a press briefing earlier this month.
The IPPPR was created in 2020 to learn lessons from the pandemic and propose reforms to the WHO that would enable it to better deal with future health threats. Its former co-chairs released a report this month to assess progress.
“In terms of reforms, there have been a few small steps, but for us, they remain very insufficient,” said Michel Kazatchkine, a former member of the IPPPR.
The pandemic has shed light on WHO’s role as a scientific guide on health-related issues. He also laid bare the gap between the world’s exorbitant expectations of the WHO and its underfunded budget.
The WHA should approve a reform of the financing of the WHO. It will also attempt to advance a long-awaited pandemic treaty. However, how far they will go will depend on the ability of the 194 members to align their sometimes conflicting priorities.
One of the main lessons of the pandemic has been the insufficient level of funding for the WHO.
Currently, assessed contributions – dues from WHO Member States – cover only about 16% of the organization’s budget. The rest is funded by so-called voluntary contributions from countries, other international organizations and private actors that are largely tied to specific programs.
These contributions are unpredictable and, according to some, compromise the independence of the WHO, as it must rely on a small number of influential donors. The Bill and Melinda Gates Foundation, for example, is the second largest contributor to the WHO after Germany and ahead of the United States. But its funding is mainly channeled towards polio eradication.
“The world will not be safe until we have a better funded WHO,” says Björn Kümmel, deputy head of the global health division at the German Federal Ministry of Health and chair of the WHO task force. WHO on sustainable financing. Above all, he believes, because investments to prevent health crises have been repeatedly neglected in the past.
The Sustainable Financing Task Force was established in 2021 by the WHO Executive Board to find solutions to the organization’s financial challenges. But until recently, member states could not agree to increase their contributions.
The group has now produced a draft resolution – yet to be passed by the WHA – to gradually increase their mandatory fees to cover 50% of the WHO budget by 2030-31. Experts say such a deal would be historic, but the timing remains an issue. Financial uncertainty will remain the norm for years to come.
“We are discussing a huge percentage increase, but we are not asking for a huge increase in absolute terms,” says Kümmel, who adds that the increase will amount to $1.2 billion (CHF 1.17 billion). ) over eight years. The bill will be split among 194 member states, with the largest and wealthiest countries such as the United States, China, Japan and Germany bearing most of the increase.
A small investment compared to the price countries had to pay to respond to the pandemic, Kümmel points out.
Another important step to better prepare the world for a future global epidemic was the WHA’s decision last year to begin negotiating what could become a pandemic treaty. But that too was a slow process.
“The treaty is advancing at a snail’s pace,” Kazatchkine said. “Negotiations are not progressing at the same pace as the virus or the next outbreak will.”
Developing an international agreement is a notoriously complex and time-consuming process. The current intergovernmental negotiating body will not produce a draft text for two years. At the earliest, an agreement could be reached during the WHA in May 2024. But it will probably take longer until it comes into effect.
To date, countries have agreed only once to establish a legally binding treaty with the WHO. This is the 2003 Framework Convention on Tobacco Control (FCTC), which oversees the worldwide sale and marketing of tobacco products.
Details on what a pandemic treaty would cover remain unknown. Experts have recommended that he give the WHO the power to send experts to investigate new outbreaks without having to seek permission from countries. But some worry that the current process is the wrong approach.
“I don’t think there’s enough evidence at this point that we need a new pandemic treaty,” said Nicoletta Dentico, global health program manager at the Society for International Development (SID). ), on the Inside Geneva podcast.
According to her, updating the current International Health Regulations (IHR) – a set of legally binding rules that deal with health emergencies – would be a more productive approach.
This view is shared by countries that have proposed amendments to the IHR, but some experts fear these are attempts to avoid giving more power to the WHO through a pandemic treaty. .
The United States has submitted a draft amendment for the WHA to consider. He proposes to shorten the amendment process, which currently takes two years, so that future revisions can come into force more quickly. But the revisions themselves are not currently on the agenda.
More than 2.7 billion people worldwide are still waiting for their first dose of vaccine. In low-income countries, less than 15% of the population has been fully immunized. This failure to vaccinate the world is a “collective moral stain on our history,” says former IPPPR panel member Joanne Liu.
Some experts argue that a pandemic treaty should also consider the equitable distribution of vaccines and other medical supplies. But that too will be difficult. At the World Trade Organization (WTO), member states have been haggling over a waiver of intellectual property rights for Covid-related technologies for nearly two years, but have been unable to reach an agreement.
“And that’s just for a waiver for a disease. […] You can imagine trying to get agreement on the kinds of difficult issues like intellectual property that we need to address in a broader pandemic treaty is going to be difficult,” says Suerie Moon, co-director of the Global Health Center at the University Institute. from Geneva.
Vaccines were developed in record time but were not all well suited to low-income countries because mRNA vaccines had to be stored at very low temperatures. Meanwhile, the COVAX mechanism, which aimed to ensure fair and equitable access to vaccines for each country, has shown its limits. Wealthier countries used it to dispose of excess doses – it was too little too late.
“When we start researching and developing vaccines, we already have to think about access for all and not access for the richest and then look for mechanisms so that it also goes to the poorest,” explains Kazatchkine.
The WHA will take place at a time when many countries consider the pandemic to be behind them. The war in Ukraine has polarized the world and made international cooperation more difficult. Health experts are urging WHA member states not to give up the fight against Covid.
” The clock is turning. As high-income countries retreat from this pandemic, it becomes invisible. And when it becomes invisible to high-income countries, that means it no longer exists, even though low-income countries are still fighting it,” Liu says.
Additional reporting by Imogen Foulkes.
Edited by Imogen Foulkes.
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