Health

SouthViews No. 259, 15 de marzo de 2024

¿Adónde va el tratado internacional vinculante negociado en la OMS contra futuras pandemias?

Por Germán Velásquez

La idea de un tratado internacional sobre pandemias es evitar que se repitan los fracasos que se produjeron durante la crisis del COVID-19. Muchas cosas no funcionaron, pero el fracaso más flagrante fue la desigual distribución y acceso a las vacunas, diagnósticos y tratamientos. Se necesita un tratado internacional basado en los principios de equidad, inclusión y transparencia para garantizar un acceso universal y equitativo.

El actual proyecto de texto del “tratado pandémico” está lejos de responder adecuadamente los retos planteados durante la crisis de COVID-19. Los países desarrollados han debilitado el texto inicial. Los países desarrollados han debilitado la versión inicial del borrador, y el texto está ahora lleno de matices innecesarios. La expresión “cuando proceda” y otras formulaciones típicas de las disposiciones voluntarias aparecen ahora repetidamente. Se trata de proteger y garantizar el interés público y la salud de los ciudadanos como un derecho, o de defender los intereses de una industria que pretende enriquecerse sin límites. El tratado contra futuras pandemias será uno de los temas centrales de la próxima Asamblea Mundial de la Salud de la Organización Mundial de la Salud (OMS) en mayo de 2024. Si los países del Sur, que representan la mayoría de los miembros de la OMS, se unen con una visión clara y fuerte de la salud pública y los países del Norte actúan con lucidez, siguiendo las pruebas científicas al tiempo que persiguen la seguridad para todos, el tratado contribuirá al bienestar de las generaciones futuras. Si al final un pequeño grupo de países se opone a un tratado con disposiciones significativas, no debemos olvidar que la OMS es una institución democrática donde existe la posibilidad de votar.

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SouthViews No. 259, 15 mars 2024

Où va le traité international contraignant négocié à l’OMS pour lutter contre les futures pandémies ?

Par Germán Velásquez

L’idée d’un traité international sur les pandémies est d’éviter de répéter les échecs qui se sont produits lors de la crise du COVID-19. Beaucoup de choses n’ont pas fonctionné, mais l’échec le plus flagrant a été la distribution inégale des vaccins, des diagnostics et des traitements, ainsi que l’accès à ces derniers. Un traité international fondé sur les principes d’équité, d’inclusion et de transparence est nécessaire pour garantir un accès universel et équitable.

Le projet de texte actuel du “traité sur les pandémies” est loin de répondre de manière adéquate aux défis rencontrés lors de la crise du COVID-19. Les pays développés ont affaibli la version initiale du projet, et le texte est maintenant plein de nuances inutiles. L’expression « le cas échéant » et d’autres formulations typiques des dispositions volontaires apparaissent désormais à plusieurs reprises. Il s’agit soit de protéger et d’assurer l’intérêt public et la santé des citoyens comme un droit, soit de défendre les intérêts d’une industrie qui cherche à s’enrichir sans limites. Le traité contre les futures pandémies sera l’un des sujets centraux de la prochaine Assemblée mondiale de la santé de l’Organisation mondiale de la santé (OMS) en mai 2024. Si les pays du Sud, qui représentent la majorité des membres de l’OMS, s’unissent autour d’une vision claire et forte de la santé publique et que les pays du Nord agissent avec lucidité, en suivant les preuves scientifiques tout en recherchant la sécurité pour tous, le traité contribuera au bien-être des générations futures. Si, en fin de compte, un petit groupe de pays s’oppose à un traité contenant des dispositions significatives, nous ne devons pas oublier que l’OMS est une institution démocratique où il est possible de voter.

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SouthViews No. 259, 15 March 2024

Where is the Binding International Treaty Negotiated at the WHO Against Future Pandemics Going?

by Germán Velásquez

The idea of an international pandemic treaty is to avoid repeating the failures that occurred during the COVID-19 crisis. Many things did not work, but the most glaring failure was the unequal distribution of, and access to, vaccines, diagnostics and treatments. An international treaty based on the principles of equity, inclusiveness and transparency is needed to ensure universal and equitable access.

The current draft text of the “pandemic treaty” is far from adequately responding to the problems faced during the COVID-19 crisis. Developed countries have weakened the initial version of the draft, and the text is now full of unnecessary nuances. The expression “where appropriate” and other such wordings, typical of voluntary provisions, now appear repeatedly. It is a question of either protecting and ensuring the public interest and the health of citizens as a right, or of defending the interests of an industry that seeks to enrich itself without limits. The treaty against future pandemics will be one of the central topics at the next World Health Assembly of the World Health Organization (WHO) in May 2024. If the countries of the South, accounting for the majority of the WHO membership, unite with a clear and strong public health vision and the countries of the North act lucidly, follow scientific evidence while pursuing safety for all, the treaty will contribute to the well-being of future generations. If in the end a small group of countries oppose a treaty with meaningful provisions, we must not forget that the WHO is a democratic institution where there is the possibility to vote.

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South Centre Report – WAAW 2023, 27 February 2024

Support for awareness campaigns on Antimicrobial Resistance

By Mirza Alas

Civil society organisations (CSOs) are crucial in mobilising local action to address Antimicrobial Resistance (AMR) and provide health promotion strategies closer to the community. Recognising this, the South Centre continuously supports grass root and context-specific efforts in developing countries on raising awareness on the threat of rising resistance to medicines that is making it harder to treat infections.

The World AMR Awareness Week (WAAW) is held annually to increase global awareness and understanding of AMR. The theme for the 2023 WAAW campaign was “Preventing Antimicrobial Resistance Together,” which took place from November 18 to 24.

To support WAAW 2023, the South Centre offered small grants to eleven CSOs to design and launch awareness and education campaigns on AMR, with financial support from the Fleming Fund. The selected organisations represent youth, women, healthcare workers, veterinarians, and students. This report is a summary of all the different campaigns.

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SouthViews No. 256, 22 February 2024

How Should the WHO Pandemic Treaty Negotiations Tackle Intellectual Property?

By Viviana Muñoz Tellez

The WHO pandemic instrument should commit the Parties to limit the exclusionary effects that government-granted patents and other IPRs may have during pandemics in support of rapid diffusion of new vaccines, diagnostics, medicines and other tools and facilitate collaboration and freedom to operate. The current draft text of Article 11 would not make any change to the status quo.

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SC Statement – 7th WHO WGIHR, 6 February 2024

South Centre Statement to the 7th meeting of the WHO Working Group on Amendments to the International Health Regulations (2005)

6 February 2024

The South Centre urges the WGIHR to ensure that equity issues are substantially addressed in the process of amendments to the IHR in accordance with decision EB150(3) which mandates the WHGIHR to “… address clearly identified issues, challenges, including equity …” in this process. To that end member States have submitted important textual proposals that seek to advance equity concerns in the IHR. As the WGIHR negotiations advance towards their culmination, it is critical that these proposals on equity, in particular articles, 13, 13A, 44 and 44A, are prioritised and treated on an equal footing with the other amendment proposals. Textual proposals on equity provisions should not be deferred to be addressed only in the INB negotiations, noting that while the INB negotiations concern an international instrument on pandemic prevention, preparedness and response, the IHR is an instrument that is different in scope and deals with public health emergencies of international concern. Equity issues are critical in both instruments.

Documento de investigación 193, 2 de febrero de 2024

Desafíos actuales y posibles escenarios futuros de la salud mundial  

By Germán Velásquez

Hace cuatro décadas los principales actores en la salud global eran la Organización Mundial de la salud (OMS), el Fondo de las Naciones Unidas para la Infancia (UNICEF) y los Estados Unidos de América y los países de Europa del Norte (mediante cooperación bilateral). Hoy asistimos a la proliferación de actores en este campo si bien con diferentes roles , ámbito de acción y niveles de influencia: La OMS, UNICEF, el Programa Conjunto de las Naciones Unidas sobre el VIH/SIDA (ONUSIDA), UNITAID,  la Organización Mundial del Comercio (OMC), la Organización Mundial de la Propiedad Intelectual (OMPI), el Programa de las Naciones Unidas para el Desarrollo (PNUD),  la Organización de las Naciones Unidas para la Agricultura y la Alimentación (FAO), el Fondo Monetario Internacional (FMI), el Banco Mundial, el G7 y el G20, el G77+China, el Movimiento de No Alineados, los BRICS (Brasil, Rusia, India, China y Sudáfrica), el Fondo Global, GAVI,  COVAX, la industria farmacéutica, Bill & Melinda Gates y otras fundaciones y organizaciones no gubernamentales (ONGs) sin o con ánimo de lucro.

Este documento de investigación analiza el papel de los múltiples actores (públicos, privados y filantrópicos) en la salud global y, con base a ello, procura esbozar posibles escenarios futuros. En particular, examina el papel de la OMS bajo cuyos auspicios los países miembros están, desde hace dos años, negociando una reforma del Reglamento Sanitario Internacional (RSI) del 2005 y la posible adopción de un nuevo instrumento internacional para prevenir y dar una respuesta a futuras pandemias como la del COVID-19. La aplicación de estos instrumentos, si se adoptaran, estaría en manos de la OMS, uno de los principales actores de la salud mundial.

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Research Paper 191, 25 January 2024

TRIPS Waiver Decision for Equitable Access to Medical Countermeasures in the Pandemic: COVID-19 Diagnostics and Therapeutics

By Nirmalya Syam and Muhammad Zaheer Abbas, PhD

The Marrakesh Agreement Establishing the World Trade Organization (WTO) allows WTO Members to agree to temporarily waive obligations under the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS Agreement). However, the TRIPS Decision adopted by the 12th WTO Ministerial Conference in June 2022, after lengthy and protracted negotiations lasting for 20 months in the middle of a pandemic, allowed only a fragment of the waiver proposal submitted by India and South Africa. Moreover, since the adoption of the Decision there has been an impasse in the WTO about extending the Decision to COVID-19 diagnostics and therapeutics even though the WTO Members were mandated by the Decision to decide on this matter within six months of the Decision. This research paper analyses the current state of play and concludes that there is a need to immediately and unconditionally extend the Decision to COVID-19 diagnostics and therapeutics. Moreover, the paper suggests options for how the TRIPS flexibilities can be optimally utilized in a pandemic situation without developing countries being resigned to the vagaries of negotiations on a waiver which is supposed to be an urgent emergency solution. In this regard, the paper also suggests options that could be considered for reforming the process of decision-making on a waiver proposal to ensure that decisions on waivers are taken in a timely and expedited manner without being negotiated for an extensive period of time in the midst of an emergency.

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Policy Brief 123, 14 December 2023

The WHO CA+ Discussions on Pathogen Access and Benefit Sharing: State of Play

 By Nirmalya Syam

This brief explores the scope of a World Health Organization (WHO) pathogen access and benefit-sharing (PABS) mechanism as a possible outcome of the negotiations ongoing in the WHO Intergovernmental Negotiating Body (INB) for a WHO Convention, Agreement or other Instrument (WHO CA+) for pandemic prevention, preparedness, response and recovery (PPRR). After seven sessions of the INB, substantial differences remain between developed and developing countries on the PABS system. While the text contains specific obligations on rapid sharing of pathogen material and genetic sequence information reflective of the primary interest of developed countries to get such access outside the framework of the Nagoya Protocol to the Convention on Biological Diversity through a specialized WHO instrument such as the PABS system under the WHO CA+, the current text continues to be weak in terms of effectively operationalizing fair and equitable-benefit sharing. To that end, it is critical that detailed provisions on standard material transfer agreements, data access relating to their genomic sequence information and specific obligations on monetary and non-monetary benefit-sharing by recipients of pathogen material and sequence information are included in the provisions establishing the PABS system. Therefore, it is important that the proposals that have been made in this regard by developing countries are incorporated in the draft negotiating text.

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Research Paper 188, 7 December 2023

The Intersection Between Intellectual Property, Public Health and Access to Climate-Related Technologies

By Lívia Regina Batista

On the 20th anniversary of the Doha Declaration on the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS Agreement) and Public Health adopted by the World Trade Organization, we realize that its impact is beyond issues of public health stricto sensu. The Doha Declaration has inspired discussions at the Council for TRIPS regarding access to climate-related technologies. Climate change is the main and most globalized environmental problem with adverse effects on public health, especially for the vulnerable communities in the Global-South. The main argument of the proponents of the discussion in the TRIPS Council is the need to rebalance public interests (such as public health and environmental/climate issues) with the private/economic interests of the most powerful countries and corporations. This debate addresses both the recognition of intellectual property rights as an important means for the promotion of technological innovation, and the required wider dissemination of technologies – be they medicines or climate-related technologies. This research paper explores the possibilities that the TRIPS Agreement and the Doha Declaration create for international transfer of climate-related technologies. Even though such discussions on climate-related technologies have initially failed in linking climate change and public health, as well as the rhetoric of human rights, the relevance of the topic remains. Besides that, the response to public health issues also must learn from the experience in climate change, such as the case studies evidencing the insufficiency and inefficiency of fast-tracking programs to provide for a wider dissemination of technologies – which have now been widely replicated to address the COVID-19 pandemic. Such comparison can also be an entrance point to discuss the public health implications for the international regime on climate change, highlighting that such issues are deeply intertwined, and need to be addressed jointly as well.

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SouthViews No. 254, 10 November 2023

Digital Health Challenges in the South: Towards Better Integration of Digital Health Practices

By Dr. Azeema Fareed and Ms. Farhana Saleem (COMSATS)

Much like any innovation, diffusion of digital health technologies in different countries depends on their level of development, availability of infrastructure, socio-economic conditions and indigenous strengths and weaknesses, political will and stability, demographics as well as social norms. Naturally for developing countries, social, economic, and technological set-backs make digital health adoption, implementation and mainstreaming more challenging. Using WHO’s e-Health components, this article highlights key challenges impacting digital health adoption in developing countries in the light of COMSATS’ experience.

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