World Health Assembly 2020: Is our response to COVID-19 adequate?

Activists of the People’s Health Movement talk about the World Health Assembly that begins today, the key issues that will come up for discussion, and the collapse of the global governance system in the realm of public health

May 18, 2020 by Ben Eder, Gargeya Telakapalli, Michael Ssemakula, Osama Ummer, Kriti Shukla, Matheus Z Falcao, Sophie Gepp, Natalie Rhodes

The article below is part of the‘WHO-Watch’ program, which is an effort of the People’s Health Movement. The program works towards democratizing global governance for health and involves young activists in following the governing body meetings of the World Health Organisation – the Executive Board meeting in January and the World Health Assembly in May – every year.

The World Health Assembly (WHA) is set to start on May 18. The annual event of the World Health Organization sees participation from governments (Member States), civil society organizations and other stakeholders such as vaccine alliances, pharma lobby groups and students organizations. In other times, the week-long saga gives an opportunity for state and non-state actors to come together and discuss health policies in the same building. It gives an opportunity to the poorer countries to push for a global governance that benefits their populations.

This year’s WHA is taking place at an unprecedented time. The world is in grip of the COVID-19 pandemic as cases and deaths increase with every passing day. The original schedule of four days has been reduced to two days and all agenda items are off the table except COVID-19. The customary speech of the director-general and some heads of states will also take place.

However, even during the time of this pandemic, countries are failing to create a robust system of governance under the leadership of WHO to ensure equitable access to medicines and other medical products across the globe. The WHO has been weakening over time – the assessed funds are declining compared to voluntary funds taking away independent decision making of the agency. Increasing bilateral agreements between countries have also undermined the WHO. The recent move by the US, accusing the WHO of promoting disinformation over coronavirus outbreak in connivance with China only has only made the UN organization more vulnerable.

The current WHA seems to continue toeing the same line, even though the need for a global leadership in health is of paramount importance today. The key discussion in the WHA will be based on a draft resolution, floated initially by the European Union, and later supported by 35 more countries. The resolution is weak as it promotes voluntary pooling of technological know-how instead of binding commitments that uphold the principles of Health for All. Voluntary pooling is an unaccountable mechanism in which the originator company of the product is expected to pool the know-how on their own accord. Whether the companies want to put patents in the pool or not would also be there decision. In effect, the multi-national corporations are being allowed to conduct business as usual. US pharmaceutical company Gilead has already started the process by giving voluntary licenses of its drug Remdesivir to five generic companies. The agreements allows sale of generic versions of the medicine in 127 countries, but leaves out most of the high-burden countries. They will serve as a monopoly market for Gilead, giving the company free reign to charge high costs for its product. To defeat such sinister designs, we need a more robust mechanism of global governance.

The resolution is also silent on the implications of lockdown which has emerged as the main strategy to contain the spread of virus. There is widespread hunger, unemployment, increase in domestic violence and police brutalities, with the poor and marginalized bearing the brunt. Economic sanctions by the US against countries such as Cuba, Iran and Venezuela continue making it difficult for them to buy medical supplies to treat their populations leading to a health crisis. The current process does not address this high-handed attitude of the US.

The other parallel and worrisome development is the launch of Access to COVID-19 Tools (ACT) Accelerator, initiated by the Bill and Melinda Gates Foundation (BMGF), Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, the vaccine alliance, Global Fund, UNITAID, Wellcome Trust and the WHO. The EU and other richer nations such as Canada, Japan and the United Kingdom have pledged US$ 8 billion towards the ACT. The initial efforts have left the developing countries (LMICs) out of it. The WHO’s role in ACT, which was launched less than a month before the WHA, is limited as it is one of the partners in this effort.

Something to watch out for is the initiaive by Costa Rica and the WHO for technology pooling. The details and modalities for the same are expected to come out later in the month.

All these developments indicate collapse of a global governance system. The civil society has been completely side-lined in these initiatives tilting the balance of power towards the power-that-be. The WHO also has been relegated to a position of partner in various interest-driven initiatives rather than a player leading from front to deliver its mandate of equitable distributions of resources, especially in times of crises such as this. Instead of multilateral agreements, we are witnessing multi-stakeholder agreements in which the poor and the marginalized do not find a voice.

The WHO has many existing documents, agreed upon by Member States after thorough deliberations. Some of them are the Transparency Resolution and the Global Strategy and Plan of Action on Public Health, Innovation, and Intellectual Property (GSPoA). United Nations Secretary General’s High-level Panel on Access to Medicines also looks into similar issues in great depths. The principles set-out in these documents should become the guiding light in any discussion around access to prevention, treatment and management of COVID-19. The WHO should be given the driving seat to act though binding agreements.

The above article is compiled with contributions from Ben Eder (UK), Gargeya Telakapalli (India), Michael Ssemakula (Uganda)  Osama Ummer (India), Kriti Shukla (India), Matheus Z Falcao (Brazil), Sophie Gepp (Germany) and Natalie Rhodes (UK).