[Ip-health] Health Policy Watch: World Health Assembly Prepares For Show Of Unity On Global COVID-19 Response – But Potential Dispute Over Taiwan

Thiru Balasubramaniam thiru at keionline.org
Sat May 16 00:25:19 PDT 2020


Analysis 15/05/2020 • Elaine Ruth Fletcher

The world seems set to make at least a symbolic display of unity in the
battle against the COVID-19 pandemic  at the upcoming World Health Assembly
(WHA), which begins on Monday. The WHO’s 194 member states are expected to
overwhelmingly approve a European Union-led Resolution that aims to step up
the global COVID-19 response, and ensure equitable access to treatments and
future vaccines.

But the show is unlikely to go off as smoothly as some might hope, and not
only because the 73rd Assembly is meeting for the first time ever in a
virtual format.

Rising geopolitical tensions between the United States and China – are also
likely to be vivid display at the very beginning of the two day event.
Before countries can start talking about COVID-19, they face a likely vote
over a procedural proposal to invite Taiwan to the Assembly as an
Observer.  The issue is less about Taiwan, however, than about the growing
conviction in Washington as well as in other western capitals that China’s
reporting on the SARS-CoV-2 virus and its possible origins has not been
entirely transparent, particularly in the early days. Lining the COVID
issue are other concerns, shared by countries in the Western Pacific
region, about the growing regional influence of Beijing.

Also looming in the background of this year’s WHA, is a WHO budget crisis
that has been triggered by the decision of US President Donald Trump to
suspend funding, which covers a hefty 15% WHO’s budget – and an even higher
proportion of its activities in Africa.  But as US and WHO legal and
technical teams work behind the scenes to mitigate the effects of that
decision, this issue seems less likely to burst onto the stage of the
abridged, two-day Assembly.  So while things could still change rapidly
over the weekend, here is the state of play for the WHA.

“This is an unprecedented moment for WHO. It is also in the line of fire as
it has never been before. We see WHO walking a tightrope between two major
world powers,” said Suerie Moon, co-director of the Global Health Centre of
the Geneva Graduate Institute, which is hosting a two-week series of events
around the WHA that kicked off Thursday.

She described the COVID-19 pandemic as “a stress test for the global health
community. It’s a stress test that can narrow or widen the divisions that
we already see.  What we need to do is to think beyond business as usual,
to move beyond politics as usual – and the WHA will be a test for that.”

European Union Resolution Has Large Consensus

On the unity side of the coin, Thursday, member states quietly endorsed the
draft of a proposed WHA resolution on COVID-19 response. The draft
resolution, the main item on this year’s official  agenda,  includes
far-reaching provisions for the creation of a voluntary pool of patents for
COVID-19 treatments [see related story]; investigation into the origins of
the virus; and strong affirmation of WHO’s central role in global health
balanced by a call for a “stepwise examination” of the agency’s response to
the pandemic.

“I think we are seeing possibly the best… in terms of international
cooperation. I am not saying we won’t also see the worst,” said French
Global Health Ambassador Stephanie Seydoux, referring to the range of
COVID-19 initiatives that have been launched by the global community in
recent weeks, and which are captured somehow in the draft WHA resolution.

In a modest victory for civil society, the resolution also makes several
references to the rights of countries to legally override international
patent rules during a health emergency, making use of so-called
“flexibilities” in World Trade Organization Trade Related Aspects of
Intellectual Property Rights (TRIPS).

The resolution had been the subject of tense, closed-door deliberations for
weeks. It was characterized by usual sparring between countries more
protective of industry and those member states, backed by civil society
groups, keen to break what one key advocate, James Love, described as
“patent monopolies” over critical health products.

“Everything right now should be preparing to scale up as fast as possible,
use as many manufacturers as possible, and have no monopolies on any of
these technologies,” said Love, head of Knowledge Ecology International,
speaking at a webinar Thursday on the planned WHO COVID-19 Technology Pool,
including leading civil society and UN advocates.

The formal WHA resolution is focused on voluntary pooling of innovations
and recognizes the private sector role. But it’s worthy of noting that
major European powers, including France, the United Kingdom, Switzerland
and Germany, all home to large pharma interests, back a final compromise
draft that also repeatedly referred to the rights of countries to break
patent rules.

This is no doubt due, in part, to the growing fears among Europeans also
been hard-hit by the virus, that reliance purely on market mechanisms to
ensure equitable distribution of the next treatment or the first vaccine
might also leave them out in the cold. The inherent challenges to  ensuring
access is equitable and broad were immediately visible this week in the
French uproar over a Sanofi statement that the US would get the first pick
of any vaccines that it produces because they had invested more in its

In the final hours of the negotiations over the EU draft text, it appeared
that the United States was the main actor still trying to make changes.
And even there, seasoned observers say, Washington’s proposals were in fact
fairly technical or cosmetic in nature – an extra nod to industry in some
key clauses as well as requests for clearer definitions of terms like
“equitable access” – but not opposition to the concept, as such.

It still remains to be seen if the White House will indeed back the final
COVID-19 Response resolution when it finally comes before the plenary –
where the resolution is expected to adopted.

In the WHA, where tradition has most resolutions adopted by consensus and
support for the  measure is overwhelming, the US is unlikely to demand a
vote. Washington may still choose to “disassociate” itself from the
resolution or from certain sections with which it doesn’t agree  –
particularly language referring to the continuation of health services,
including services for “sexual and reproductive health” regarded as code
for abortion by the White House.

But there are also clearly elements in the draft resolution that the United
States appears keen to support. This includes the call for a thorough,
science-based investigation into the sources of the virus; as well as an
“examination” of the performance of WHO (as well as other UN agencies and
countries) in the overall pandemic response – in a  “stepwise” approach –
that countries hope can make the investigation timely without detracting
from the overall pandemic response.

While deferring comment on the resolution, per se, a US Mission
spokesperson told Health Policy Watch: “The United States will be present
and vocal at the World Health Assembly, as in all years past. Addressing
global health threats effectively would be impossible without the United
States, which contributes close to 40 percent of the world’s global health
assistance – nearly five times larger than the next largest donor, and more
than 20 times more than China…. We expect the Secretary of Health & Human
Services Alex Azar to be the leader of our delegation to the WHA this year.”


Thiru Balasubramaniam
Geneva Representative
Knowledge Ecology International
41 22 791 6727
thiru at keionline.org

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