James Roguski
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Many of the participants in the WHO negotiations have repeated the phrase “Nothing is agreed until everything is agreed.”
Wait. Let me fix that to make it more clear:
https://www.youtube.com/watch?v=kqEu5sxC6PY
https://rumble.com/v4sij73-follow-the-money.html
We, the Ministers of Health of African Union Member States… have agreed as follows…
EMPHASISING the need for a joint robust pandemic prevention, preparedness and response system that ensures solidarity and equity against public health threats and guided by the main principles on fair and equitable allocation of pandemic-related products to African countries, technology transfer, multilateral pathogen access and benefit sharing system, regional manufacturing, sustainable financing mechanism, and the need for a robust and multisectoral governance mechanism that can insist on and support transparency and accountability for the benefit of Member States;
RECOGNISING the current limitations of the Pandemic Fund in terms of important gap in its financing and governance to better support Pandemic Prevention, Preparedness and Response, health systems strengthening, local production capacities in Africa, and the importance of additional sources of innovative financing, including through the African Epidemic Fund;…
COLLECTIVELY, WE RESOLVE AND COMMIT OUR GOVERNMENTS AND INSTITUTIONS TO:
1. ENSURE EQUITY IN THE DRAFT PANDEMIC AGREEMENT through:
a. A multilateral pathogen access and benefit sharing system (PABS), which provides legal certainty for both users and providers and ensures an improved access to pandemic-related health products, technologies with measures that establishes regionally-distributed production of pandemic related health products.b. Commitments to organize and resource technical support on the range of matters covered by the draft agreement, including all equity-related provisions, as well as pandemic prevention and public health surveillance, preparedness, readiness, and resilience, and health and care workforce through WHO coordinated mechanisms that are accountable to the Conference of Parties.
3. PREDICTABLE, SUSTAINABLE FINANCING AND GOVERNANCE
a. Call for an International financing mechanism that is accountable to the Conference of Parties and enshrining explicit commitments to new, sustainable, and increased funding support from developed countries for country-level pandemic prevention, preparedness and response in developing countries, debt relief and debt restructuring mechanisms including debt for PPPR swaps.b. Accelerate the operationalisation of the financing of the African Epidemic Fund.
Addis Ababa, Ethiopia 27 April 2024
To start with IHR itself, as a tool, is not, was not designed to be a financing mechanism or the IHR core capacities.
So, there have to be other ways to help Member States maintain and build their core capacities for IHR. That’s why there are mechanisms internally inside WHO, other intergovernmental organisations, and bilateral collaborations between countries to try to address the issue of core capacity financing. However, without financing core capacity, the world will continue to be at risk of epidemics and pandemics, and that’s where the discussion on pandemic financing comes in.
So, in the beginning, there was, I mean, trying to address the financing as one package for both processes. But it was clear that this is not going to fly. We need to have some intellectual separation between financing an actual pandemic that is already happening and you need a different set of interventions that are out of scale of any financing mechanism.
But in the same time, in order to not reach to the stage [of a pandemic], you need to have continuous mechanism of maintaining the core capacity in that member state. And that’s what the equity part is becoming into play into the IHR discussion. So, there is a good progress in introducing for the first time the concept of equity in IHR. Trying to find legal terms within the IHR to help Member States build and maintain their core capacities, stronger surveillance systems and other core capacities that are required to provide pandemics.
Financing is a tricky discussion whenever the international collaboration comes in into play.
But for the IHR I think the focus now is more towards how do we make equity operational inside that IHR, of course, if we succeed to progress with that we’ll definitely reflect on less propensity for having pandemics or triggering any pandemic treaty.
-Dr. Abdullah Assiri (WGIHR Co-chair)
https://genevahealthfiles.substack.com/p/equity-and-financing-are-really-key
So here is the somewhat simplistic topline:
The final toss for some countries will be about pushing for a PABS mechanism in lieu of agreeing to One Health provisions. Much will depend on the nature and seriousness of One Health obligations. But this is not a simple lever that developing countries can exercise. The buttons pushing a dedicated financing mechanism is under the thumb of a few developed countries. So, the promise of money will not come till developing countries also agree to One Health demands. And we are not even talking about tech transfer and intellectual property concerns yet.
A legitimate question to raise is why would the Africa CDC push for a role for the Pandemic Fund – a position that has been opposed by developing countries and African countries in particular. These countries have after all been pushing for a dedicated fund with a reform of representation and governance gaps in the existing structure of the Pandemic Fund. Well, it turns out that the Africa CDC had been considered for the first stage to be an Implementing Entity for the Pandemic Fund, just a few weeks ago.
So, while there is staunch opposition by mostly developed countries to the creation of a new dedicated fund for PPPR under the aegis of WHO and its member states, there are other competing factors complicating the picture around the Pandemic Fund.
There have been indications of competing interests between the Global Fund to Fight AIDS, Malaria and Tuberculosis, and the Pandemic Fund, for example (including during the conception of the World Bank’s Fund). The Global Fund has defined its stake PPPR financing on the back of its role over the last 20 years. And the Pandemic Fund is not backing off.
(Also see Devex: “Why the US commitment to the Global Fund has cratered”)
https://genevahealthfiles.substack.com/p/inb9-resumed-africa-group-cdc-pabs-one-health
Article 44 Collaboration and assistance, including financial assistance
2bis. Pursuant to Paragraph 1(c) of this Article, States Parties shall undertake to collaborate to: (a) mobilize financial resources through all relevant sources, including existing and future bilateral, sub-regional, regional and multilateral funding mechanisms, to assist each other, in particular developing countries, as necessary and in complementarity to domestic funding as outlined in Paragraph 1bis of Article 13, in the implementation of these Regulations;
2bis. Pursuant to Paragraph 1(c) of this Article, States Parties shall undertake to collaborate to: (b) encourage governance and operating models of existing financing entities and funding mechanisms to be responsive to the needs and national priorities, related to the these Regulations, of developing countries;
2bis. Pursuant to Paragraph 1(c) of this Article, States Parties shall undertake to collaborate to: (c) secure the financial resources necessary to support the implementation of these Regulations through coordination and/or funding mechanisms that may be established in future International Agreement(s) related to pandemic prevention, preparedness and response;
2bis. Pursuant to Paragraph 1(c) of this Article, States Parties shall undertake to collaborate to: (d) review the effectiveness of the provisions in this paragraph two years from their entry into force, and address identified gaps in financing IHR implementation that are not being met by current or future domestic funding, existing and new bilateral, sub-regional, regional and multilateral funding mechanisms, including, if necessary, through the establishment of a dedicated financing mechanism to provide targeted, supplementary financing, in particular to developing countries, to build, strengthen and maintain the capacities required under these Regulations.
https://apps.who.int/gb/wgihr/pdf_files/wgihr8/WGIHR8_Proposed_Bureau_text-en.pdf (page 32) (17 April 2024)
Article 20. Sustainable financing
1. The Parties shall strengthen sustainable and predictable financing, in an inclusive and transparent manner, for implementation of this Agreement and the International Health Regulations (2005).
2. In this regard, each Party, within the means and resources at its disposal, shall:
(a) maintain or increase, as necessary, domestic funding for pandemic prevention, preparedness and response;
(b) mobilize additional financial resources to assist Parties, in particular developing country Parties, in the implementation of the WHO Pandemic Agreement, including through grants and concessional loans;
(c) explore, and as appropriate, promote, within relevant bilateral, regional and/or multilateral funding mechanisms, innovative financing measures, including transparent financial reprogramming plans for pandemic prevention, preparedness and response, especially for developing country Parties experiencing fiscal constraints; and
(d) encourage governance and operating models of existing financing entities to minimize the burden on countries, offer improved efficiency and coherence at scale, enhance transparency and be responsive to the needs and national priorities of developing countries.
3. A Coordinating Financial Mechanism (the Mechanism) is hereby established to provide sustainable financing support, strengthen and expand capacities for pandemic prevention, preparedness and response, and to provide any surge response necessary for day zero, particularly in developing country Parties.
The Mechanism shall, inter alia:
(a) conduct relevant needs and gaps analyses to support strategic decision-making and develop every five years a financial and implementation strategy for the Pandemic Agreement, and submit it to the Conference of the Parties for its consideration;
(b) promote harmonization, coherence and coordination for financing pandemic prevention, preparedness and response and International Health Regulations (2005)-related capacities;
(c) identify all sources of financing that are available to serve the purposes of supporting the implementation of this Agreement, and maintain a dashboard of such instruments and related information and the funds allocated to countries from such instruments;
(d) establish, as necessary, following a mandate from the Conference of the Parties, working arrangements with relevant identified financing instruments and entities to facilitate their support of the financial and implementation strategy;
(e) provide advice and support, upon request, to Parties in identifying and applying for financial resources for strengthening pandemic prevention, preparedness and response; and
(f) leverage voluntary monetary contributions for organizations and other entities supporting pandemic prevention, preparedness and response, free from conflicts of interest, from relevant stakeholders, in particular those active in sectors that benefit from international work to strengthen pandemic prevention, preparedness and response.
4. The Mechanism shall function under the authority and guidance of the Conference of the Parties and be accountable to it. The Conference of the Parties shall adopt terms of reference for the Mechanism and modalities for its operationalization and governance, within 12 months after the entry into force of the WHO Pandemic Agreement.
5. The Conference of the Parties shall periodically consider, as appropriate, the financial and implementation strategy for the Pandemic Agreement referred to in paragraph 3(a) of this Article.
The Parties shall endeavour to align with it, as appropriate, when providing external financial support for the strengthening of pandemic prevention, preparedness and response.
https://apps.who.int/gb/inb/pdf_files/inb9/A_inb9_3Rev1-en.pdf (pages 17-18) (22 April 2024)
The old system is crumbling, and we must build its replacement quickly.
If you are fed up with the government, hospital, medical, pharmaceutical, media, industrial complex and would like to help build a holistic alternative to the WHO, then feel free to contact me directly anytime.
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Originally Published: 2024-04-30 19:04:03
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