La 73th he World Health Assembly saw the United States continue its attacks on China and the World Health Organisation. The Assembly recognised immunisation as a global public good for health, but failed to do the same for vaccines.
The article below is part of the ‘WHO-Watch’ programme, an initiative of the People's Health Movement, a global movement in which Viva Salud is active. The programme aims to democratise global health policy and encourages young activists to follow the meetings of the World Health Organisation's governing bodies - the Executive Board meeting in January and the World Health Assembly in May - every year.
The WHO's role in containing COVID-19
The General Health Meeting which has just ended had a strong political bias, At the conference, country delegations presented their political positions on issues as varied as the World Health Organisation's (WHO) management of the COVID-19 pandemic and intellectual property, as well as the economic sanctions imposed by the United States on Iran, Cuba and Venezuela. The Director-General of the WHO, Dr Tedros Adhanom Ghebreyesus, made a strong statement about seeking support for the organisation in its fight against COVID-19. The WHO has received support from many quarters, from many low- and middle-income countries to high-income countries such as Sweden and Germany.
South Africa stated that «we must take this opportunity to appreciate the advice of the WHO's technical experts».
Sweden expressed its «strong support and appreciation of WHO's crucial role and irreplaceable leadership in the face of this pandemic. Now, perhaps more than ever, is the time to strengthen our international cooperation and show global solidarity.»
German Chancellor Angela Merkel said that the WHO was the legitimate global health organisation and added that its funding needed to be reviewed to ensure sustainability.
The WHO's role in containing COVID-19 has become a hot political issue over the past month, and this was felt during the two days of the virtual World Health Assembly. The agency has come under attack from the US for allegedly colluding with China to withhold information about a possible spread of the coronavirus. The US froze its subsidy to the WHO in April and has sent mixed messages about whether it will restore some or all of its aid. On the first day of the Assembly too, the United States had harsh words for the organisation.
US Health Secretary Alex M Azar said: «We need to be frank about one of the main reasons the epidemic got out of hand: this organisation failed to get the information the world needed, and that failure cost many lives». He added that «the WHO should change and become much more transparent and accountable».
Clearly referring to China, the US statement added that, «in an apparent attempt to hide this expansion, at least one member state has flouted its transparency obligations, at enormous cost to the world.» China has repeatedly rejected these allegations.
The United States also submitted a letter to the WHO DG setting out the details of its allegations, stating that the agency had objected to a travel ban on China, even though it had been established as early as February that the coronavirus had affected all regions of the world. They also accused the WHO of delaying in declaring the pandemic.
Constructive criticism of the WHO is a healthy practice and its decisions should be examined to determine the way forward. Nevertheless, the role of the United States has not been constructive. Delaying or suspending funding to the WHO when it is the largest donor will prevent a global management mechanism from being put in place to combat the virus.
Will the COVID-19 vaccine become a global public good?
Meanwhile, China has made two important announcements. The country promised that any COVID-19 vaccine developed in China would be a global public good. In other words, it would respect the principle of being affordable, accessible and available, and China would not seek to profit from it. China has also announced a contribution of US$2 billion$ towards the containment of COVID-19.
Representatives from many other countries spoke out in favour of a vaccine being considered a public good. However, the resolution proposed by the European Union and 37 other countries and adopted unanimously on 19 May does not include this condition. The COVID-19 resolution considers the government function of immunisation as a public good, but does not do so for the vaccine.
In a Commentary on the draft Resolution, the People's Health Movement (PHM) endorsed the recognition of immunisation as a global public good for health but condemned the exclusion of vaccines from this status, which effectively allows market-based production and distribution, despite the prohibitive price and failure to invest in meeting public health needs that are part of this approach.
As for the United States, it dissociated itself from certain key parts of the resolution, namely sexual and reproductive health and rights (SRHR) and TRIPS flexibilities.
Barbados, speaking on behalf of the Caribbean islands, thanked Cuba for sending doctors to the island and to other countries. Delegates also raised the issue of the economic embargoes imposed by the United States on countries such as Iran, Cuba and Syria. While the US has suggested that sanctions do not apply to products for humanitarian needs, these sanctions have in fact prevented the supply of medical products and food to these countries. Private companies that want to continue to look good in the US are reluctant to supply products to these countries.
There is some encouraging language in the resolution on TRIPS flexibilities, palliative care and other issues. But it fails to address key issues that have become essential in the response to the COVID-19 pandemic. These include gender-based violence, the effects of confinement on famine and the migrant crisis. These issues cannot be isolated from other COVID19 efforts. What is needed now is a comprehensive management mechanism that is sensitive to the social determinants of health and that sees social and economic marginalisation as the main cause of inadequate access to healthcare.
Civil society organisations monitoring global policy have submitted their statements to the World Health Assembly. One of the main calls was for the fair distribution of medicines and medical products to be guaranteed.
The joint statement from Médecins Sans Frontières International (MSF) and the Drugs for Neglected Diseases initiative (DNDi) set out five steps to transform good intentions regarding access to medicines, diagnostics and vaccines against COVID-19 into tangible health tools in the hands of practitioners and patients. The declaration states that health tools should be free from intellectual property restrictions, which can prevent the research and large-scale production of affordable health technologies. It calls on the WHO and Member States to ensure sufficient production, equitable distribution and affordability and to use TRIPS flexibilities to achieve this.
The statement from the US-based think-tank Knowledge Ecology International makes a similar point. «There should be no monopoly on patents, regulatory exclusivities, data or know-how in this pandemic. Any technology applied to COVID-19 products should be freely available or openly licensed with non-discriminatory, reasonable and affordable royalties.
The necessary technologies should become global public goods. Where incentives are needed, they should not be linked to price and exclusive rights». She added: «Governments control property rights and spend billions to fund research and development and to buy the necessary products. Governments need to cooperate and use their power for the benefit of the public.»
In its commentary, the Mouvement Populaire pour la Santé (People's Health Movement) drew attention to the social determinants of health and to an approach to strategies in relation to COVID-19 as part of broader health systems. Beyond the «pandemic-related priorities, there are broader global health objectives: action on the social determinants of health, action on equity in health and action to strengthen health systems in each country to the degree necessary for the progressive realisation of the right to health and care. The pursuit of these objectives is necessary for global preparedness, but planning for global preparedness and response must also work towards these goals», said the MPS.
The above article is a compilation of 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).
The article was first published on Peoples Dispatch
