In a letter written to the WHO, civil society leaders have urged the global health body to ensure equity, transparency and accountability during public hearings.
Limited public hearings are now in progress for the proposed WHO global accord on pandemic prevention, preparedness and response (pandemic treaty). In negotiation since February, the process is already raising significant concerns, not least of which is who is allowed to offer substantive input and how will the treaty negotiation harmonize with the WHO review of the existing vehicle for addressing health emergencies, including pandemics. More than 200 civil society organizations (CSOs), health experts, and lawmakers are appealing to the International Negotiating Body Members (INB) and negotiators to shift course without delay.
At stake, civil society claims, is history repeating itself. Millions of deaths. Staggering health care costs. Livelihoods decimated. Widespread and severe illness. All thanks in large part to a “lack of international cooperation” and failure to fully recognize “the inherent injustice and structural inequities exacerbated by such crises”—crises that cannot be properly addressed by a purely biomedical approach, if future pandemics are to be avoided.
In their letter, signatories are calling for the INB to inoculate the process against the “undue influence of the private sector and its powerful lobbyists.” Commercial interests and their proxies have prevented publicly-funded vaccines from reaching millions in need. They’ve used the pandemic crisis to advance the privatization of healthcare, often with support from international development circles. And the tobacco industry’s ownership of pharmaceutical corporations is already providing a potential back door for perpetrators of another global health crisis to influence how pandemics are governed into the future. Yet WHO leadership insists on embracing a “multistakeholder model” in this treaty making process, inviting such conflicted commercial interests to sit at the table as “relevant stakeholders.”
‘Whole of Society’ approach?
Organisations have pointed out that the WHO Director-General’s repeated reference to negotiations inspired by a “whole-of-society” approach – adding that “it is not easy to comprehend what this soothing locution really means”.
“For several years now the WHO has opened its doors to philanthropic organizations, transnational corporations and their proxies, and has invited them into policy spaces under the guise of “stakeholders”,” they had said.
“We are at the treaty’s first fork in the road. Will negotiators go down a path that allows big, vested interests to steer the process? Or will Member States’ delegates establish the primacy of human rights and indispensable safeguards against corporate political interference?” said Ashka Naik, research director for Corporate Accountability.
Both the WHO and the INB claim to be looking to the precedents of the WHO’s only other treaty as guidepost, the breakthrough Framework Convention on Tobacco Control (FCTC). Not only does the FCTC have strict provisions and guidelines on conflicts of interest, its negotiations have long involved broad and consistent civil society participation. This despite the tobacco industry’s attempts to ensure otherwise in the early 2000’s. As the letter notes, “the limited transparency on the INB process so far is reason for serious concern.” Details for the public hearings, including times, procedures, and other key issues, were only made available last week. Those who are selected for “substantive” oral testimony have no more than two minutes to speak, while written, “open-ended” submissions are limited to no more than 250-words.
Just a checked box?
“Public hearings are welcome, but we fear they may amount to little more than a checked box. Broad, substantive civil society participation needs to be an enduring and a vital part of the process, not a one-off,” said Nicoletta Dentico, co-chair of the Geneva Global Health Hub (G2H2).
“What’s more, the elements of the treaty must be selected based on a coherent ex-ante vision of what countries realistically need to prevent and prepare for future pandemics, rather than a lengthy shopping list of elements hastily provided in a few weeks”.
Another primary concern raised in the CSO letter is around the international community’s ongoing neglect of the “interconnected dynamics” contributing to pandemics. For example, “unsustainable food production and livestock breeding, wildlife trading, resource intensive lifestyles and consumption systems” cause and exacerbate global pandemics. The very model for providing health care is similarly fundamental to the treaty’s aspirations.
“Discussing the strategy for the prevention and preparedness for future pandemics entails, among many other radical decisions in the economic governance of the world, a clear uncompromising option for universal and public health systems in countries,” said Giulia Grillo, Italy’s former minister of health. “This is the only reliable barrier to safeguard a society when an outbreak emerges, and it must be supported financially, with no hesitation, for the public interest.”
These concerns are being raised at this week’s hearings. The World Health Assembly presents the next vital juncture for the nascent treaty in late May. Draft treaty language is anticipated in September.