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Palestine & "Unbalanced Text" Dominate Concerns of Developing Countries, Developed Countries Bristle at IP & Financing [Country Statements: INB7]
Newsletter Edition #53 [Treaty Talks]
If the inequitable access to COVID-19 medical products sowed deep distrust and rancour among countries, the parallel wars between Russia-Ukraine and Israel-Hamas have driven a further wedge on whatever remains of the multilateral firmament.
The job of global health negotiators working on a new Pandemic Agreement, and to amend the International Health Regulations, was already stacked against all odds. This has become even more difficult with Israel’s retaliation on Palestine following attacks by Hamas. The incessant attacks by Israel on health facilities in Palestinian Territories, directly speaks to the mandate of the WHO. It was no surprise that the crisis, bled into the discussions on the seventh inter-governmental meeting on the Pandemic Agreement this week in Geneva. Undoubtedly the stench of war pervaded the sterilized confines of the WHO headquarters where member states met this week.
It is on this fractured, splintered notion of international cooperation that diplomats have to now sew together new and complex rules on surveillance, information exchange and access to medical countermeasures. Commitments on accountability and transparency are also being sought. Tough that.
In this edition edition, my colleague Tessa Jager presents to you statements from a few countries that reflect the mess of geopolitics, and their positions on the evolving discussions towards a Pandemic Agreement. Our readers tell us, that they find these statements useful - as a record for posterity.
Watch out for our signature analysis on the meeting this week. Coming soon.
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I. COUNTRY STATEMENTS AT INB7
Palestine & “Unbalanced Text” Dominate Concerns of Developing Countries, Developed Countries Bristle at IP & Financing [Country Statements: INB7]
By Tessa Jager & Priti Patnaik
We present to you a few excerpts from verbatim statements made by some countries at the seventh meeting of the Intergovernmental Negotiating Body at WHO this week.
These statements reflect views on process, substantive elements in discussions towards a new Pandemic Agreement and the prevailing geopolitics.
Bangladesh, on behalf of the SEARO region:
… “We align ourselves with the statement to be delivered by the Equity Group. We appreciate the Bureau and the Secretariat for the draft negotiating text and thank for the guiding questions. We note that there is progress in our effort to draft a pandemic treaty. Nevertheless, more remains to be done. We have the following observations:
In line with the Equity Group statement, we are not against taking forward the discussions as for the guiding questions, provided by the Bureau. Nevertheless, we will suggest to incorporate textual suggestions from the Member States into that negotiating text, as a part of the negotiation process. As Member States make further amendments to improve the text to the desired level, the Co-Chairs may propose their textual suggestions to build consensus as appropriate, taking into account the discussions held during the meetings.
We’d like to reiterate that there should be no threshold limit regarding the number of Member States in any regional group for textual suggestions. Such group may be either regional or cross-regional. We welcome the idea of the Vice-Chairs of the Bureau or Co-Facilitators to facilitate the discussion in all formal or breakout sessions. Our preference is for the INB7 to address the most important issues of equity in the negotiating texts. Particularly, Article 9, 10, 11, 12, 13, 16, 19 and 20. Articles in the Treaty are interlinked, and development in one Article will affect the other. So, to develop the contents in a harmonised manner, we cannot support parallel informal or breakout sessions…..”
Ethiopia on behalf of 47 Member States of the Africa region
“ …We are at a crucial stage that will determine the success of this Member State-led process. Even though there are some positive developments, African Member States are concerned that the text, as it stands, falls short of addressing the key elements for the operationalization of equity.
Overall, we find some of the key issues to have been [presented] in an aspirational manner with no real commitment on how they will translate into concrete actions. The draft negotiating text takes a framework approach, and relegates important elements, such as the pathogen access and benefit sharing system, and the financing, to be established at a later date. There is also an overemphasis on unilateralism or national approaches in several articles, which can undermine the effectiveness of this international legally binding instrument. The text also did not fully incorporate the discussions and progress from the Co-Facilitated informal sessions.
Chair, we recognise that the burden is on us, the Member States, to improve the text: noting that nothing is agreed until everything is agreed. As such, we propose that the key elements that are missing in the negotiating text are incorporated into the current draft before textual negotiations can commence.
Regarding informal meetings, we recall that INB1 agreed on modalities that would not adopt any parallel process, as this would compromise inclusivity and consensus building. Therefore, we are not in a position to agree to this approach at this stage. We agree with the proposal to start with Chapter one, and have a complete read through of the current text, but remain flexible.
It would be important to understand the reasoning behind the deletion of key elements, such as recovery of health systems, and the principle of common but differentiated responsibilities. As a region, we are fully committed to ensuring that equity remains central to this instrument, and are prepared to strengthen this text for the realisation of this goal. We recognise that this will require commitment and political will from all Members and partners, in the spirit of true multilateralism. International cooperation and solidarity to ensure that some of the injustices of COVID-19 are not repeated…”
South Africa on behalf of the Equity Group
“… South Africa is honored to deliver this statement on behalf of the following 29 Member States who are Members of the cross-regional Group for Equity: Argentina, Bangladesh, Botswana, Brazil, China, Colombia, Dominican Republic, Egypt, El Salvador, Eswatini, Ethiopia, Fiji, Guatemala, India, Indonesia, Iran, Kenya, Malaysia, Mexico, Namibia, Pakistan, Palestine, Paraguay, Peru, the Philippines, South Africa, Tanzania, Thailand and Uruguay.
The Group of Equity thanks the Bureau and the Secretariat for the negotiating text, notwithstanding its imperfections. We welcome some areas of the draft and will make suggestions to improve others. The Group notes that the document falls short of, and lacks some important elements, that are key to making equity a reality. We would like to reiterate our position for a legally binding text on equity-related matters, to address the concerns of developing countries.
The group believes in particular that the principle of Common but Differentiated Responsibilities and Respective Capabilities, which was removed without having full discussion in the INB and enjoys the support of a large number of countries, should be retained. The said principle is essential to achieve a more equitable outcome in the future. We request an opportunity to discuss the CBDR principle at an appropriate time set by the drafting group.
The group would like to recall that the method of work of the INB stated that the Bureau can present proposals on the way forward. In this regard, we look forward to further proposals from the Bureau, with a view to helping us find consensus. We believe that the negotiating text should be maintained as a living document, and consider INB on the basis of the principle that nothing is agreed until everything is agreed. The Group of Equity has developed textual proposals to be included in the draft negotiating text, that will lead to the realisation of equity as the central mandate for consideration of the Bureau. The improved texts could form the basis of negotiations to which changes will be made during the drafting group meetings. The Equity Group is the view that the negotiating text has to be owned by Member States, which the text has to last in both contents and articulation. This is aimed at creating a level playing field in the negotiations……..
…The Group strongly believes that international solidarity and inclusivity, with full respect for the Common but Differentiated Responsibilities and Respective Capabilities-principle of Member States should be included in the Treaty, with a view to achieving equity and attaining the highest standard of health for all. The Group for Equity remained steadfast in its commitment to strengthen the draft negotiating text, with respect to the equity provision in the text especially, with greater emphasis in the eight Articles of the proposed instrument.
These include: health-and care workforce; Article seven; research and development, Article Nine; sustainable production, Article 10; Technology Transfer, Article 11; access and benefit sharing, Article 12; supply chain and logistics, Article 13, implementation support, Article 19; and financing, Article 20. With an emphasis on legally binding commitments in these areas, the Group of Equity reserves its right to propose textual suggestions. Finally, the Group of Equity reaffirms its full commitment to the negotiation process, including the mandate to adopt a consensus text at the 77th World Health Assembly in May 2024, provided that the INB process results in an action-and-results oriented Pandemic Treaty, that is just, fair, and equitable, in terms of the rights and responsibilities of all States, and cognizant of the circumstances and vulnerabilities faced by developing Member States…’’
“…Allow me to begin by expressing our solidarity to Palestine and deepest condolences to the families of the thousands of victims, including women, men, children and babies, as well as the health- and humanitarian workers who have lost their lives during this humanitarian catastrophe. As our session is not held in a vacuum, Indonesia is deeply outraged by the deteriorating human rights and humanitarian situation in Gaza. We strongly condemn Israel’s indiscriminate attacks against critical infrastructure, especially health infrastructures in Gaza. Attacks on healthcare, and any restriction to essential aid, including medical supplies, fuel, and water, are violations of international human rights law. The lack of access to essential medicines and antibiotics could lead to increase in infections and deaths. We cannot let the situation progress. All illegal acts by Israel must be stopped now.
Now on the matter at hand. Co-Chair, we align ourselves with the statement made by South Africa on behalf of the Group for Equity and Bangladesh on behalf of SEARO. Indonesia would like to thank the Bureau and the Secretariat for this proposed negotiating text, as well as the Co-Facilitators for the various informal sessions or the efforts in working with Member States to get us closer to consensus. There is room for improvement in the negotiating texts. Nevertheless, we accept it as a living document that could be further improved to ensure that the principle of equity is reflected in all Articles, and is implementable. For this purpose, we support the submission of textual proposals by countries or groups of countries, and reiterate the importance of the principle that nothing is agreed until everything is agreed. Indonesia, and I believe many other countries, are ready to begin textual negotiations among States. For this purpose, our delegation this week includes subject matter experts from various related fields. We would also like to reiterate the need to ensure that our negotiations continue to be inclusive in nature, and avoid parallel sessions.
We welcome the proposal for Bureau Members or co-facilitators to facilitate informal breakout sessions with a view to come up with consensual language…. However, we would like to underscore that the Co-facilitators should be given the mandate to produce alternative text for the Member States considerations. On time scheduling of this weeks’ discussion, we would like to support the prioritisation of Articles related to equity in the instrument, as highlighted by the Group for Equity, namely the Article 7, 9, 11, 12, 13, 19 and Article 20. In addition, also Article 16 on international collaboration and cooperation, should be also discussed in great details. Furthermore, Indonesia emphasizes the need to reintroduce the element of Common Responsibilities and Different Capabilities in Pandemic Prevention, Preparedness and Response….”
“ … We acknowledge that the new text is an improvement from the previous text, but we also have a number of serious concerns about the text. We are concerned about the general lack of specificity and clarity of the text, which would not allow for effective implementation or binding obligations. For example, we are concerned that several provisions, such as those related to prevention and preparedness, are still insufficient to address the gap that COVID-19 exposes. This would undermine our collective capacity to prevent future pandemics from happening, which is also an important aspect of ensuring equity.
We see room for improvements in the references to human rights. And we are also concerned that many key issues are, to a significant degree, pushed to the future for further work by the Conference of the Parties.
Furthermore, parts of the text remain very problematic. We have strong reservation against how some provisions have been drafted, in particularly those related to intellectual property rights and technology transfer on the one hand, and financing on the other…..
…At this juncture, we want to underline the importance of an efficient, clearly structured, and inclusive negotiating process. To this end, the informal groups have proved very valuable, and we support the continuation of the work in informal groups with the help of Co-facilitators, both during formal sessions, but even more importantly, between sessions. The informal will facilitate discussion of substantive matter, facilitate possibilities for stakeholder participation, and inclusiveness. They will be key, in our mind, in enabling us to reach convergence. We encourage the Bureau to use this valuable tool, both during the meeting and in the intersessional period, and clarify the mandate and role of co-facilitators. This will also bring useful guidance to Member States on how the negotiation will be conducted, and thereby allow for better preparations…
The European Union and its Member States are already engaging in concrete action to improve PPR. For instance, by supporting the diversification of manufacturing with a 1.2 billion ‘’Team Europe’’ for Africa, among others, and in addressing capacity gaps in Prevention and Preparedness through in particular, the Pandemic Fund….”
“…On process, we believe we need to start direct negotiations within Member States. And we believe that that could be done on the basis of the text in front of us. We need a clear plan for a negotiation, including which Articles will be discussed at what time, and how Member States’ input to the text will be taken forward. We agree with colleagues proposing to focus on Chapter Two.
On content, we consider the following needs to be improved:
On prevention, surveillance and one health, we welcome further streamlining and clear commitments on Member States. On research and development, we call for reintroducing commitments on equitable access conditions in public financing as well as more transparency, sharing, and coordination of the research agenda. On Article 12, while we note some slight improvements, we remain concerned that the PABS system might not function as intended. It is also unnecessarily complex…”
“ … An Agreement needs, in our view, to make clear what is expected by whom, at what point in time. And this goes for those Member States that choose to become a party, and for International Organizations, including the WHO that may be given a role through the agreement. Consideration needs to be made regarding who on the Global Health scene is best placed to carry out certain tasks in light of their mandate and capacity. We think that in May next year, we need to present provisions that are specific and clear, so that parties know what binding obligations they would potentially be signing up to. And we are not there yet.
To give one example, and this is just one, provisions on prevention, including antimicrobial resistance, need in our view to be clarified and strengthened. Through the adoption of the global action plan on AMR back in 2016, Member States have already committed to a number of measures that are highly relevant to PPR and the relevant connections should be made in the CA+.
…Furthermore, we strongly reserve ourselves against the draft provisions on intellectual property rights and technology transfer. IPR is important for innovation and regulations must be robust, effective and conceivable to the industry. And suggestions to change these rights need to be made in the relevant and competent forums.”
“ …We ask the three questions of the proposed text:
First, taken as a whole, does the text result in a meaningful change to existing practice? And on the balance of probabilities, is it more likely to result in a material impact felt by ordinary people on the ground? On the whole, we would say yes. We welcome the increased emphasis on the full PPR cycle. But there are elements that address the response part of that cycle, where we do think the text reverts to the status quo with an absence of legally binding obligations.
Second, how embedded is equity within the text? Is it more likely than not to ensure that future responses to pandemics will be more equitable? And will it reduce health inequalities at a global level? Here, while we appreciate the intent of the Bureau, we think there are some missed opportunities to truly contribute to sustainable and timely access. For example, we note the deletion of conditionalities on public financing of research and development, that was present in the Bureau text and that received a strong support at the informal consultations. We also note the lack of clear and binding commitments on sharing technology and IP barriers during a pandemic, with the insertion of qualifying language, such as mutually agreed terms.
Third, are the proposed provisions feasible for Member States to implement? On this, we feel that the Article and sustainable financing will play a crucial role. We do not feel that establishing new financial mechanisms is a sustainable approach and need to consider alternatives that address, this including frameworks that strengthen accountability, flexibility and mobilization of existing resources.
Given our thoughts on these questions, how then should we now proceed? First, we should adopt the text as the basis for negotiation. Despite our own concerns, we feel it is only natural that all parties will have certain concerns regarding the text. Indeed, it will not be a balanced text if one party was completely happy with it. Nonetheless, we believe that this text is progress, and we should not let the perfect be the enemy of the good.
Second, we should proceed with negotiations based not on positions, but on interests. Indeed, we have already spent the last few months stating our positions and proposing texts that meet those specific positions. As we move through negotiations this week, we would not consider text-based, opposition-based negotiations, at this stage be ideal. As this may lead us to either going round in circles, leaning back to where we were, or to the INB inadvertently adopting a lowest common denominator approach and a watered-down convention. Instead, we propose an interest-based negotiation process, where Member States are explicit about their interests. Where there are tensions, and of course there will be between the expressed interests of the various parties, we should seek alternative formulations or potential third ways that meet the entire range of interests expressed….”
“..There is, as a general proposition, we feel, Co-Chair, a lack of clarity in a number of areas particularly around some of the mandatory obligations. And we're concerned that many key issues are being postponed to the future for work by the Conference of Parties.
More specifically, we have reservations around provisions relating to IPR, and technology transfer, financing, and indeed, governance. We recognize, of course, that it is important to balance the costs to industry of research and innovation and to maintain a workable IP regime while at the same time ensuring fair and equitable access to medicines and products during a public health crisis. However, we feel that these provisions must respect the mandate and decision-making processes of the WTO and WIPO to be the appropriate fora for IPR.
Ireland welcomes the provision on global supply chain and logistics generally. However, some of these requirements, we feel, may prove difficult to implement in practice as currently drafted, particularly relating to the sharing of information. Furthermore, we would like to see alignment between the procurement requirements. In this provision, there are similar measures which are in place in the EU. We also have concerns around government funded purchase agreements in this provision.
On financing, Article 20. We believe that it would be a benefit if a subgroup was established to further explore this. We feel it will be difficult to secure a political agreement for an unknown amount and unspecified amount that will be managed and allocated by the Conference of Parties. We have concerns, Co-Chair, about some of the provisions also in chapter three around governance and oversight with Conference of Parties, and its ability to amend the Treaty post-adoption.
And indeed, on the protocol adoption measures, set out in Article 30. We were concerned that the current provisions, in respect of States, were not part of its final agreement could serve to undermine the final agreed text.”
“ …Co-chair, in general terms, Botswana supports the proposed text as a foundation to advance the discussions. This is, of course, with the understanding that the INB will make additional textual inputs in order to strengthen the proposal and allow negotiations to commence.
We note with appreciation the elaboration of a multilateral access and benefit sharing system, R&D, global supply chain and network, as well as a standalone Article on sustainable production.
Whereas we welcome the streamlined text, this has come at the expense of some priority and core issues that address equity. Overall, Botswana notes that the revised text is aspirational and proposes softer noncommittal language. The central role of the WHO has also been decreased, which we find concerning. Health system recovery remains key and it is unclear why it was systematically removed from the text.
We also note that the proposal for negotiating text increasingly makes reference to consistency with national laws. We believe that it is important to first elaborate the Treaty, then domesticate or align with national laws.
Both the PABS system under Article 12 and the financial mechanism under Article 20 need to be established, and are key components adopted together with the Treaty, and not at a later time in the future. Governments’ investments in research and development to develop medical products including vaccines, diagnostics and medicines and finance…..There is need for further development of specific legally binding obligations that attaches acts as conditions to public funding. The whole fair and equitable allocation framework also needs to be further developed.
There is also a need to make interlinkages and cross-referencing on Articles that address equity. For example, Article 9, 10, 11, 12, 13 In order to ensure synergy, including IHR 2005. Lastly, Co-Chair, Botswana looks forward to working with other Member States to support the process in order to move forward with the proposed text, cognizant for ambitious timelines, to deliver on this very important work...’’
“…Before, making this intervention, I would like to state that our hearts are bleeding. Our hearts are bleeding because there is an ongoing genocide in Gaza perpetrated by Israel with the support of our allies. We condemn in the strongest terms the Israeli aggression against Gaza. We call for an immediate ceasefire, and …access for humanitarian assistance for the Palestinian civilian population in Gaza. We also call on Israel, we call on Israel’s allies, to comply with their erga omnes obligations under international law. These allies of Israel are complicit in the commission of atrocity crimes, by, amongst others, providing military support to Israel.
Co-Chairs, Namibia aligns itself with the statement delivered by the distinguished representative of Ethiopia on behalf of the 47 Members of the African region and by South Africa on behalf of the Equity Group. The draft negotiating text before us takes the same approach that has been taken on international health law since 1951. This is since the adoption of the International Sanitary Regulations in 1951. We have, again, before us, a text that attaches far greater importance to the pillars of prevention and preparedness - legally binding obligations proposed for provisions that would operationalize these pillars. While the provisions on equitable response are presented in aspirational language, and framework formats, or promises, to be achieved through the goodwill of individual Member States.
We ask ourselves if the Bureau really wanted to produce a balanced text. Why did the bureau not present aspirational or non-binding language for the provisions that seek to operationalize the pillars of prevention and preparedness? Why did the Bureau not suspend the development of important issues under Article 4 and 5 to a later date, as they have done for Articles 12 and 20. The texts, while acknowledging the different levels in capacities of States, and the peculiar situations of developing countries, fails to apportion an appropriate degree of responsibility on those who have more resources to provide the necessary support to developing countries to implement obligations envisaged under the Pandemic Treaty, or to strengthen the health systems.
In developing the text, the Bureau also omitted to take into consideration the fact that developing countries have limited human resource capacities. Major equity proposals that enjoyed the support of more than 60 developing countries [have not been reflected]…developing countries who already have stretched human resources have now to gather themselves again, to seek the incorporation of stronger provisions on equity in the negotiating text….”
“… we would like to call to the attention of different countries and parties here, is that this negotiation is a negotiation that is intrinsically unbalanced. And why that this negotiation on health capabilities is intrinsically unbalanced?
First of all, many of the obligations that we are going to create through this Instrument are obligations that are already met, mostly by developed countries. So, you have your systems more developed, better established, and then of course, you are not going to have to do all the work that us, as developing countries are going to have to do. So, the finish line is further ahead for us, in terms of what we have to build. Also, specifically on the surveillance bit and One Health obligations. Many developing countries find themselves in a situation that is geographically more prone to this, and more difficult to make the surveillance. So, we have to build bigger, more able capacity. And this is a challenge that we have more specifically in the context of megadiverse developing countries.
An additional unbalanced element is the issue of financial and technological availability. Of course, developed countries, they have more capability in terms of financial resources, but also in terms of technology that is available for their use. Sometimes, when we, as developing countries want to access this kind of technology, we find ourselves in a situation where either we can't access that specific technology because it is somehow protected or we have to pay a lot of money also to be able to have this technological resource. So, this unbalanced situation invites us, to also make some conclusions. So, we have to somehow enshrine this, or we have to acknowledge this imbalance through some means. Either through the principle of Common but Differentiated Responsibilities, we have to acknowledge of course different capacities, but also different obligations.
We also have to have more commitments from the part of developed countries with issues that are of interest to come to developing countries. And specifically, I would say about tech transfer and IP. When I heard several developed countries say no, no, no, we cannot touch this issue because it's an issue that has to be better dealt with in WTO or WIPO. And the same argument is not true for other instances, where we are also discussing matters that fall under the purview of different organizations. So, we also have to be coherent here...”
“…while all Member States support the theoretical concept of equity in the pandemic agreement, there is clear divergence between developed and developing countries with regards to operationalizing equity, including through concrete legally binding obligations in the instrument.
We see Common but Differentiated Responsibilities and Respective Capabilities as a principle that puts equity into practice. We're concerned that CBDR has been removed as a principle or approach in article three of the text, despite the support of many Member States, and replaced with principles of responsibility and recognition of different levels of capacity, which is seemingly supported by solidarity. These replacements recognize different capacities, but do not recognise differentiated responsibility and are even weak on collective responsibility.
Regarding the core equity Articles in the text, Articles 9 to 13, we welcome the retention of key text on intellectual property rights and transfer of technology and know-how. However, we note with concern the weak legal language and (qualifying use), in contrast, for example, to more legally binding language in Article 4 on pandemic prevention and public health surveillance…”
…the One Health approach must be strengthened in the negotiating text. One Health has been removed from Article three general principles and approaches. And while there is an article dedicated to One Health, the wording is very general and fails to identify the related drivers of pandemics and the emergence and reemergence of diseases at the human, animal and environment interface. For example, climate change, land use change and a loss of biodiversity. Climate change, in fact, which is the biggest threat to global health is now mentioned only once in the negotiating text within the definition of One Health in Article 1, use of terms.”
“Dear Co-Chairs, to ensure equity in future pandemics, the Treaty needs strong legal commitments on provisions that would operationalize equity. Provisions calling only for the promotion and encouragement of measures necessary to ensure equitable access to medical countermeasures must be transformed into obligations and commitments. We also regret that CBDR principle has been prematurely removed, before members can engage constructively. The different levels of capacities introduced in the text is ignorant on the unequal development stages of Member States. We hope that at the INB7, the negotiating text can be maintained as a living document, but during the negotiations, the language should be strengthened so the objectives which are in these provisions can be realistically achieved. We do believe that if there should be an informal session, it will best not to run in parallel as it will be difficult for small delegations.
…Co-Chairs, Malaysia is deeply concerned over the rising death totals of over 9000. Including 4800 children and 2500 plus women in and around the Gaza Strip. 88 of UNWRA employees have also been killed since the seventh of October, the highest number of UN fatalities ever recorded in a single conflict. The commitment to the protection of the civilians and healthcare workers in conflict should be backed with actions. Attacks on healthcare are a violation of international humanitarian law. 14 of 36 hospitals in Gaza Strip are non-functional, affected by lack of food and clean water, and the lack of fuel to power generators. 23 hospitals have been ordered to evacuate the Gaza City and North Gaza. We need to ensure that all people in Gaza have access to life saving health and humanitarian services in this almost impossible situation. We call for the Israeli regime to abide by their obligations under international humanitarian law, and we call on all who can, to deescalate this conflict. Palestinians have the legal right to live in a state of peace within its own internationally recognised border, based on the pre-1967 borders, with East Jerusalem as its capital. As well as this, as their inalienable right to return to their homes and property from which they have been displaced.”
“…Several in the room have raised the tragic situation in the Middle East. We are heartbroken by every innocent life lost, whether they are Israeli or Palestinian. Israelis and Palestinians equally deserve to live in safety, dignity and peace. We continue to support Israel's right to defend against terrorism, consistent with international humanitarian law, including the obligation to protect civilians, just as we stand with the people of Israel who have suffered horrific violence. We also stand with Palestinian civilians whose lives have been upended by this terrible conflict. The United States calls on all sides to uphold international humanitarian law, including regarding the protection of civilians and to enable access for humanitarian assistance and personnel. We express our steadfast and united support to the State of Israel, and our unequivocal condemnation of Hamas and its appalling acts of terrorism. We make clear that the terrorist actions of Hamas have no justification, no legitimacy and must be universally condemned. There is never any justification for terrorism. Hamas bears responsibility for sparking this violence. They have compounded and perpetuated the suffering of the Palestinian people at every step of this crisis. The United States supports Israel's right to defend itself against the terrorist attacks by Hamas, consistent with international law, including the need to take all feasible precautions to minimise harm to civilians. This is not genocide, indeed, to call it that is to distort the term beyond recognition.
And now with respect to the Pandemic Accord. We support the regional statement delivered by Mexico, and thank the Member States of the Americas for productive discussions last week in Washington. The United States remains fully committed to this process. This agreement will be a meaningful step forward in advancing global health security for all people. It should be ambitious, but also practical, operationally feasible and implementable. We appreciate that the due text has been streamlined. However, we are disappointed that more input from the Co-Facilitators has not been incorporated. As we move forward, an important guiding principle is that we should not undermine aspects of the system that worked in the response to COVID-19. Eliminating intellectual property protections will not effectively improve equitable access during pandemic emergencies, and will, in fact, harm the systems that have served us well in the past. The United States believes strongly in IP protections which serve to fuel investment and innovation. We agree that more timely access to these innovations should be central to our discussions and our exploring options to prioritise the availability of medical countermeasures for developing countries during future pandemic emergencies.
We are also looking carefully at the pathogen access and benefit sharing system, so that we can provide constructive feedback that will make the system effective and consequential.
We have serious reservations about the mechanism for financing proposed in Article 20, recognising we must tackle this element of pandemic PPR in a meaningful way. There should be no doubt on the US’s commitment to equity or global health. The United States is the world's largest global health donor. Since 2021, we've spent nearly $16 billion globally to end the acute phase of the COVID-19 pandemic, and we have provided hundreds of millions of vaccine doses to over 100 countries. In addition, the United States has committed $700 million to the Pandemic Fund to date to support countries in filling critical gaps.
We understand that effectively in implementing this agreement will require resources, and want to work with partners to strengthen the financing architecture, to ensure that this agreement will make a difference in tangible ways. We have continually urged consideration of industry and stakeholder views, which will be essential for the future implementation of this agreement. This outreach needs to be done with greater intensity given these partnerships will provide important information about the viability of many of the proposals in the text. We are willing to accept this draft as the basis for negotiation, but stress that Member States must begin direct negotiations expeditiously, focusing on areas of highest impact and priority, preferably beginning with chapter two. We strongly urge continuing the informals with a clear mandate to the Co-Facilitators, perhaps working with a dedicated Bureau Member to further their work and bring new texts back to the INB for consideration.”
‘’…We support the statement delivered by the Kingdom of Saudi Arabia on behalf of EMRO. We will begin by expressing our grave concern about the ongoing humanitarian catastrophe in Gaza, in occupied Palestinian territory. There is no justification for attacks on healthcare facilities, including on ambulances and hospitals. And these attacks must stop. We also call for continuous supply of humanitarian assistance including medicines and medical supplies for Gaza. We echo the call made by heads of 18 UN Agencies, including WHO, for an immediate ceasefire. We also wish to highlight concerns expressed by the UN human rights experts on blatant violations of international human rights law, and humanitarian laws.
….[ON INB] “ We would like to address our reflections in three parts. Firstly, we take note the positive elements within this proposal. The inclusion of a separate Article on sustainable production marks a significant advancement in our text. Enhancing local and regional production capacities is critical for preventing any disease outbreak or health emergency, from becoming a pandemic. Furthermore, the efforts made to shorten the text and make it more precise, enhancing its clarity and precision, are more are welcome.
Secondly, we wish to note the elements that are conspicuously missing from the current draft. Notably, the principle of Common but Differentiated Responsibilities and Respective Capabilities has been omitted. This principle is not just a policy stance, but a fundamental aspect of equity. We believe that the retention of this principle is vital for our future discussions.
Alongside this, the provisions related to equity have been perceptively weakened. Language around technical financial cooperation has either been made non-obligatory, or some of these critical aspects have been pushed to a later time, most notably of developing a PABS system and having a sustainable financing mechanism….”
“…In our view, in order to truly make a difference in future pandemics that takes must be strengthened significantly on the following areas. One is on building health system capacity and infrastructure including a maintained and retained competent multidisciplinary health workforce. This entails fully abiding to the ethical principles of the WHO Code of Practice for the international recruitment of healthcare workers, among others. Significant poaching of healthcare workers from the African region to developed countries has hampered our health systems and compromised our fulfilment of UHC, so this is quite important.
Second, the concept of health systems recovery and CBDR need to be added.
Third, there's insufficient focus on making the mechanisms in the text available to prevent small outbreaks and public health emergency of international concern from becoming pandemics. As we all know, the most manageable pandemics are those that do not happen in the first place. So, we also put greater emphasis on this. The other one is on the proposal for the new fund. It needs to be further specific on how contributions will be assessed and sustained. The language on debt relief or debt swap as a key component of making resources available for PPPR has also been removed, and it needs to be restored. This is very, very crucial for the African region and the Arab Republic of Egypt. In the face of rising debt burdens faced by several African countries, commitments of support for implementation need to move beyond promises and aid. And as such, the Agreement must be clear, effective and binding…”
Our analysis on the dynamics of INB7 will follow in the coming days.
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