“Some aspects of IHR amendments linked to, dependent on, where the INB process finishes. Need for us to remain in step until May 2024”: WG-IHR Co-Chairs Asiri & Bloomfield
“Some aspects of IHR amendments linked to, dependent on, where the INB process finishes. Need for us to remain in step until May 2024”: WG-IHR Co-Chairs Asiri & Bloomfield
Newsletter Edition #37 [Treaty Talks/IHR - The Files Interview]
Hi,
When we first began reporting on potential new reforms for the governance of health emergencies two years ago, many countries repeatedly emphasized the centrality of the International Health Regulations. This was notwithstanding the steady political momentum that a new Pandemic Treaty was gaining in some countries back then.
Countries often highlighted the delicate balance and careful negotiations over the years, that had made the IHR one of the centerpieces of global health law.
These somewhat less-understood, technical regulations are now being amended, as they have been before. What is different now though that it is a fairly different world where technology and disease are fusing to present evolving challenges for countries.
In today’s edition we bring you an interview with Abdullah Asiri of Saudi Arabia and Ashley Bloomfield of New Zealand, Co-Chairs of the Working Group for the amendments to the IHR. They have led this careful process and are tasked with concluding these negotiations with some ambitious proposals in tow. (Also see our interview from last week with INB Co-Chairs)
We hope you find this edition timely and useful.
If you find our work valuable, become a paying subscriber. Tracking global health policy-making in Geneva is tough and expensive. Help us in raising important questions, and in keeping an ear to the ground. Readers paying for our work helps us meet our costs.
Watch out for our final edition from these July meetings in the coming days with an update from the on-going WG-IHR 4.
We will head to a summer break in August and we will be dialing down on our reported editions. As we take a step back from editorial, we take this time to focus on the operational areas of this media entrepreneurial initiative.
Thank you for understanding.
Best,
Priti
Feel free to write to us: patnaik.reporting@gmail.com or genevahealthfiles@protonmail.com; Follow us on Twitter: @filesgeneva
I. THE GENEVA HEALTH FILES INTERVIEW
“Some aspects of IHR amendments linked to, dependent on, where the INB process finishes. Need for us to remain in step until May 2024”: WG-IHR Co-Chairs Asiri & Bloomfield
By Priti Patnaik & Tessa Jager
In the politically charged discussions that current global health negotiations have become, diplomats have to walk a tightrope between delivering on political goals and bringing in concrete reforms to beef up preparedness, prevention and respond to health emergencies. The relative low profile of the discussions surrounding the amendments to the IHR (2005) is in contrast to the optics generated by the negotiations for a Pandemic Accord. This could be partly by design, and partly by the very nature of these discussions that are technical but undoubtedly also political. During the sidelines of the WG-IHR4, Geneva Health Files, spoke with Abdullah Asiri and Ashley Bloomfield, Co-Chairs of the WG-IHR talk about how they see these negotiations progressing. Countries have often described this track fo global helathnegotiations as being efficient and streamlined. In this lucid interview, the Co-Chairs lay out the challenges and opportunities in these negotiations.
Geneva Health Files [GHF] Q1. We wanted to get your overall impressions on the progress so far. Although the IHR discussions began later than the INB, it seems that you have caught up and made progress. Does the December 2023 effective deadline still stand?
Ashley Bloomfield [AB]:
Thanks for the opportunity to update on the progress. I guess, the first important point is of course, we have had a different starting point from our INB colleagues, in that we have got an existing, very good set of regulations that have been serving us well. And we have got the task of considering a large number of amendments, and that what we are working through. So, in a sense, there is probably no surprise that we are making good progress, and we should be. One thing that I would say about our meetings right from the start last November, and now we are on our fourth meeting this week, is that there’s been a very strong sense of purpose, shared purpose, a sense of solidarity in the room. And we have seen that starting to come to fruition very much this week with the nature of the discussions around the articles that we are going into in-depth, not just speaking to the amendments, but really reflecting on the proposals…including the Secretariat, and their advice in particular on how the process currently works, how any proposed amendments might impact on, or be implemented by the work of the National Focal Points, and the team inside the WHO that are implementing the regulations. So, I would say this week, from my perspective, is been a really productive week and we have still got some time before we finish.
Abdullah Asiri [AA]:
Absolutely. The IHR as a document has been designed to protect the world from emergencies, public health emergencies. And to gear the world to better respond to public health emergencies. But it has been a while since the current IHR has been enacted. And there have been significant changes in the way that the public health is addressed. The way that surveillance is being done… medical countermeasures to emergencies have evolved significantly. And in addition, the lessons that we have learned from the COVID-19 pandemic has necessitated the Member States to start the process of looking into various Articles and Annexes in the current IHR and update them to the current situation that we are having, and be also guided by the lessons that we have learned from COVID-19.
It is a Member State-led process. It is from them to them. We are in the WGIHR Working Group, and the Bureau is working as a facilitator with support from the WHO Secretariat to help guide the process. But after all, it is the Member States who will decide if these amendments will be incorporated into the new version of the IHR or not. So, we had an agreed method of work by the Member States, and we think that we are progressing as planned, [considering] our method of working, to the agenda that we had agreed for every of our four formal meetings that we had so far.
[GHF] Q2. On the question of timelines, I think there is increasing recognition that the processes are complimentary, but they are also have different paces and processes. The INB has had a lot of informal sessions, for example. But they also have a longer time frame till May 2024, but you have a shorter one by January 2024. Can you elaborate on that?
We also heard that you could do a status update to the WHO Executive Board in January and buy more time.
[AB]:
Well, I think as a Bureau, and I am sure as a Working Group, everyone is focused on the task we have been given which is to come up with this package of amendments, and make a package available four months before the World Health Assembly May 2024. So, we remain focused on it. We have planned our meetings till December. At the same time, everyone is also cognizant of the link between the two processes. And, for example, I was there last week for the full INB meeting…to make sure that it was part of our combined effort to ensure that the two processes are complementary coherent, and also aligned.
And it is clear that there are some aspects of that final package of IHR amendments that will be linked to and dependent on where the INB process finishes. And so there will be a need for us to remain, I guess, in step, right up until May 2024. So, saying, we don’t have a requirement to report the package to the Executive Board per se, that we have an opportunity as you have suggested, to update the Executive Board, and if necessary, to sort of map out what our pathway is to ensure we have got that package of amendments.
[AA]:
In fact, the interlinkages between the two processes have been recognized from the beginning. And that’s why we have as a joint work between our two processes set up a series of meetings between the Bureaus of the two processes. And also, we had two sessions of joint plenary with Member States, trying to address the areas of common interest between the two processes.
So, we…the Member States, found that very helpful and delineating the continuum of these two processes. And we don’t think that ….there is a risk of one process being lagged behind, affecting the other process. Yes, both processes have a lot of commonalities, but I mean, they don’t really negatively affect each other if one process is lagging behind.
And there are, of course, safety nets when it comes to, for example, the WGIHR process… that we are already having a document in action. So even the worst-case scenario is not bad. So, we would end up having a document that has been serving the purpose for some time. Yes, it will need to be updated, but to have this update, we need to have a consensus from Member States on these amendments. So, we don’t see that that these linkages have a negative effect per se. We see that the Member States, with support from the Bureaux are addressing them, and they should be addressed.
[GHF] Q3. Yes, indeed the joint session that was webcast was really useful and interesting. I believe you could potentially have more sessions in the future addressing common topics, in a way that could save time for delegations.
[AB]:
Well, the joint meeting, actually the whole of it was webcast. So that was, I think, a really good innovation. And as those who listened, and would have heard, there was both really good discussion and also a shared view that is important. We take some of these issues forward together. And one concrete example was the definition and elaboration of a pandemic. And so, that’s a piece of work that we have been tasked with doing. We will work with the Secretariat on it.
And in terms of further detail around how we take forward these other common issues of interest, in particular, the really important ones for both processes, financial mechanisms, and access and benefit sharing. Those are two issues that need to be fundamental, really to, I think, progress and resolution of both processes. And there is keen appetite for us to do that as much as possible in a joint way.
And as Bureaux, the two Bureaux, intend to get together once we have finished our week of work this week, and map out the pathway forward. And there is an appetite for further joint work, but also realism by all of us, about the heavy workload we already have. And you would have heard many people talk about the need to avoid a third track, and to ensure that the joint work is actually increasing our efficiency, so that we are not duplicating the same discussions with the same people. In both processes is a really strong focus on it.
[GHF]: Would you like to add something on this, Dr Asiri.
[AA]:
The way that the bureaux have been designed is really helpful and thoughtful of how the background work of the bureaux is overseen by the Member States. Because the composition of the Bureau are representatives of the region, and there are in continuous dialogue with Member States through the existing structure of the WHO regions. So that, I think, was really helpful in sensing what Member States are perceiving from the progress of the process, what is their willingness, or positions on certain files, even if we are not in the formal meetings… in the intersessional periods. So, I think that the way that the composition of the Bureau was made was really helpful in getting the message back and forth to Member States.
[GHF] Q4. That is really interesting. Just a quick follow up question. In terms understanding what potentially a new financing mechanism can look like for Prevention Preparedness and Response, in the context of WHO; and what a new multilateral mechanism on Access and Benefits Sharing can look like….My understanding is countries will be looking at something that will be applicable across both these instruments. Is that one of the goals of treating these issues in a joint format?
[AB]:
Well, the principal reason we need to take it forward jointly is that there are proposals put forward for amendments to the IHR that address these issues. And at the same time, they are also key issues that are part of the discussions in the INB process. So, there will need to be a resolution of these issues, and agreement around both issues, that can then be appropriately reflected in both documents.
And of course, the importance of the IHR is that they apply to all Member States and to other States Parties, so they are in a sense universal in their application. Whereas the accord that comes through the INB process, like you know, even 20 years on from the Agreement around the Framework Convention on Tabacco Control, it has a very high number of members but it still doesn’t include all Member States.
So, the way that financing mechanisms, access and benefit sharing, is reflected in the two documents will be different, but they need to be aligned, they need to be coherent, and they need to be agreed by Member States.
[GHF] If the goal is to have essential bare bones of an ABS mechanism in the Accord, to be followed up by a protocol with more details, then there would be, I believe, a placeholder for the ABS in the IHR to reflect a future protocol. Is that how it will work?
[AB]:
Well, we will just need to see. You know, these are substantive issues. And whilst we have had initial discussions, they are the ones, we are very aware, as joint Bureaux. We will need to progress with some really intense, thoughtful and inclusive discussions.
[GHF] Q5. Are there a set of amendments that are easier to accomplish and those that are more difficult, in your view?
Also, what is your understanding of the scope of your mandate: in the event that countries are not able to reach consensus on some of the proposals, are you going to forge consensus by having smaller forums…what mechanisms will you adopt, let’s say in those final days and hours of the negotiations?
[AA]:
So, I think, the main objective of the whole process is to be as inclusive as possible. And all kinds of discussions that are happening should always take that into consideration. And that’s why the formal meetings might not be enough to explore all the positions and discussions. That’s why there are intersessional activities, that are designed in a way that it is inclusive, all Member States are aware of it. And they have a specific set of agenda that is known to everybody before the meeting is taking place, and it is overseen or moderated by the Bureau of the WGIHR.
This was helpful in advancing some of the discussions in areas that have been new to the IHR as a concept. Of course, this will be the most difficult to discuss because they have no precedent in the existing document. But Member States feel that they should be part of the IHR. So that’s why the discussions have to be designed in a way to be specific to these new areas. And as my colleague mentioned, these have been already defined, and they are more or less the same that are in common with the INB process.
So what Member States are now trying to do is: how can we address them in both documents without interference, or without overlap? And I think that it’s getting clearer with time. For example, when you think about financing, when you are talking about capacity building and the financing mechanism in the context of IHR, you are talking about resilience. You are talking about building capacity, day-to-day activities that are required for public health protection. But in the INB process, you are thinking about a different ballgame… you are talking response during an actual pandemic.
[GHF] Do you want to take a stab at the easier set of amendments. Do you want to articulate that, Dr Bloomfield?
[AB]:
Abdullah, I think just sort of touched on this…where there are relatively small amendments or updates to existing text and the IHR existing articles, those are the ones that tend to be easier to get convergence on. So, saying, sometimes you look at amendments and you think ‘this should be relatively straightforward’ and it transpires that’s not quite where the discussion goes. So, the important thing is the way we do it. And this week has been, I think, very satisfying in the sense, the way that we have held the discussions, the degree of engagement, listening to each other, the involvement of the Secretariat, the reflection on the Review Committee’s report.
And again, there this common sense of purpose, and whilst the process of the IHR revisions has got a lower profile than the INB discussions, it is no less and arguably more important, in that the regulations apply to everybody.
They are the existing legal framework for us to protect citizens around the world from outbreaks and prevent them escalating to the sort of catastrophic pandemic we had just a few short years ago. And arguably, one of our biggest challenges now, is that there are other new issues that are distracting countries. So, we have got that very much on our mind. We are intent on taking this once in a generation opportunity to update, and we feel a sense of responsibility. I certainly do personally, I know the Bureau does. We take it seriously, and we are very intent on delivering what we’ve been tasked with doing.’
[GHF] Q6. Yes, exactly. It is acknowledged that all the previous revisions of the IHR were substantial and expansive at the time that they were negotiated. So, do you think now there is that pressure, that you could potentially end up with something that is more expansive and that would be very different compared to what was there prior to COVID-19?
[AA]:
I think the scope of the IHR is not really much different with the current proposed amendments. There are, I mean, yes, there are new concepts that are being introduced, but they are within the general scope of the IHR. So, we don’t expect any significant changes to the architecture of the current IHR. If there are agreements on the proposed amendments, there will be some changes to the existing articles.
The overall architecture, I don’t think it will have any drastic change. Member States understand that. They see this as extremely important tool that was well-written. And in the past, it was the implementation, not the actual structure or the scope or the existing articles. And so, with this in mind, I think the countries have been focusing on trying to improve current articles, and to update them to the current status of public health rather than just creating new streams or new lines.
[GHF] Thank you so much for setting aside time.
Also see from us on IHR negotiations since earlier this year:
Global Health Negotiations Kick Off In Geneva - Amendments to the IHR
"It can’t be that a WHO Accord is silent on equity": INB Co-Chairs Matsoso & Driece
Global health is everybody’s business. Help us probe the dynamics where science and politics interface with interests. Support investigative global health journalism.