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The pivotal meeting in the global health calendar starts Sunday with representatives from health ministries around the world descending on Geneva to take decisions on health policy.
While much of the diplomacy will happen at receptions and private meetings, the first fully in-person World Health Assembly in two years is expected to adopt several resolutions that will start to shape how the world emerges from the COVID-19 pandemic. The WHA is the decision-making body of the World Health Organization’s 194 members.
But it won’t be the defining moment in the WHO’s history. Many of the consequential decisions, such as those on a pandemic treaty and changes to the International Health Regulations, will only happen years from now. Even the matters that will likely be agreed on at the assembly, such as the WHO’s future budget and the timelines to increase the budget, stretch years into the future.
Helen Clark, co-chair of the Independent Panel for Pandemic Preparedness and former New Zealand prime minister, said her message to health ministers at the assembly will be “don’t give up on fighting COVID-19.” Speaking at the launch of the panel’s report that found it will take the world years to prepare for the next pandemic if it continues at the current pace, Clark said the assembly needed to “look at the big picture of all the reforms that are needed as one.”
With a 73-item long agenda, it’s one of the most packed in the history of the organization, but POLITICO takes you through the four most important items to watch:
Preparing for the next pandemic
Right-wing media pundits have alleged that the World Health Assembly is the moment for the WHO to make a giant power grab to give it sweeping powers over countries’ sovereignty. The reality is that the most controversial proposal — for a pandemic treaty — isn’t even on the agenda at the assembly.
What was meant to be considered were amendments proposed by the U.S. to the International Health Regulation, a legally binding law that governs how countries are meant to respond to health threats. The wide-ranging proposal from the U.S. suggested giving the WHO greater powers to share information from countries experiencing events that could put public health at risk. But decisions on this are now set to be delayed, with countries having agreed on a watered-down proposal related to procedural decisions on when changes to the regulations would come into effect.
The more substantive document that will be looked at by countries is a report from the working group on strengthening WHO preparedness and response to health emergencies. This week, the group was still discussing the final version of the report and the actions it wanted to be taken at the assembly. It’s likely that any decisions in the report would be focused on the process for IHR amendments.
“There is this burgeoning sense of business as usual that we need to reset,” said Eloise Todd, co-founder of Pandemic Action Network. “We’re hoping that the connections and conversations [at the WHA] can build on progress made at the Global Covid Summit and lead to a bit more common thinking about how we reboot this agenda, so that things like WHO financing, like WHO reform, like IHR, don’t get pushed down the list, but actually get booted to the top.”
Russia’s war on Ukraine is likely to be on the agenda. A draft resolution driven by Ukraine and seen by POLITICO “condemns in the strongest terms Russian Federation’s military aggression against Ukraine, including attacks on health care facilities” and calls on Russia to cease these attacks and protect medical personnel.
Importantly, it states that Russia’s “aggression against Ukraine constitutes exceptional circumstances.” That’s a requirement under the WHO constitution for the World Health Assembly to potentially suspend a country’s voting privileges and services to which a country is entitled. The document raises the possibility of taking such action against Russia if it continues negatively affecting health care in Ukraine.
If the resolution is put forward, it will likely need to be put to a vote by members.
Funding the WHO
It’s the constantly discussed and never resolved issue that plagues the WHO — by anyone’s standards, WHO’s core funding is woefully small and leaves the organization constantly on the backfoot. Finally, there seems to have been real movement here but as usual, change isn’t going to happen anytime soon.
The Working Group on Sustainable Financing proposed an increase in countries’ assessed contributions to 50 percent of the base budget by 2030-2031. That means that the WHO would have significantly more of its funding coming from regular assessed contributions from countries rather than from earmarked donations.
The signs look promising from the G7 Health Ministers’ meeting on Friday. “The WHO, which plays an essential coordinating role in global health, is to be strengthened financially,” the German health ministry, which hosted the meeting, said in a statement. “The G7 want to increase their mandatory contributions by 50 percent in the long term so that the WHO can better exercise its leadership role.”
A proposal on clinical trials — initially from the U.K. and now co-sponsored by Argentina — is also slated to be on the agenda. As with the report on preparedness for health emergencies, the discussion has gone down to the wire. The draft of the resolution calls on countries to coordinate on research priorities and avoid duplication in trials. Some of the measures called for include mechanisms to ensure results from trials are reported including negative results; pre-publication results being shared with regulatory bodies and the mandatory registration of clinical trials in a registry.
Louis Westendarp contributed reporting.
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