The World Health Organization (WHO) is currently developing two international legal instruments intended to increase its authority in managing health emergencies, including pandemics;
(1) Amendments to the 2005 International Health Regulations (IHR), and
(2) A pandemic treaty, termed “CA+” by the WHO.
The draft IHR amendments would lay out new powers for the WHO during health emergencies, and broaden the context within which they can be used. The draft CA+ (‘treaty’) is intended to support the bureaucracy, financing and governance to underpin the expanded IHR.
Context
The threat of pandemics
The current rapidly increasing funding for pandemics and health emergencies is based on several fallacies, frequently repeated in white papers and other documents as well as the mainstream media as if they were facts, in particular:- Pandemics are increasing in frequency.
- Pandemics are causing an increasing health burden.
- Increased contact between humans and wildlife will promote more pandemics (as most are caused by zoonotic viruses).
Thus, pandemics in the past century have killed far fewer people and at an older age than most other major infectious diseases.
The role of the WHO in public health
The WHO, whilst having a role in coordinating cross-border health emergencies included in its Constitution, was founded on human rights principles and originally emphasized community and individual rights. These culminated in the Declaration of Alma Ata, emphasizing the importance of community participation and “horizontal” approaches to care.The WHO pandemic instruments
The WHO is pushing two instruments to enhance its role and authority in health emergencies including pandemics; (1) Amendments to the International Health Regulations (2005) (IHR) and (2) a new treaty-like instrument currently designated CA+.The IHR amendments and the CA+ (treaty) instrument are due to be presented to the WHA in May 2024. Adoption of the CA+ will require a two thirds majority of Member States, and the IHR amendments will require a simple majority.
What the two WHO pandemic instruments will do
As currently drafted, the CA+ and IHR amendments complement each other. The IHR amendments concentrate on the specific powers and processes sought by the WHO and its sponsors. The CA+ concentrates more on the governance and funding to support these. Specificities in both instruments will change between now and when the WHA votes on them in May 2024. However, in broad terms, they are currently written to achieve the following:IHR draft Amendments:
- Expand the definitions of pandemics & health emergencies, including the introduction of “potential” for harm rather than actual harm. It also expands the definition of health products that fall under this to include any commodity or process that may impact on the response or “improve quality of life.”
- Change the recommendations of the IHR from “non-binding” to mandatory instructions that the States undertake to follow and implement.
- Solidify the Director General’s ability to independently declare emergencies.
- Set up an extensive surveillance process in all States, which WHO will verify regularly through a county review mechanism.
- Enable WHO to share country data without consent.
- Give WHO control over certain country resources, including requirements for financial contributions, and provision of intellectual property and know-how (within the broad definition of health products above).
- Ensure national support for promotion of censorship activities by WHO to prevent contrary approaches and concerns from being freely disseminated.
- Change existing IHR provisions affecting individuals from non-binding to binding, including border closures, travel restrictions, confinement (quarantine), medical examinations and medication of individuals. The latter would encompass requirements for injection with vaccines or other pharmaceuticals.
CA+ (treaty):
- Set up an international supply network overseen by WHO.
- Fund the structures and processes by requiring ≥5 percent of national health budgets to be devoted to health emergencies.
- Set up a “Governing Body,” under WHO auspices, to oversee the whole process.
- Expand scope by emphasizing a “One Health” agenda, being defined as a recognition that a very broad range of aspects of life and the biosphere can impact health, and therefore fall under the “potential” to spread harm across borders as an international health emergency.
The momentum behind the agenda
An international bureaucracy is currently being built with funding envisioned at up to $31 billion per year, including $10 billion in new funding. (For context, the entire current WHO annual budget is about $3.6 billion). This same bureaucracy will surveil for new and variant viruses, identify them, determine their “threat” and then implement a response. This is essentially creating a self-perpetuating pandemic industry, with major internal conflicts of interest, funded by the world’s taxpayers but, being under a UN agency, having no national legal oversight and little accountability. Its justification for continued funding will rely on declaring and responding to perceived threats, restricting the lives of others whilst accruing profit to its sponsors through pharmaceutical recommendations and mandates.What can be done
These initiatives, if continued, will reverse the direction of international public health and the WHO itself, driving back towards a colonialist and fascist approach to health governance reflecting values the world sought to put aside in the aftermath of World War Two. As the COVID-19 response demonstrated, they will have a wide and profound impact across society, removing basic human rights, increasing poverty and wealth concentration. They deserve global attention and a robust society-wide response.Both draft instruments could be stopped by the IHR amendments failing to achieve 50 percent of Member States’ support, and the CA+ failing to achieve two-thirds majority, or, after adoption, failing to have a minimum 30 ratifications). While it is inevitable that some provisions will change prior to being put to a vote, and some amendments may fail to pass, the bureaucracy and mechanisms being built in parallel mean that the passage of any of the proposed provisions will further promote this anti-democratic approach to society. Blocking them seems vital, but the voting structure of the WHA (one country—one vote) makes international diplomacy by vested interests influential. Votes commonly depend on the views of a small group of health bureaucrats.
Blocking in national legislatures seems a very important approach, including the introduction of legislation to embed health policy including emergency responses within national jurisdictions, and specifically preventing national agencies from following external dictates.
IHR Amendments
The IHR amendments contain the most important aspects of the WHO’s pandemic preparedness initiative.INB CA+ zero draft
Extracts from the INB Zero Draft of the CA+.Article 4. Guiding principles and rights
17. Central role of WHO—As the directing and coordinating authority on global health, and the leader of multilateral cooperation in global health governance emphasizing the central ‘directing’ role of the WHO.Article 6. Predictable global supply chain and logistics network
2. The WHO Global Pandemic Supply Chain and Logistics Network (the “Network”) is hereby established.3. The Parties shall support the Network’s development and operationalization and participate in the Network, within the framework of WHO, including through sustaining it in inter-pandemic times as well as appropriate scale-up in the event of a pandemic.
(b) assess anticipated demand for, and map sources of, manufacturers and suppliers, including raw materials and other necessary inputs, for sustainable production of pandemic-related products (especially active pharmaceutical ingredients)
(c) develop a mechanism to ensure the fair and equitable allocation ...
Article 7. Access to technology: promoting sustainable and equitably distributed production and transfer of technology and know-how
The Parties, working through the Governing Body for the WHO CA+, shall strengthen existing and develop innovative multilateral mechanisms that promote and incentivize relevant transfer of technology and know-how for production of pandemic-related products on mutually agreed terms, to capable manufacturers, ...4. In the event of a pandemic, the Parties:
(a) will take appropriate measures to support time-bound waivers of intellectual property rights that can accelerate or scale up manufacturing of pandemic-related products during a pandemic, to the extent necessary to increase the availability and adequacy of affordable pandemic-related products; ...
(c) shall encourage all holders of patents related to the production of pandemic-related products to waive, or manage as appropriate, payment of royalties by developing country manufacturers on the use, during the pandemic, of their technology for production of pandemic related products, and shall require, as appropriate, those that have received public financing for the development of pandemic-related products to do so; and ...
Article 8. Regulatory strengthening
2. Each Party shall build and strengthen its country regulatory capacities and performance for timely approval of pandemic-related products and, in the event of a pandemic, accelerate the process of approving and licensing pandemic-related products for emergency use in a timely manner, including the sharing of regulatory dossiers with other institutions.Article 12. Strengthening and sustaining a skilled and competent health and care workforce
3. The Parties shall invest in establishing, sustaining, coordinating and mobilizing an available, skilled and trained global public health emergency workforce that is deployable to support Parties upon request, based on public health need, in order to contain outbreaks and prevent an escalation of small scale spread to global proportions.4. The Parties will support the development of a network of training institutions, national and regional facilities and centres of expertise in order to establish common guidance to enable more predictable, standardized, timely and systematic response missions and deployment of the aforementioned public health emergency workforce.
Article 13. Preparedness monitoring, simulation exercises and universal peer review
4. Each Party shall provide annual (or biennial) reporting, building on existing relevant reporting where possible, on its pandemic prevention, preparedness, response and health systems recovery capacities.Article 15. Global coordination, collaboration and cooperation
2. Recognizing the central role of WHO as the directing and coordinating authority on international health work, and mindful of the need for coordination with regional organizations, entities in the United Nations system and other intergovernmental organizations, the WHO Director-General shall, in accordance with terms set out herein, declare pandemics.Article 17. Strengthening pandemic and public health literacy
1. The Parties commit to increase science, public health and pandemic literacy in the population, as well as access to information on pandemics and their effects, and tackle false, misleading, misinformation or disinformation, including through promotion of international cooperation. In that regard, each Party is encouraged to:(b) conduct regular social listening and analysis to identify the prevalence and profiles of misinformation, which contribute to design communications and messaging strategies for the public to counteract misinformation, disinformation and false news, thereby strengthening public trust; and,
2. The Parties will contribute to research and inform policies on factors that hinder adherence to public health and social measures, confidence and uptake of vaccines, use of appropriate therapeutics and trust in science and government institutions.
Article 19. Sustainable and predictable financing
1. The Parties recognize the important role that financial resources play in achieving the objective of the WHO CA+ and the primary financial responsibility of national governments in protecting and promoting the health of their populations. In that regard, each Party shall:(a) cooperate with other Parties, within the means and resources at its disposal, to raise financial resources for effective implementation of the WHO CA+ through bilateral and multilateral funding mechanisms; (b) plan and provide adequate financial support in line with its national fiscal capacities for: (i) strengthening pandemic prevention, preparedness, response and recovery of health systems; (ii) implementing its national plans, programmes and priorities; and (iii) strengthening health systems and progressive realization of universal health coverage;
(c) commit to prioritize and increase or maintain, including through greater collaboration between the health, finance and private sectors, as appropriate, domestic funding by allocating in its annual budgets not lower than 5 percent of its current health expenditure to pandemic prevention, preparedness, response and health systems recovery, notably for improving and sustaining relevant capacities and working to achieve universal health coverage; and (d) commit to allocate, in accordance with its respective capacities, XX percent of its gross domestic product for international cooperation and assistance on pandemic prevention, preparedness, response and health systems recovery, particularly for developing countries, including through international organizations and existing and new mechanisms.
Article 20. Governing Body for the WHO CA+
1. A governing body for the WHO CA+ is established to promote the effective implementation of the WHO CA+ (hereinafter, the “Governing Body”).2. The Governing Body shall be composed of: (a) the Conference of the Parties (COP), which shall be the supreme organ of the Governing Body, composed of the Parties and constituting the sole decision-making organ; and (b) the Officers of the Parties, which shall be the administrative organ of the Governing Body.
3. The COP, as the supreme policy setting organ of the WHO CA+, shall keep under regular review every three years the implementation and outcome of the WHO CA+ and any related legal instruments that the COP may adopt, and shall make the decisions necessary to promote the effective implementation of the WHO CA+.
Article 21. Consultative Body for the WHO CA+
1. A consultative body for the WHO CA+ (the “Consultative Body”) is established to provide advice and technical inputs for the decision-making processes of the COP, without participating in any decision-making.Another oversight body, part of this growing workforce supported solely for this purpose.