On Friday, 26 April 2024, the World Health Organization (WHO) circulated the 72-page annotated on-screen Bureau text of the Working Group on Amendments to the International Health Regulations (2005) (WGIHR)to Member States. Knowledge Ecology International (KEI) has obtained a copy of this text. Article 6 (Notification), Article 7 (Information-sharing during unexpected or unusual public health events), Article 8 (Consultation), Article 9 (Other reports), Article 27 (Affected conveyances), and Article 28 (Ships and aircraft at points of entry) are fully green meaning these provisions have found consensus.
Article 13 (Public health response, including access to relevant health products) on the other hand is heavily bracketed. Even part of the title, “including access to relevant health products” has reservations pending an agreement on the definition of “health products”. It should be noted that the Bureau’s title for Article 13 is “Article 13 Public health response, including access to health products”. Currently, the title of Article 13 in the the marked up 26 April 2024 text reads as follows:
[Article 13 Public health response, including access to relevant health products RESERVE (pending definition) CHE, USA, RUS, SAU, CHN, UK, TUR, TUN/ RETAIN BGD, MYS, BRA, FJI, SAU, CHN, SYR, CHL, IRN, IDN, COL, URY, ARE, QAT, AF GROUP+ EGY, GTM/ DEL JPN] RETAIN BRA, BGD, IND, AF GROUP+EGY / RETAIN IHR TITLE CHE]
Article 13.7 reads as follows:
An alternative text on 13.7 supported by Switzerland, Russia, Israel, United Kingdom, Singapore, and Japan reads as:
ALT
[7. WHO shall support States Parties and coordinate response activities during public health emergencies of international concern, including pandemic emergencies. To facilitate equitable access to relevant health products, this support may include, as necessary, coordinating with mechanisms and networks that facilitate equitable allocation and distribution of relevant health products. CHE, RUS, ISR, UK, SGP, JPN]
A messier alternative for 13.7 is reproduced below:
ALT
[7. WHO shall support States Parties and coordinate response activities during public health emergencies of international concern, including pandemic emergencies. To enable equitable [and unhindered DEL NOR, USA, ISR, UK, CAN, JPN, NZL / RETAIN NGA, SYR, PAK, IRN, CHN, ZAF, EGY, ECU, NAM] access to [relevant USA, ISR, UK, SGP, CAN, PHL, JPN, NZL] health products, this support may include, as necessary, coordinating with mechanisms and networks that facilitate equitable allocation and distribution of relevant health products based on public health needs, including regional arrangements and those established under relevant international agreements. The aforesaid mechanisms and networks may include, but are not limited to, mechanisms that promote [voluntary DEL NGA, SYR, PAK, IRN, ZAF, BOL, NAM, EGY, ECU, UGA / RETAIN USA, UK, ISR, SGP, CAN, JPN, NZL] [technology DEL USA, ISR, UK, SGP, CAN, JPN, NZL] transfer [of technology USA, ISR, UK, SGP, CAN, JPN, NZL] and [know how DEL UK, NZL / expertise UK, NZL] [on mutually agreed terms DEL NGA, SYR, PAK, IRN, ZAF, EGY, ECU / RETAIN USA, ISR, UK, SGP, CAN, JPN, NZL], in order to diversify and scale up production. COL, BRA, TZA, IND, NGA, FJI, SYR, BGD, MEX, IDN, NOR, CHN, USA, NAM, ISR, UK, SGP, ZAF, CAN, EGY, PHL, ECU, JPN, NZL, UGA, DOM, MYS, BRN, GTM / DEL RUS]
An “ALT CLEAN” version of Article 13.7 is reproduced below:
ALT CLEAN
[7. WHO shall support States Parties and coordinate response activities during public health emergencies of international concern, including pandemic emergencies. To enable equitable [and unhindered DEL USA, UK, AUS / RETAIN IRN, NIC, SYR, VEN, TZA, CUB, CHN, IRN, AF GROUP+ EGY, MYS] access to relevant health products, this support may include, as necessary, coordinating with mechanisms and networks that facilitate equitable allocation and distribution of relevant health products based on public health needs, including regional arrangements and those established under relevant international agreements. The aforesaid mechanisms and networks may include, but are not limited to, mechanisms that promote [the diversification and the scaling up of production. MCO, EU, DOM / DEL AF GROUP+ EGY] [[voluntary DEL BGD, PAK, NGA, UGA, ZMB, MYS, EGY, IRN, IND, IDN, COL, MOZ, CHN, TUN, BRN, ECU, ZAF, TZA / RETAIN USA, EU, UK, AUS] transfer of technology and [know how / expertise DEL BRA] [on mutually agreed terms RETAIN BGD, PAK, UGA, ZMB, BRA, MYS, NZL, IND, IDN, USA, COL, EU, CHN, DOM, UK, TUN, IRN, AUS / RESERVE NGA, EGY, ZAF] [and know how BRA, IND] [in case of licensing MYS], in order to diversify and scale up production. DEL MCO, EU/ RETAIN UGA, EGY, TUN, AF GROUP+ EGY] DEL RUS]
Article 13.9 is rife with brackets; the transparency mandate contained in Article 13.9(c), however, is in yellow which points the way to consensus. While much work remains, perhaps the progress made in this process is a portent of white smoke in WHO’s efforts to amend the International Health Regulations (2005).
ALT
[(c) Publishing relevant terms related to government-funded research and development agreements for relevant health products related to promoting equitable and timely access to such products during a PHEIC, including a pandemic emergency as well as provisions, where relevant, on affordable pricing policies regarding these products.