STRENGTHENING PANDEMIC PREVENTION, PREPAREDNESS AND RESPONSE: INTERGOVERNMENTAL NEGOTIATING BODY

STRENGTHENING PANDEMIC PREVENTION, PREPAREDNESS AND RESPONSE: INTERGOVERNMENTAL NEGOTIATING BODY

1. STRENGTHENING PANDEMIC PREVENTION, PREPAREDNESS AND RESPONSE: INTERGOVERNMENTAL NEGOTIATING BODY to draft and negotiate a WHO convention, agreement or other international instrument on pandemic prevention, preparedness and response - INB October 2024

2.   COVID-19 – millions of cases and deaths reported across the globe. Substantial strain on health systems and disruption of essential health services. Enormous impact (economic, social, etc.) on lives and livelihoods, especially on the poor and most vulnerable. Start working towards better prevention, preparedness and response for the next pandemic. International attention - why now ? The world must act today – organize and measure the best of our collective energies and skills.

3. Intergovernmental Negotiating Body (INB) Mandate : to draft and negotiate a WHO convention, agreement or other international instrument on pandemic prevention, preparedness and response, with a view to adoption under Article 19, or under other provisions of the WHO Constitution as may be deemed appropriate by INB. INB9R – Apr. 2024 INB9RR – May 2024

4. What is the WHO pandemic agreement and why is it beneficial? The Pandemic Agreement is intended to be a legally-binding instrument under international law on pandemic prevention, preparedness and response. It’s an agreement on the key principles that would underpin the world’s preparation for and response to pandemics . It builds on strong national systems, that together, form a unified approach to pandemics. In a globalized world, infectious diseases do not respect borders. Stronger mechanisms for international cooperation and coordination are essential to implementing robust and equitable responses to pandemic threats. Collective threats like pandemics demand collective global action and underscore an imperative to ensure that every country has the resources, systems and capacities to respond . As such, strengthening ties among countries, sectors and institutions – both within and across regions, as well as globally – is essential .

5. Purpose of a legally-binding agreement Promote political commitment at the highest level to a more equitable, cooperative and interconnected global system that addresses pandemic prevention, preparedness, and response. Establish globally agreed principles, priorities and targets for pandemic prevention, preparedness and response. Support and develop a constituency of interested stakeholders at national, regional and global levels , with defined tasks to implement the Agreement and, where necessary, to develop and implement actions that will support the objectives of it. Commit to present and future generations that the world will not only not forget the lessons this pandemic has taught us – but ensure that our mistakes are not repeated .

6. Stage of the negotiations – up to WHA77 INB9R – Apr. 2024 INB9RR – May 2024

7. WHA77 – decision on INB Extend mandate  Bureau  July meeting  The INB Bureau consists of two co-chairs, reflecting a balance of developed and developing countries, and four vice-chairs, one from each of the six WHO regions, per decision SSA2(5) : AFR – Ms Precious Matsoso (South Africa), co-chair EUR – Ambassador Anne-Claire Amprou (France), co-chair AMR – Ambassador Tovar da Silva Nunes (Brazil), vice-chair EMR – Ambassador Amr Ramadan (Egypt), vice-chair SEAR – Dr Viroj Tangcharoensathien (Thailand), vice-chair WPR – Ms Fleur Davies (Australia), vice-chair

8. INB10 agreed the following timeline

9. Provisions in the WHO Pandemic Agreement (1/4) The way the draft pandemic agreement is structured is across three chapters: I with objective, scope, principles and use of terms; II with the substantive provisions; and III with the usual legal and institutional arrangements. Chapter II, each article is intended to address a challenge or gap in the global health architecture for pandemic prevention, preparedness and response. Chapter III, deals with issues of governance, Secretariat, ratification, entry into force, etc.

10. Provisions in the WHO Pandemic Agreement (2/4) Zooming in on Chapter II: Article 4: on putting in place the capacities and infrastructure to prevent an outbreak from becoming a pandemic. The provisions are very much aligned with the International Health Regulations. Article 5: on promoting a One Health approach to pandemic prevention, preparedness and response which recognizes that the health of humans, domestic and wild animals, plants and the wider environment (including ecosystems) is closely linked and interdependent. This is an integrated multi-sectoral approach that aims to sustainably balance and optimize the health of people, animals and ecosystems, including by addressing various social, economic and environmental determinants of health in an equitable manner. Article 6: on preparedness, readiness and health system resilience, to ensure continuity of health services and scalable clinical care during pandemics. Article 7: on health and care workforce, with provisions on ensuring the protection and safety of health and care workers.

11. Provisions in the WHO Pandemic Agreement (3/4) Zooming in on Chapter II, continued Article 9: on research and development of pandemic related health products, with provisions on strengthening capacities, scientific research partnerships, clinical trials, publication of results, among others. Article 10: on local production, with provisions on achieving more equitable geographical distribution and rapid scale-up of the global production of pandemic-related health products. Article 11: on technology transfer, with provisions on facilitating or incentivizing transfer of technology, skills and know-how for production of pandemic-related products, and reaffirming TRIPS flexibilities. Article 12: on pathogen access and benefit sharing, with provisions to establish a multilateral system for access to material and information and equitable sharing of benefits, on equal footing. Article 13 and 13bis: on global supply chain and logistics, as well as procurement and distribution, respectively. Article 14: on regulatory strengthening, with provisions focusing on strengthening capacities, and aligning norms and standards in this area.

12. Provisions in the WHO Pandemic Agreement (4/4) Zooming in on Chapter II, continued Article 17: on whole of society and whole of government approaches, with provisions focused on obligations at national level to strengthen, and maintain, a national multi-sectoral coordination mechanism for pandemic prevention, preparedness and response. Article 18 (initial agreement on the article): on communication and public awareness, with provisions on strengthen science, public health and pandemic literacy in the population. Article 19: on international cooperation and implementation support, with provisions that encourage and enable cooperation and support among Member States, especially for developing countries to facilitate implementation of the Pandemic Agreement. Article 20: on sustainable and predictable financing for pandemic prevention, preparedness and response, with provisions focusing on enhancing domestic financing and establishment of a coordinating financial mechanism to promote sustainable financing for the implementation of the Agreement and the IHR.

13. In summary - areas requiring further discussion

14. INB – complementarity and coherence with IHR In general… f or the two instruments, IHR as amended in 2024 and the WHO Pandemic Agreement, to be coherent, complementary, and applicable in an effective manner, the consistent and unambiguous use of terms across them is necessary, where possible For consideration of INB: Pandemic emergency Relevant health products/pandemic-related health products work to remove barriers/unhindered access Coordinating financial mechanism (Sub-)Committee for Implementation

15. INB – moving towards INB12 (4-15 November 2024) Intersessional period: plan for informal meetings INB11: 9-20 September 2024 Legal architecture Complementarity and coherence with IHR Key articles discussed: Article 4 and Article 5; Article 9; Article 10 and Article 11; Article 12; Article 13 and Article 13 bis; and Article 14.

16. PA Adoption:        December 2024 (SSA3)          PA opens for Signature:  January 2025          Instrument(s) Adoption:  May 2026 (WHA79)          Ratification Process begin: June 2026          Entry Into Force (EIF):   2027* Year WHA Session Action( 2024 WHA Special Session (WHASS3) •WHASS3 ADOPTS the PA •The PA is then opened for SIGNATURE •WHASSA3 Resolution/Decision is adopted to: (a) Provide the mandate for IGWG(s) for instrument(s) with outcome to WHA 79 in May 2026 (in 18 months) ; (b) Request the DG to commence preparatory work for implementation of the PA; (WHASS3 could also mandate a progress report to WHA78 (2025)) 2026 WHA79 • WHA ADOPTS instrument(s) from IGWG(s) • WHA Resolution/Decision is adopted to: (a) Invite all Member States to consider ratification of the WHA PA and its instrument(s), i.e., ratification process of PA+I(s) begins ; (b) Request the DG to commence preparatory work for the implementation of the PA+I(s), and the first COP following EIF. 2027 • Notional entry into force (EIF) of WHO PA and its instrument(s) *Note: EIF date not certain, depends on number of ratifications. Possible timeline: scenario A

17. PA Adoption:        May 2025 (WHA 78)          PA opens for Signature:  June 2025          Instrument(s) Adoption:  May 2027 (WHA80)          Ratification Process begin: June 2027          Entry Into Force (EIF):   2028*   Year WHA Session Action 2025 WHA78 •WHA ADOPTS the PA •The PA is then opened for SIGNATURE •WHA Resolution/Decision is adopted to: (a) Provide the mandate for IGWG(s) for instrument(s) with outcome to WHA 80 in May 2027 ( in 24 months ); (b) Request the DG to commence preparatory work for implementation of the PA; (WHA could also mandate a progress report to WHA79 (2026)) 2026 WHA79 • Progress report from IGWG(s) on work to date 2027 WHA80 • WHA ADOPTS instrument(s) from IGWG(s) • WHA Resolution/Decision is adopted to: (a) Invite all Member States to consider ratification of the WHA PA and its instrument(s), i.e., ratification process of PA+I(s) begins; (b) Request the DG to commence preparatory work for implementation of the PA+I(s), and the first COP. 2028 WHA81 • Notional entry into force of WHO PA and its instrument(s) *Note: EIF date not certain, depends on number of ratifications. Possible timeline: scenario B

18. The Pandemic Agreement and countries’ sovereignty There is nothing in the provisions that would take away from, or jeopardize countries’ sovereignty in any way. On the contrary, Article 24 clearly states: “ 2. Nothing in the WHO Pandemic Agreement shall be interpreted as providing the WHO Secretariat, including the WHO Director-General, any authority to direct, order, alter or otherwise prescribe the national and/or domestic laws, as appropriate, or policies of any Party, or to mandate or otherwise impose any requirements that Parties take specific actions, such as ban or accept travellers , impose vaccination mandates or therapeutic or diagnostic measures or implement lockdowns .”

19. In conclusion… The need for solidarity and equity, the need for financing to reach those in need, R&D, transfer of technology, sustainable and geographically diversified production of pandemic-related health products, should all allow us to move forward in a collective effort. We have covered the substantive issues. W e all stand to lose if we do not reach an agreement. The world is witnessing outbreaks that can become pandemic emergencies. The world needs this Agreement as the first step to be better prepared to prevent and respond . L et’s come together to work towards consensus by the end of the year – collectively, we can do it! A legacy to future generations: c ommitment at the highest level to minimize the impact of future pandemics on our economies and our societies.

20. Thank you! With acknowledgement to all those involved and supporting the Member State-led processes to strengthen pandemic prevention, preparedness and response 20