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Delegates agree rules for the next pandemic

A trade-off between developing countries and rich member states has paved the way for a new agreement on national health obligations

The World Health Organization is to push ahead with reforms to its International Health Regulations, which govern countries' obligations on public health emergencies, after opposition from Africa and other developing blocs was satisfied by new concessions.

The new proposal, which must be formally approved by the assembly, includes references to the need to address 'equity' issues. That refers to demand for guarantees about the sharing of vaccines and treatments for future health emergencies.

The reforms to the regulations have been driven by the United States and the European Union: they include measures to authorise the deployment of expert teams to contamination sites and the creation of a new compliance committee to monitor implementation of the rules.

Fights over reforms at the WHO dates back to disputes that emerged during the Covid-19 pandemic. The rows started with difficulties of obtaining personal protective equipment. That was followed by the frustration of many African leaders at the difficulty and delays in obtaining Covid vaccines, prompting accusations of 'vaccine apartheid' from South Africa's President Cyril Ramaphosa (Dispatches 7/11/21, Rich countries offer funds for future vaccine production but do little this year to get the serum to developing economies).

'The African region shares the view that the process should not be fast-tracked…,' Moses Keetile, deputy permanent secretary in Botswana's health ministry, told the WHO assembly last week on behalf of the Africa region.

It is not clear what other concessions African delegates have secured, either to the International Health Regulations or ahead of the upcoming negotiations on a new WHO treaty to cope with future pandemics.

Newly reappointed WHO Director-General Tedros Adhanom Ghebreyesus wants to broker the treaty this year but it would not come into force until 2024. Rules on vaccine-sharing are likely to be included in the package after what is likely to be more difficult negotiations.

The new pandemic treaty is to pave the way for a new multi-billion dollar global fund for pandemic preparedness that may be run by the World Bank.

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