Poor Hygiene in Health Services. Time for Commitments on Infection Prevention and Control?

A WHO/UNICEF joint report, published earlier this week, found that only half of all health facilities around the world met the criteria for having basic hand hygiene services– a figure that drops to 32% in least developed countries (LDCs). Globally, 3.85 billion people receive care from a facility that lacks basic hygiene service. According to the report, 78% of health facilities, and 53% of health facilities in LDCs, have basic water service from an improved water source, leaving 1.7 billion people without basic water service at the point of care. Recently published research, including the WHO/UNICEF report, has highlighted the importance that … Continue reading Poor Hygiene in Health Services. Time for Commitments on Infection Prevention and Control?

Coming Soon: The TRIPS Waiver Negotiations, A Compilation from Geneva Health Files

THE GENEVA HEALTH FILES BOOK ON THE TRIPS WAIVER NEGOTIATIONS Presenting a comprehensive volume capturing the blow-by-blow account of the TRIPS Waiver discussions at the WTO that unfolded during October 2020-June 2022. This is a compilation of 50 stories from Geneva Health Files on the subject. The book has been put together at the request of several readers of Geneva Health Files, including trade negotiators, academics, and activists. The objective has been to weave together and present the path of these negotiations in a chronological, linear fashion. Nearing 450 pages, the book is being presented as a ready reckoner and a journalistic chronicle … Continue reading Coming Soon: The TRIPS Waiver Negotiations, A Compilation from Geneva Health Files

Deconstructing the TRIPS Waiver Discussions: The Susan Sell Interview

In June 2022, the World Trade Organization adopted a decision at its 12th Ministerial Conference, that could potentially help facilitate easier production of COVID-19 vaccines. This was the outcome of a 20-month long discussion at the WTO on the so-called TRIPS Waiver. But ultimately what resulted was a rather narrow legal mechanism, essentially clarifying existing rules in the WTO TRIPS Agreement. For many, this outcome was not entirely surprising. Susan K Sell from the Australian National University has long examined and explored the nature of the TRIPS Agreement and the politics at the WTO. We spoke with Sell during her recent visit to Geneva … Continue reading Deconstructing the TRIPS Waiver Discussions: The Susan Sell Interview

No Mandate on Extending WTO TRIPS Agreement Decision to Medicines & Tests: The U.S.

The US has expressed its reservations on extending the June Ministerial Decision on the TRIPS Agreement to medicines and tests, going beyond vaccines. At the General Council meeting this week, the US reportedly has said that WTO does not have a mandate and that the decision is limited to whether or not to extend the new rules to medicines and tests. But other countries are keen on discussing ways to adapt and negotiate an outcome so as to include medicines and tests in the scope of the new clarifications. Geneva-based trade officials said that nearly 30 delegations took the floor to discuss … Continue reading No Mandate on Extending WTO TRIPS Agreement Decision to Medicines & Tests: The U.S.

Set into Orbit: WHO Member States Agree to Binding Nature of a New Instrument to Govern Pandemics

New rules to also have non-binding elements. In a decisive move, WHO member states, this week, agreed on a legal route to frame new, binding and non-binding rules to govern pandemics. This was the outcome of the second Intergovernmental Negotiating Body that was set up to draft and negotiate a WHO convention, agreement or other international instrument on pandemic prevention, preparedness and response. For the moment, it appears member states have bought time, for, the consensus language suggests that the new instrument could be affiliated to Article 19 of the WHO constitution (a reportedly “wider” opt-in approach), while also not … Continue reading Set into Orbit: WHO Member States Agree to Binding Nature of a New Instrument to Govern Pandemics

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Climate Looms Over A New Pandemic Accord, Could Risk Crowding Out Access to Medicines & Equity Issues, Experts Say

That a new pandemic accord will be a closely contested policy space is already obvious. A first, new working draft published on July 13, 2022, gives a nod to equity, and pushes for accountability. But it also refers to the impact of climate change, among many other policy matters. Some caution, that bringing the complex and expansive issues of climate change into the negotiations towards a pandemic accord might crowd out space and time for discussions on more pertinent matters directly relevant to global health, including the barriers caused by intellectual property for the access to medical products during health … Continue reading Climate Looms Over A New Pandemic Accord, Could Risk Crowding Out Access to Medicines & Equity Issues, Experts Say

TRIPS Waiver 2.0 at the WTO: Proponents back at the table to push for therapeutics and diagnostics

The embers from the WTO’s 12th ministerial conference are still warm. While the supporters of the original TRIPS waiver are still coming to terms with the remains of the 20 month saga that yielded a ministerial decision clarifying the rules of compulsory licensing for the production of vaccines, they are back at the WTO to stomach another fight. This time, to discuss the way forward to boost the production of therapeutics and diagnostics by seeking to extend the applicability of the June decision to these medical products. This puts the co-sponsors, again, directly in opposition to industry interests where companies such as … Continue reading TRIPS Waiver 2.0 at the WTO: Proponents back at the table to push for therapeutics and diagnostics

WHO Member States Begin to Define Form and Function of a Pandemic Accord

Geneva is no stranger to contentious discussions in international health policy-making. The current times are also witnessing the conduct of crucial negotiations at breakneck speed. However, speed and time cannot be excuses in the way diplomatic processes are being conducted, Geneva-based health diplomats say. Several countries have not been happy about forcing consensus on several matters in recent weeks on the back of time and resource constraints. The discussions around the World Health Assembly in May this year, give us an indication on what is to come in the negotiations for a pandemic accord. In July, member states will discuss … Continue reading WHO Member States Begin to Define Form and Function of a Pandemic Accord

Trade Won, Health Did Not. A Sliver of a Waiver at the WTO.

There was jubilation and cheer after the landmark ministerial conference at the WTO which saw a raft of agreements between its 164 members, that some say, has set a new benchmark for success, a kind not witnessed in decades. The outcome also included a weak text clarifying the use of existing rules in the WTO TRIPS Agreement. For the 100-odd countries that supported the original TRIPS waiver proposal, and countless supporters globally, conference was a moment of resignation. It was the culmination of 20 months of a fight that saw sustained resistance from many developed countries that refused to waive intellectual property … Continue reading Trade Won, Health Did Not. A Sliver of a Waiver at the WTO.

So Close, Yet So Far: TRIPS Waiver at the WTO

Proposed Waiver Text in Ministers’ Hand, Key Differences Remain Less than 24 hours before the 12th Ministerial Conference gets underway in Geneva – the capital of global health, and the seat of pandemic policy-making – WTO members continue to disagree on key aspects of the organization’s response to the pandemic, including an agreement on a potential waiver of a provision of the TRIPS Agreement. The discussions on the TRIPS Waiver remain on tenterhooks, as ministers will now consider a bracketed text, the WTO reported last night. Key differences remain on how to adapt international trade rules meant to protect intellectual property rights in … Continue reading So Close, Yet So Far: TRIPS Waiver at the WTO

Is the delay the defeat of the TRIPS Waiver discussions at the WTO?

With barely 10 days left for the WTO ministerial conference, countries are increasingly under pressure to arrive at a consensus on the text proposed by DG Ngozi Okonjo-Iweala. Members have met in small group discussions over the last few weeks, that have included participation of up to 30 members. Countries with smaller delegations have been spread thin across multiple, parallel negotiations at the WTO in the run up to the ministerial conference (12-15 June 2022) including for disciplines such as agriculture, fisheries among others. This analysis is based on the negotiations the version of the text dated May 30, seen … Continue reading Is the delay the defeat of the TRIPS Waiver discussions at the WTO?

Health Emergencies Engulf WHO & its Priorities: A Wrap of WHA 75

Seldom has WHO been forced to take such a decisive political stand, during its existence for three-quarters of a century. It may have now set a precedent that will be difficult to walk away from, in the future. This week will likely be seen as a watershed moment for WHO, when scores of member states pushed through a politically significant resolution, albeit, one that may be limited in practical terms, condemning “in the strongest terms Russian Federation’s military aggression against Ukraine, including attacks on health care facilities documented via the WHO’s Surveillance System for Attacks on Health Care (SSA)”. The … Continue reading Health Emergencies Engulf WHO & its Priorities: A Wrap of WHA 75

Curtain-Raiser: WHA75

The US sets in motion process to amend the International Health Regulations; Developing countries try to restore balance in WGPR discussions Rules to govern health emergencies continue to dominate the policy discussions at WHO. As the 75th World Health Assembly gets underway in a few days, a crowded agenda awaits member states: from the re-election of the director-general, to the Ukrainian crisis, from formal efforts towards the amendments of International Health Regulations to increasing countries’ assessed contributions to boost sustainable financing of WHO. The first in-person meeting in two years will bring ministers, delegates and other attendees, to Geneva in … Continue reading Curtain-Raiser: WHA75

China’s Spokes WTO Quad Waiver Text, Offers to Sidestep if Conditions Met

China, one of the biggest exporters of COVID-19 vaccines, told WTO members this week that it has concerns on an exports-based eligibility criterion that seeks to exclude developing countries that export more than 10% of the world’s vaccines – a condition that has been proposed as a part of the “Quad waiver text”, now being negotiated at the WTO. China said that “using the criterion of export share to define eligible members will send a wrong signal to the outside world and also have systemic implications to the future negotiations”. China also offered that if its concerns on such a … Continue reading China’s Spokes WTO Quad Waiver Text, Offers to Sidestep if Conditions Met

WTO DG Serves Up New Proposed Text on the TRIPS Waiver to a Divided House, Tense Negotiations Expected

This week WTO members were given access to a letter that was described as an outcome document based on the discussions between select members. This letter was sent by the Director General Ngozi Okonjo-Iweala to the Chair of the Council for Trade-Related Aspects of Intellectual Property Rights, Ambassador Lansana Gberie of Sierra Leone, describing the progress of the informal discussions on the TRIPS Waiver proposal. The letter also shared a proposed text by the DG on the waiver discussions.   Although the document does not specifically mention the quadrilateral group (comprising the US, the EU, India and South Africa) it is understood … Continue reading WTO DG Serves Up New Proposed Text on the TRIPS Waiver to a Divided House, Tense Negotiations Expected

Member States Pull Back WHO from the Brink of Irrelevance, Reach Consensus to Pay More in Dues.

Barely hours before the proceedings came to a close, member states reached a consensus at the final meeting of the Working Group on Sustainable Financing, agreeing in principle for an increase in their contributions to WHO, diplomats told Geneva Health Files. The road to consensus on this proposal was not without bumps. And compromises had to be made. A consistent diplomatic effort, and public pressure might have contributed to the break in opposition by some Latin American countries to this much-debated proposal, sources say. As we had reported earlier, despite an overwhelming support for an increase in assessed contributions (ACs) from … Continue reading Member States Pull Back WHO from the Brink of Irrelevance, Reach Consensus to Pay More in Dues.

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Pfizer Allegedly Pressured UNICEF to Keep Secret, Pricing for Anti-Viral Treatment Paxlovid. UNICEF Yielded

Pharmaceutical giant Pfizer allegedly pressured UNICEF to agree to non-disclosure requirements on pricing that would protect information on the prices of the company’s anti-viral treatment for COVID-19 Paxlovid, sources told Geneva Health Files. UNICEF, a procurement partner for the ACT Accelerator, recently concluded a supply agreement with Pfizer for up to 4 million courses of treatment. It is further learned that UNICEF reportedly took a unilateral decision to finalise the supply agreement with Pfizer without taking into account other partners of the therapeutics pillar of the ACT Accelerator (ACT A) including WHO, Global Fund, Unitaid. (Charitable Foundation Wellcome Trust is also a part … Continue reading Pfizer Allegedly Pressured UNICEF to Keep Secret, Pricing for Anti-Viral Treatment Paxlovid. UNICEF Yielded

The Chronic Crisis in WHO Financing: A Temperature Check on Member States’ Commitments

Sustainable Financing Working Group Final Meeting Next Week WHO member states have so far struggled to reach a consensus on increasing their assessed contributions that would make the organization’s financing more predictable and sustainable. That window of making this decision may be closing fast, also given the simultaneous proposals that will transform global health financing in a post-pandemic world.   The Bureau of the Working Group on Sustainable Financing has recommended that the World Health Assembly in May, must commit to future incremental increases of assessed contributions to an eventual level of 50% of the budget for 2022–2023 base programmes. The first increase … Continue reading The Chronic Crisis in WHO Financing: A Temperature Check on Member States’ Commitments

Public Hearings on a Pandemic Agreement Open Floodgates of Interest; WTO DG To Take Compromise Text on TRIPS Waiver to the Wider Membership

Public Hearings on a Pandemic Agreement Open Floodgates of InterestAn impressive range of stakeholders made their interests and concerns known at the public hearings this week conducted by the Intergovernmental Negotiating Body set up to establish a new pandemic agreement. From feisty civil society activists to hard-as-knuckles lobbyists; from social justice champions to focused medical products manufacturers; from professors at American universities to healthcare workers; from representatives of the families of the deceased to wildlife experts; from anesthesiologists to anthropologists; from human rights scholars to teachers’ unions. These disparate group made forceful, incisive statements on what the pandemic meant to … Continue reading Public Hearings on a Pandemic Agreement Open Floodgates of Interest; WTO DG To Take Compromise Text on TRIPS Waiver to the Wider Membership

Countries Find Chaos in Parallel Tracks on Drawing Up New Rules for Health Emergencies, Many Unprepared

It was never going to be easy. As countries get deeper into the processes for defining new rules for future health emergencies, many delegations in Geneva and in the capitals, are finding it difficult to keep up with multiple consultations, formal, informal and across different forums. “It is chaotic and disorganized”, one Geneva-based health diplomat told us this week. While this is just the beginning of long drawn negotiations, churn and disagreements are to be expected. But it is clear that the processes that guide these negotiations, will undoubtedly determine outcomes. Most immediately, that there are two competing priorities. One … Continue reading Countries Find Chaos in Parallel Tracks on Drawing Up New Rules for Health Emergencies, Many Unprepared

Curb Private Sector Participation In The Treaty-Making Process: Some Member States At WHO

[Update from the Intergovernmental Negotiating Body] In a significant move, some member states at WHO have expressed caution and have sought to limit the participation of the private sector in the negotiations for new rules on pandemic preparedness and response. Last week, the Intergovernmental Negotiating Body (INB) met at the resumed session of its first meeting on March 14-15. The INB was set up earlier this year, to work towards a WHO convention, agreement or other international instrument on pandemic prevention, preparedness and response, following the Special Session of the World Health Assembly in November 2021. These efforts to limit … Continue reading Curb Private Sector Participation In The Treaty-Making Process: Some Member States At WHO

The Lowest Common Denominator: The Quad Text on the TRIPS Waiver

A developing country ambassador told us a few months ago that the best outcome on the waiver proposal would be to persuade the Americans and Europeans to have a solution that would include all kinds of medical products not just vaccines, and waiving all kinds of IP  protections not just patents, underlining the positions of these key WTO members respectively. Now, as a potential for a compromise is beginning to emerge, it seems that the proponents of the waiver might have lost out on both accounts. While scholars and access to medicine advocates have already panned the compromise text, these … Continue reading The Lowest Common Denominator: The Quad Text on the TRIPS Waiver

A compromise on the horizon? TRIPS Waiver talks in the ‘Quad’ at the WTO

While the Russian invasion of Ukraine has upended trade diplomacy at the WTO in recent days, the TRIPS waiver discussions have proceeded among a small group of members and is likely nearing a compromise, although differences persist. Sources familiar with the process told us that technical deliberations among the quad that includes the US, the EU, India and South Africa, are now nearing completion. These discussions are soon expected to follow at the level of the ministers of these four WTO members. “If the current text is acceptable by high-level decision-makers, it will then be taken up by the wider … Continue reading A compromise on the horizon? TRIPS Waiver talks in the ‘Quad’ at the WTO

Game on at WHO: International Health Regulations Vs The Pandemic Treaty

We are pleased to bring you the first edition of Treaty Talks, a new series that will track negotiations around a potential pandemic treaty in the coming months (and years). This edition is a comprehensive analysis of the first meeting of the Intergovernmental Negotiating Body that took place last week. The launch of the negotiations for a new instrument to govern health emergencies marks a significant milestone for global health power brokers. Yet no sooner than these discussions kicked off last week (now a world away), the geopolitical and humanitarian crisis in Ukraine, was lit by Russia. Inevitably, the flames from … Continue reading Game on at WHO: International Health Regulations Vs The Pandemic Treaty

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The Geneva Health Files Summer Fellowship 2022

THE GENEVA HEALTH FILES SUMMER FELLOWSHIP 2022 Volunteer Opportunity in Global Health Journalism: Geneva Health Files Geneva Health Files is an inter-disciplinary journalistic initiative that reports on power and politics at the heart of global health. This small, but growing news operation is looking for students or interested folks who can help us report on global health and promote our work in order to expand our readership and subscriber base.  This is an opportunity to work with an influential and contemporary newsroom, and gain hands-on experience in learning how global health journalism is crafted in Geneva. It is a great opportunity … Continue reading The Geneva Health Files Summer Fellowship 2022

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EXCLUSIVE: Efforts to limit the implementation of the TRIPS Waiver, proposals to exclude India & China

A small group of WTO members deliberating on the TRIPS Waiver, are discussing suggestions to limit the geographical scope of the implementation of the waiver – plans that seek to exclude India and China, sources familiar with the process say. These discussions among the US, the EU, South Africa and India, are still fluid and are likely subject to other diplomatic considerations outside of the waiver. India has been a lead co-sponsor of the TRIPS waiver proposal along with South Africa since October 2020. While it appears that India will likely not accept such a proposal, and yet, it is … Continue reading EXCLUSIVE: Efforts to limit the implementation of the TRIPS Waiver, proposals to exclude India & China

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Guest Editorial: WHO under DG Tedros – The Last Five Years

At this point, global health policy-making needs predictability. When the WHO Executive Board nominated DG Tedros for a second term, last week, it should have assuaged anxious politicians, the scientific establishment, and the world’s people. The continuity of leadership at WHO, is helpful, given that WHO remains at the eye of the storm. Sources told us that of the 34 members of the EB, 31 members endorsed the nomination of Tedros (the rest were reportedly absent). Recall that Tedros was voted into office with a historic and an overwhelming majority in 2017. His mandate was absolute and powerful. Some would … Continue reading Guest Editorial: WHO under DG Tedros – The Last Five Years

The Inevitable Fragmentation of Global Health: The Signs from WHO EB 150

Health emergencies appear to have upstaged all other aspects of global health policy-making. At least that’s what it seems like, observing the proceedings of WHO’s 150th Executive Board. The governance of health emergencies could well turn out to be a decisive lever to reorient the entire workings, financing and priorities of WHO significantly. Hinging on a much-wanted effective response to future emergencies are a whole host of proposals to reform not only WHO, but the wider governance of global health. Therefore a meeting such as the EB, becomes a spectre to see how such a system can be molded. Underlying … Continue reading The Inevitable Fragmentation of Global Health: The Signs from WHO EB 150

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A Profound Shift is Underway: A Curtain Raiser Ahead of the WHO 150th Executive Board

A profound shift is underway. While the last two years were spent fire-fighting the pandemic, this year will see definitive lines being redrawn in the governance of global health. There are essentially three key changes brewing on governance, financing and health emergencies that will shape outcomes on the more operational aspects in global health policy-making. The contours of some of these changes are already taking shape. We will see this most immediately at the WHO Executive Board which meets next week. Diplomats are already referring to the inevitable changes in the global health architecture, not all of which will stem … Continue reading A Profound Shift is Underway: A Curtain Raiser Ahead of the WHO 150th Executive Board

Divergences Continue on the Approaches to Reform the Governance of Health Emergencies 

If the WGPR meeting was any indication, the coming year will witness a decisive fight between competing interests on safeguarding equity in global health. This week countries tried to agree on a work plan for the next few months that will see the building blocks for new rules on governing health emergencies put into place. Therefore much is at stake on how to design this process and the resulting negotiations across different forums on a range of issues including incorporating meaningful equity considerations, the strengthening of the International Health Regulations, among others. This in essence is what was discussed at … Continue reading Divergences Continue on the Approaches to Reform the Governance of Health Emergencies 

Reflections on self-publishing [2021]: Year Two, Geneva Health Files

Dear Readers, Reflections are a luxury in a frenzied news cycle. But it is a necessity for any media entrepreneur. In the midst of our annual break, we bring you some lessons we learned in running Geneva Health Files. We believe this has relevance not only for media entrepreneurship but also for the role of the media in global health. The act of self-publishing is fairly radical. Geneva Health Files was born in 2020 to meet the demand for comprehensive, inter-disciplinary reporting on global health from Geneva. Buoyed by the response, we took a step further in 2021 and went paid in … Continue reading Reflections on self-publishing [2021]: Year Two, Geneva Health Files

Member states could consider paying more to support WHO, some remain unwilling

In a rare but crucial opportunity, WHO member states are now poised to seize the moment and finally decide to pay more to support the organization which they see as a leading authority to protect and shape health outcomes for people globally. Or, nationalistic considerations may win and they may let this moment pass, sealing the fate of WHO. This would further marginalize and weaken WHO’s role in global health governance precisely when a health crisis has struck a blow at the heart of how the world functions. WHO’s Sustainable Financing Working Group will meet next week to discuss recommendations … Continue reading Member states could consider paying more to support WHO, some remain unwilling

Podcast: The Story Of The TRIPS Waiver

Dear Readers, Listeners, I am happy to bring you our next episode of the Geneva Health Files podcast, encouraged by the response to our first earlier in the year. In this episode we take you on the journey of the TRIPS waiver, how it began and the way it has captured public imagination. While uncertainty swirls around what will happen next in the story of the waiver, let’s seize the moment to review and recap in broad brushstrokes, the journey so far and what this means for the world. This podcast has been made possible when a reader, a trained radio journalist, … Continue reading Podcast: The Story Of The TRIPS Waiver

At WTO, Some Developing Countries: “No Waiver – No Walker”; Destination undecided, but countries divided over legal route for new WHO instrument

With just days left for the 12th WTO ministerial, members are yet to reach a decision on the TRIPS waiver – one of the most important deliverables for this meeting. While the waiver decision may hold the key to the success or failure of this event, it is emerging as a key bargaining chip for developing countries in trying to steer the overall outcomes from this ministerial, according to trade diplomats. There was already pressure building on the opponents to the waiver as hours towards the ministerial get smaller. In a dramatic turn of events, the rise of a new variant detected … Continue reading At WTO, Some Developing Countries: “No Waiver – No Walker”; Destination undecided, but countries divided over legal route for new WHO instrument

Is the ‘Walker Process’ at the WTO undermining the TRIPS Waiver?

In crafting a WTO response to the pandemic, not all members favor referring to a potential decision on the TRIPS Waiver. This, among other issues, threatens consensus around a broader declaration on what is being referred as the WTO response to the pandemic that builds on the trade and health initiative suggested by the Ottawa Group. (The group is a coalition of countries that first proposed a trade and health initiative in November 2020) At stake is not only what members want as text in this declaration, but also the process of negotiating this text in the run up to the … Continue reading Is the ‘Walker Process’ at the WTO undermining the TRIPS Waiver?

The Emerging Path to the TRIPS Waiver

With just a fortnight left for the 12th WTO ministerial conference, WTO members continue to diverge on the TRIPS Waiver proposal that many believe will bolster the response to COVID-19. But countries hope that they will be able to find convergence on a potential waiver to ensure a strong outcome on WTO’s response to the pandemic on intellectual property issues. Members are exploring ways in which vaccine manufacturers who are ready to produce, should be able to begin production of COVID-19 vaccines without worrying about patents. But it is unclear which route this could take – whether under existing TRIPS flexibilities … Continue reading The Emerging Path to the TRIPS Waiver

Round One to the EU & Friends: “Treaty” Option Gains Support

WHO member states have agreed to explore further the need for new rules, even as they would consider strengthening existing rules. The Working Group on strengthening WHO preparedness and response to health emergencies met this week to agree on a draft report that will be submitted to the Special Session of the World Health Assembly later this month. These discussions are one of the most contentious policy choices for countries battling the pandemic, and under pressure to be seen as responding to a political process. After four days of intense discussions where countries negotiated to draft text for this report, it appears … Continue reading Round One to the EU & Friends: “Treaty” Option Gains Support

Pathogen-Sharing and the Access to Benefits: Theory And Practice

By Divya Venkatesh In a pandemic, the sharing of pathogen samples – and associated data such as genetic sequences and epidemiological information are critical for effective public health response – both globally and locally. This is particularly important for the development of medical countermeasures, such as vaccines and diagnostics. And as this pandemic has shown, the sharing of these medical countermeasures across the world is as important to fight the spread of disease. Nominally, the sharing of pathogen samples is governed by the Convention on Biological Diversity (1992), specifically through its supplementary agreement – the Nagoya Protocol which came into effect in … Continue reading Pathogen-Sharing and the Access to Benefits: Theory And Practice

“Equity” Expands in Pandemic Treaty Discussions at WHO

WHO member states continue to engage and wrestle with the question on whether the world needs a new legal instrument to address future emergencies. Considerations on equity are fast-assuming center-space in these discussions. However, it is too early to say whether and to what extent will equity be addressed meaningfully in future governance of health emergencies. Under the Working group on strengthening WHO preparedness and response to health emergencies (WGPR), member states had several consultations this week. In two inter-sessional meetings this week, the working group had discussions in a “deep dive” format on “equity and medical countermeasures and sample sharing … Continue reading “Equity” Expands in Pandemic Treaty Discussions at WHO

Examining the “subtle shift” in the TRIPS Waiver talks

The EU calls on South Africa to resolve impasse Over the last two weeks, there have been indications of some behind-the-scenes movement that show WTO members’ willingness to arrive at a consensus on the intellectual property response to the pandemic. Although at the face of it, there has been no structural change in the way countries have aligned on the TRIPS Waiver discussions, nevertheless there has been greater engagement among members, sources familiar with the discussions say. As we reported last week, during the General Council meeting at the WTO, officials had suggested “a subtle shift” in these discussions. What continues … Continue reading Examining the “subtle shift” in the TRIPS Waiver talks

Review of International Health Regulations Makes Space in Treaty Talks

The opposition to the idea of a pandemic treaty appears to be strengthening, even as there is emerging preference for a revision of existing rules such as the International Health Regulations, in order to better address future emergencies.On-going discussions suggest that WHO member states might prefer other ways to govern pandemic preparedness and response instead of crafting a new instrument. As in other policy spheres, these matters too, are being driven by geopolitical considerations. At a meeting this week, the working group on strengthening WHO preparedness and response to health emergencies (WGPR), set up to discuss the need for a new legal … Continue reading Review of International Health Regulations Makes Space in Treaty Talks

A Replenishment Model for WHO

Faced with inadequate and uncertain support for a meaningful increase in assessed contributions from WHO member states, the Sustainable Financing Working Group has been left to contend with what seems to be an inevitable dependence on the replenishment model to shore up finances for the organization. Without enough resources from its member states, WHO may be forced to depend on donor funds to meet its mandate, sources familiar with the discussions say. In its fourth meeting this year, the working group met this week to review essential functions of WHO and the ways to fund these in a sustainable manner. … Continue reading A Replenishment Model for WHO

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To improve access to vaccines, Gavi will ask countries to resell to COVAX

The board of Gavi – The Vaccine Alliance will meet next week on the 28th of September to consider key strategic issues around the COVAX Facility including enabling reselling of vaccine doses by countries, and preparing for a potential administration of booster doses by participating countries. In June, we reported on Gavi Board’s approval on the way the COVAX Facility engages with Self-Financing Countries and the plans to service low- and middle-income countries. The new goal of covering 70% of the global population is significant for Gavi, that will also soon review the operations for the COVAX Facility going forward. … Continue reading To improve access to vaccines, Gavi will ask countries to resell to COVAX

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A Meeting Among the Friends of the Pandemic Treaty

A meeting in Montreux: Friends of the Pandemic Treaty A photograph of a somewhat crumpled sheet of paper read “Retreat of the Group of Friends of the Pandemic Treaty”, Friday September 17, 2021. The image showed potential guiding questions that would discuss the need for a new legal instrument – discussions for which are underway in the Working Group on strengthening WHO preparedness and response to health emergencies. Last week when this information was shared with us, the questions on the agenda were revealing on the direction of these discussions. Early endorsers to the idea of a pandemic treaty are a group … Continue reading A Meeting Among the Friends of the Pandemic Treaty

TRIPS Waiver opponents ring-fenced by growing support for proposal

A month is too long in geopolitics. As trade diplomats resumed discussions this month on the TRIPS waiver proposal after a month long break in August, they returned to changing contours of these discussions. At the face of it, not much has changed namely that the key opponents including the EU, Switzerland and the UK, have continued to dig into their heels, resisting the approach to temporarily waiving intellectual property protections for COVID-19 medical products. In the meantime, the co-sponsors were joined by more WTO members including Jordan and Malaysia. Australia and China have also said that they will support the … Continue reading TRIPS Waiver opponents ring-fenced by growing support for proposal

The politics of surplus production & vaccine scarcity

A SNAPSHOT OF VACCINE INEQUITY: SURPLUS IN TIMES OF SCARCITY    When a source alerted us to a potential glut in vaccine production at the end of 2021, back in January this year, it was hard to believe it. At that time the glaring inequities in the access to medical products, was already making global headlines. That COVID-19 vaccines production could touch 12 billion doses in a few months is as hard to believe today, even though the numbers look increasingly convincing. For all the advances in predictive analyses, streamlined logistics, we will still not be able to get vaccine doses from countries that … Continue reading The politics of surplus production & vaccine scarcity

“The idea of pathogen sharing is based on power dynamics”: Q&A with Senjuti Saha

THE GENEVA HEALTH FILES INTERVIEW By Divya Venkatesh “The idea of pathogen sharing is based on power dynamics” During an outbreak, accessing pathogen samples and sequencing data easily are critical for designing effective public health responses and developing medical products. The norms that govern the sharing of pathogens in “peace” times, will have consequences on how samples and information are shared and compensated for, during outbreaks. Despite the growing chorus for sharing pathogens, this fundamental requirement that has not been discussed enough. We spoke with Senjuti Saha, a well-known Bangladeshi scientist who works at the intersection of Clinical Microbiology and Public … Continue reading “The idea of pathogen sharing is based on power dynamics”: Q&A with Senjuti Saha

Threats of sanctions from Berlin ahead of talks in Geneva might alter support for pandemic treaty

From a glittering ceremony in Berlin this week, that saw the launch of the new WHO Hub for Pandemic and Epidemic Intelligence, WHO top boss Tedros Adhanom Ghebreyesus, flanked by German Health Minister Jens Spahn, made unequivocal calls for sanctions for uncooperative states in the context of future health emergencies. Germany, WHO’s biggest funder, repeatedly asked China to cooperate on the investigations on the origins of SARS-CoV-2. These first shots for sanctions rang out just as the intergovernmental Working Group on Strengthening WHO preparedness for and Response to Health Emergencies (WGPR) resumed discussions in Geneva this week (September 1-3). We have noted earlier how the origins debate has … Continue reading Threats of sanctions from Berlin ahead of talks in Geneva might alter support for pandemic treaty

“Health is a strategic frontline target”: Guest Essay by Mukesh Kapila on the Tigray Crisis

Health in the cross hairs of the Tigray conflict By Mukesh Kapila As Ethiopia’s civil war  approaches its first deadly anniversary in November, there is, as yet, little prospect for peace.  The underlying causes of the immediate conflict are bitterly contested and the essential conditions for solutions remain elusive. Geopolitical factors mean that the African Union and United Nations are paralysed, even if there was a mood for external intervention after the Afghanistan debacle. Ethiopia was starting to do well… Ethiopia has a long and bloody history with repeated internal conflicts distinguished by extreme brutalities. But recent periods of peace and stability were bearing fruit. … Continue reading “Health is a strategic frontline target”: Guest Essay by Mukesh Kapila on the Tigray Crisis

The U.S. hopes to reshape post-pandemic governance with a “Global Health Threats Fund”

The U.S. government is seeking to play a key role in the establishment of a Global Health Threats Fund, a new proposed structure envisaged to be under the aegis of the World Bank. This could potentially upend parallel discussions on a pandemic treaty and eventually impact WHO’s role to meaningfully address future pandemics, sources familiar with recent discussions say. The Global Health Threats Fund and a Board, were recommendations made by the G20 Independent Panel on Pandemic Preparedness and Financing. (Separately, the Independent Panel of Pandemic Preparedness and Response had suggested a Global Health Threats Council.) The U.S. government, reportedly is keen to … Continue reading The U.S. hopes to reshape post-pandemic governance with a “Global Health Threats Fund”

Guest Essay: “Do We Really Need a Pandemic Treaty?”

By Nithin Ramakrishnan and K M Gopakumar The Member-State  Working Group on Strengthening WHO Preparedness and Response to Health Emergencies (the working group) met during the 15th and 16th of July 2021 and adopted its method of work.  The 74th World Health Assembly (WHA) decision has mandated the Working Group to prioritize the assessment of the benefits of developing a WHO  convention, agreement or other international instrument on pandemic preparedness and response, and report to the Special Session of the WHA to be held from 29 November to 1st December 2021. The Working Group is expected to start its work on this prioritised … Continue reading Guest Essay: “Do We Really Need a Pandemic Treaty?”

Understanding Germany’s Trenchant Opposition To the TRIPS Waiver

By Rithika Sangameshwaran In January 2021, Achim Kessler, member of the Left Party of Germany (known as Die Linke) co-submitted a motion in the Bundestag (Parliament). It called on the German Federal Government to support the TRIPS waiver. After months of deliberation, the motion was rejected in May 2021, with majority members voting against it. While they unanimously agreed that more needed to be done to increase global vaccine production, just like at the WTO, they differed on ways to achieve it. “There is a difference even within the government, between members of the Social Democratic Party (SPD) and members of the conservative party. Some … Continue reading Understanding Germany’s Trenchant Opposition To the TRIPS Waiver

Where does India truly stand on the TRIPS Waiver: Q&A with Murali Neelakantan

India has played a crucial role in supporting South Africa, as a lead co-sponsor in bringing the TRIPS Waiver proposal to the WTO in October 2020. In the months since, more than 60 other WTO members have formally supported the proposal – a bold initiative that seeks to temporarily suspend a range of intellectual property protections in order to decisively respond to the pandemic by seeking to unblock production shortages for critical COVID-19 medical products. As these discussions reach a critical juncture ahead of the WTO ministerial in November this year, concerns have been expressed on India’s commitment to the waiver proposal. … Continue reading Where does India truly stand on the TRIPS Waiver: Q&A with Murali Neelakantan

The many promises of the mRNA tech transfer hub in Africa

WHO: New consortium working to boost vaccine production in South Africa: MPP, WHO, AFRIGEN, BIOVAC, SAMRC, and Africa CDC sign a letter of intent towards establishing the tech transfer hub in South Africa “The Medicines Patent Pool (MPP) and the World Health Organization (WHO),  Afrigen Biologics (PTY) Limited, the Biologicals and Vaccines Institute of Southern Africa  (Biovac), the South African Medical Research Council (SAMRC) and Africa Centres for Disease Control and Prevention (Africa CDC) have signed a letter of intent to address the global imbalance of manufacturing capacity for COVID-19 vaccines.” The letter of intent sets out the terms of the collaboration and responsibilities between … Continue reading The many promises of the mRNA tech transfer hub in Africa

The Writing on the Wall? The EU Seeks to Steer Talks Away from the TRIPS Waiver Proposal

Calling the crucial discussions on the TRIPS Waiver as a “stalemate”, the European Union this week, urged the WTO membership gathered for the General Council meeting, to consider its “pragmatic”, albeit, watered down proposal on the IP response to the pandemic instead of the TRIPS waiver proposal, a far more comprehensive approach to address IP barriers in the context of COVID-19. The EU proposal mostly focuses on the use of compulsory licensing, while South Africa-India’s proposal seeks a temporary suspension on rules across a range of intellectual property protections from patents, copyright, to trade secrets among others in order to … Continue reading The Writing on the Wall? The EU Seeks to Steer Talks Away from the TRIPS Waiver Proposal

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Guest Essay on Governing Health Emergencies: “The Exclusive Force of International Law Cannot be the Answer”

“The IHRs (2005) were adopted on a scientific and political consensus which is still valid today” Axelle Ebode, a Paris-based Cameroonian expert who has examined the implementation of International Health Regulations from the perspective of geopolitics, writes for us this week. Ebode is wrapping up her PhD at the Institut Français de Géopolitique. With a specialization in health geography, her research analyzes the relationship between health and geopolitics throught the implementation of the IHRs (2005) in Cameroon, Kenya and Mexico.  Here are her thoughts on this timely matter: As the discussions for a pandemic treaty began on 15 July 2021, many voices are … Continue reading Guest Essay on Governing Health Emergencies: “The Exclusive Force of International Law Cannot be the Answer”

The Mechanics of the Tech Transfer Narrative during COVID-19

If 2020 resulted in extreme vaccine inequities, 2021 appears to stand witness to the ways in which technology transfer is being restrained by exclusivity fuelled by commercial and political considerations. This is not only widening the gulf between those who have COVID-19 vaccines now, but will also expand inequities in the access to medical products in the future, by restricting the way technology will be shared. We have reported on how massive political capital is being invested in continuing with industry-determined technology transfer arrangements even as the world faces acute scarcity in the access to medical products for COVID-19. In this story … Continue reading The Mechanics of the Tech Transfer Narrative during COVID-19

COVID-19 Lessons from UNICEF: Q&A with Gian Gandhi

“Dose donations are proving to be a good medicine for vaccine nationalism”: Gian Gandhi, UNICEF As an official partner of the COVAX Facility, UNICEF is responsible for procurement, logistics and delivery of COVID-19 vaccines. We spoke with Gian Gandhi, who leads COVAX operations for UNICEF, to get a sense of the challenges faced by the organization during the pandemic in the context of production shortages and realities at the national levels. He also discusses the procedures around the donations of vaccine doses. 1.      [GHF] Can you elaborate on the role of UNICEF in the delivery of COVID-19 vaccines as a … Continue reading COVID-19 Lessons from UNICEF: Q&A with Gian Gandhi

Confidential Communication on the TRIPS Waiver Shows the EU’s Unwillingness to Negotiate

When the European Commission presented a proposal in June 2021 laying out its strategy on the role of intellectual property in addressing the pandemic, critics were quick to conclude that it was an effort to undermine the TRIPS waiver. Yet, many diplomats at the WTO hoped to engage in what they call “good faith negotiations”. Internal communications suggest this may not be the case. A confidential communication sent by diplomats of a Western European Country in June 2021, has come to light that illustrates the EU’s stated reluctance to negotiate the waiver proposal. Experts suggest that it also reveals the problematic ways … Continue reading Confidential Communication on the TRIPS Waiver Shows the EU’s Unwillingness to Negotiate

Countries wrestle with regulatory data, trade secrets and tech transfer: TRIPS Waiver discussions at WTO

As countries get deeper into discussions on how a potential waiver of certain obligations of the TRIPS agreement can be implemented, they are beginning to engage with the question on how the implementation of such a proposal can look like at the national level.   Even as a small group of countries including the EU, UK, Switzerland, among others continue to remain entrenched in their positions, unconvinced that a temporary suspension of intellectual property rules will help address the pandemic effectively, in general, the WTO membership continues to clarify certain questions in the on-going negotiations unfolding at the bilateral level … Continue reading Countries wrestle with regulatory data, trade secrets and tech transfer: TRIPS Waiver discussions at WTO

Vaccines falling through the cracks in the regulatory mosaic

The ongoing goof-up around European Union’s prized vaccine certificates which do not recognize some WHO-approved vaccines, has brought back to life memories on governmental dysfunctions. Having spent a substantial part of my life in India, I am long used to bureaucratic delays, inexplicable and convoluted ways in which red tape eats into productive hours. It is a fact of life. Indians mostly account for unanticipated surprises from unimaginative public servants who put the letter of the law above the spirit of it, and are often, averse to common sense. Watching vaccine barriers go up in the EU, on the back … Continue reading Vaccines falling through the cracks in the regulatory mosaic

The clock is ticking on securing WHO’s finances

Financing WHO: How much must countries pay & what are essential functions An update from the Sustainable Financing Working Group Meeting Discussions among countries on ways to fund WHO in a predictable manner are reaching an important phase with an emerging view that member states must pay more to protect the role of WHO in global health. So while many countries may, in principle be ready to cough up more, it is far from clear by how much and by when would they agree to do so. Countries also appear undecided on the ways to prioritize essential functions of WHO, … Continue reading The clock is ticking on securing WHO’s finances

TRIPS Talks: Interview with João Aguiar Machado, EU Ambassador to the WTO

THE GENEVA HEALTH FILES INTERVIEW “Only a multi-pronged approach will bring about real change” Q&A: João Aguiar Machado, EU Ambassador to the WTO As WTO members continue to negotiate on ways to streamline, adapt intellectual property rules in the response to the pandemic, we bring you this timely interview with EU’s ambassador to the WTO, João Aguiar Machado. He discusses the different strands in the EU’s overall strategy on trade and health at the WTO in the context of this health emergency. Later this week, members head to an informal TRIPS Council meeting on 30 June to discuss South Africa-India’s … Continue reading TRIPS Talks: Interview with João Aguiar Machado, EU Ambassador to the WTO

A Moment of Reckoning for the COVAX Facility

Gavi – The Vaccine Alliance, that legally administers the COVAX Facility, has had to do some serious stock-taking in rethinking its role in the international response to COVID-19. This week the Gavi Board approved proposals, among others, to redefine the way the COVAX Facility engages with Self-Financing Countries and the way it plans to service low- and middle-income countries in the future. It is also an acknowledgement of the limitations faced by the structure that has been set up and constrained by the donors of the COVAX Facility. According to Gavi, over 80 million doses from COVAX have been delivered to 129 … Continue reading A Moment of Reckoning for the COVAX Facility

South Africa bags first mRNA tech transfer hub

For a world clutching at the straws, there is palpable excitement about a first tech transfer hub to produce mRNA vaccines in Africa. The statement from WHO on the South African consortium that has bagged the first COVID mRNA vaccine technology transfer hub, is scant on the details particularly on licensing terms. It is not clear whether for instance, such a hub, would work with the COVID-19 Technology Access Pool. (See our earlier story on this). Neither the press release nor the statement of DG Tedros has any mention of C-TAP. In April, WHO issued a call for expressions of interest to establish technology transfer … Continue reading South Africa bags first mRNA tech transfer hub

The importance of the scope of the TRIPS Waiver. Talks off to a tough start at WTO

Why the scope of the TRIPS Waiver is crucial to address the pandemic? Tough start to the negotiations on the TRIPS Waiver. Countries remain divided, but agree to engage. The U.S. does not commit to a deadline to reach decision on TRIPS Waiver talks In today’s update on the TRIPS Waiver talks, we look at the informal meeting among WTO members on June 17 where countries agreed on a roadmap for the negotiations. We also look at the substantive elements in the revised proposal and the procedural aspects to this discussion. For this story, we had extensive interviews with diplomatic sources … Continue reading The importance of the scope of the TRIPS Waiver. Talks off to a tough start at WTO

Essay: The Economics of Health For All

While COVID-19 demands a reset of capitalism, nearly a year and a half into the pandemic, we are still tinkering at the edges of what is truly possible. Despite the usual skepticism, the house view is that The WHO Council on the Economics of Health for All (set up in November 2020), will contribute to changing the conversation on health and economics, in global health and beyond. We agree that global health is too important to be left only to disciplinary experts, and there needs to be a fundamental rethink on our priorities to bring health front and center of economies. Today … Continue reading Essay: The Economics of Health For All

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Announcing the Geneva Health Files Summer Fellows

It is our honor to announce the first cohort of the Geneva Health Files Fellowship. When we sent out a call seeking support to scale this initiative, we never imagined post-doctoral researchers evincing interest in this exciting but small initiative. All of them have inter-disciplinary interests and backgrounds, much like our DNA if you will. Join me in welcoming: Meena Tafazzoli: A former strategy consultant from San Diego who has worked extensively in healthcare, and has an interest in the access to medicines. She is currently doing her thesis on The Changing Financial Incentives for Vaccines in a Post-COVID World, at the … Continue reading Announcing the Geneva Health Files Summer Fellows

Stage set for TRIPS Talks: An intense summer of negotiations for Geneva

After months of pushing for a blanket, time-bound, waiver on intellectual property protections to effectively address the pandemic, South Africa and India joined by more than 60 co-sponsors of the TRIPS Waiver proposal, finally managed to get the WTO membership to agree to talk text. Members will convene at an informal meeting on 17 June to assess how they can move forward ahead of General Council meeting in July. Notably, UK, Switzerland, EU, Korea, remain opposed to the waiver proposal. As many as 48 delegations took the floor this week, during the TRIPS Council formal meeting. Image credit: Photo by Sandeep Ket from Pexels To read … Continue reading Stage set for TRIPS Talks: An intense summer of negotiations for Geneva

The demand for vaccine indemnity from countries & the terms of COVAX

Vaccine Indemnity and The COVAX Facility Some manufacturers have demanded indemnity against the introduction of vaccines, from countries. We wanted to know how this ties in with The COVAX Facility’s no-fault compensation fund. Here are some responses from a spokesperson from Gavi – The Vaccine Alliance. (See our earlier story on these issues) [GHF] 1. Why did Facility leave the question of indemnity to individual countries participating in the Facility? The foundational goal of COVAX is global equitable access to COVID-19 vaccines, which includes working to ensure that ability to pay is not a barrier to access. As we strive towards this goal at … Continue reading The demand for vaccine indemnity from countries & the terms of COVAX

WHA74 WRAP: Pandemic Treaty Talks Eclipse Prevailing Vaccine Inequities

More than half way into the 74th World Health Assembly, a serious discussion on the efforts to address vaccine inequities have been conspicuous by its absence. What has instead dominated much of the Assembly proceedings are talks for a pandemic treaty to address health emergencies in the future, and the important, but continuing push towards investigations on the origins of the virus, among other matters. When this story went to print, the decision on the pandemic treaty was yet to be approved. The decision is expected to be approved at this Assembly. (See our story on this from earlier this week.) To be … Continue reading WHA74 WRAP: Pandemic Treaty Talks Eclipse Prevailing Vaccine Inequities

Pandemic Treaty Opponents Have Bought Time Till a Special Session of WHA in Nov, Supporters Manage to Keep Pressure On

Pandemic Treaty Talks: Special Session in November to Assess The Need for International Instrument Opponents to the Pandemic Treaty talks have made early gains on deferring commitments to launch negotiations immediately. After several rounds of wrangling on the decision-text into early hours of Saturday last week, WHO member states have now reached consensus. It is now proposed that the discussions for “an international instrument” will formally be addressed at a special session of the World Health Assembly in November 2021, where countries will decide on the need to establish an inter-governmental process to draft and negotiate a potential treaty (or other international … Continue reading Pandemic Treaty Opponents Have Bought Time Till a Special Session of WHA in Nov, Supporters Manage to Keep Pressure On

Spanner in the works for a pandemic treaty: The U.S., Brazil & Russia Converge to Oppose EU plans at WHO, Discussions Continue

EU-led plans for pushing through with the setting up of an inter-governmental body to undertake negotiations for a pandemic treaty have been soured by unwillingness on the part of a few member states of WHO including US, Mexico, Brazil and Russia, among others, according to diplomatic sources in Geneva. As this story went to print, countries were locked in consultations on a decision text which if approved by the World Health Assembly would kick start the process for negotiations towards a treaty. It is not clear whether countries were likely to reach a consensus on these discussions before the start … Continue reading Spanner in the works for a pandemic treaty: The U.S., Brazil & Russia Converge to Oppose EU plans at WHO, Discussions Continue

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Geneva Health Files: Summer Internship Announcement

Volunteer Opportunity in Global Health Journalism: Geneva Health Files Geneva Health Files, is an inter-disciplinary journalistic initiative that reports on power and politics at the heart of global health. This small, but growing news operation is looking for a student who can help us report on global health and promote our work in order to expand our readership and subscriber base.  This is an opportunity to start with a contemporary, small newsroom and gain hands-on experience in learning how global health journalism functions in Geneva. It is a great opportunity to not only learn to think and write about global health … Continue reading Geneva Health Files: Summer Internship Announcement

“The Independent Panel did not meet the moment”: Guest Essay – A critique of The Independent Panel Report

An Independent Panel for COVID-19 recovery The Independent Panel tasked by WHO with reviewing the global management of the COVID-19 pandemic has fulfilled its terms of reference. But despite the best efforts of the panelists, it did not meet the moment. The world might still need an Independent Panel — but one that is transparent, accountable and participatory. This Independent Panel report does summarize many of the issues the world has witnessed in the past 14 months: weak pandemic preparedness, lugubrious bureaucracies, and government passivity. It poetically describes global inequalities, including the stark sacrifices of healthcare workers. However, its narrow recommendations sidestep … Continue reading “The Independent Panel did not meet the moment”: Guest Essay – A critique of The Independent Panel Report

At Risk: COVAX Plans to Vaccinate 20% of the People in LMICs

The challenges for the world’s most vulnerable in accessing vaccine doses to protect themselves from a devastating pandemic gets more acute every week. Only 0.3% of the vaccine supply is going to low-income countries. COVAX has so far delivered 65 million doses to 124 countries. The surge in cases has compromised global vaccine supply and there is already a shortfall of 190 million doses to COVAX by the end of June, WHO has said. UNICEF was more direct in encapsulating the failure of the international mechanism: “The COVAX Facility will deliver its 65 millionth vaccine dose this week. It should’ve been at least its … Continue reading At Risk: COVAX Plans to Vaccinate 20% of the People in LMICs

Tied Funds To WHO, But Flexible Funds To Its Partners: Sustainable Financing Working Group Confronts Challenges

WHO partners have long eclipsed the UN’s only technical agency – they are better funded and increasingly have exercised greater power and influence on global health in Geneva and in countries around the world. As WHO’s working group on sustainable financing gets down to work, it is bringing to light the extent to which its financing is tied – this includes even those funds coming from partner agencies. The inter-governmental working group on sustainable financing met late last month (April 29-30) for its second meeting and set off discussions on the potential ways to prioritize essential functions of the WHO given the … Continue reading Tied Funds To WHO, But Flexible Funds To Its Partners: Sustainable Financing Working Group Confronts Challenges

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The dash for the pandemic treaty

A decision-text to kick start discussions towards a pandemic treaty is being considered by member states this week. Member states will consider establishing an intergovernmental meeting (IGM) to draft and negotiate a WHO framework convention on pandemic preparedness and response. In line with timelines discussed in internal EU documents that Geneva Health Files has seen, this IGM is expected to convene its first meeting not later than the end of June 2021. According to the draft text, “meetings of the IGM shall be held either in person, virtually or in hybrid format” and shall conduct its work in accordance with … Continue reading The dash for the pandemic treaty

The WTO Becomes the Nerve Center for Pandemic Response

In the late evening of the 5th May, here in Geneva, the international trade community was jolted from its end-of-the-day fatigue with the news of the US support to the waiver of intellectual property protection for COVID-19 vaccines. While the news was cheered among the global health community that has long faced the specter of vaccine shortages and rising deaths from COVID-19, it perplexed the trade lawyers. After all, in one stroke, the US had upended its long-entrenched position on the primacy of the protection of intellectual property, in the 25 plus years of the existence of the TRIPS Agreement. Irrespective … Continue reading The WTO Becomes the Nerve Center for Pandemic Response

Variants of Concern & Variants of Interest: SARS-CoV-2

The SARS-CoV-2 variant B.1.617 present in India and other countries has been designated as a variant of concern despite the on-going surge of infections and mortality in India. We wanted to understand why this wasn’t a variant of concern yet. Is this due to an alleged lack of sufficient information collection and sharing of important data in India. This variant was first detected in October 2020.ticular variant.  Image credit: Photo by Jeswin Thomas from Pexels Continues… To read the full story, you will need to sign up to our newsletter.   While our edition on Tuesdays, The Weekly Primer is free, our exclusive analyses published in The Friday Deep … Continue reading Variants of Concern & Variants of Interest: SARS-CoV-2

Countries divided on ways to reform WHO emergency preparedness

WHAT THIS TELLS US ABOUT THE PANDEMIC TREATY DISCUSSIONS Some would argue that we are in the run up to one of the most crucial discussions on how the world must prepare for the next health emergency, even as the current pandemic continues to light up waves of infections and deaths in countries like India and Brazil, among many others. Apart from the status of the negotiations itself, this story also looks at the underlying process in these negotiations and how this can impact the discussions towards the pandemic treaty. We reported earlier that the draft resolution on strengthening WHO … Continue reading Countries divided on ways to reform WHO emergency preparedness

COVAX counts on dose-sharing to counter vaccine crunch, vaccine diplomacy makes it worse

DOSE-SHARING: THE PLAN B FOR COVAX THAT RESTS ON BENEVOLENCE In December 2020, Gavi spelt out the COVAX principles on dose-sharing for COVID-19 vaccines. Authorities had hoped that countries who had bought more doses than they require would be amenable to sharing the doses through the COVAX Facility. This was, what now seems like a far less challenging time, before the emergence of the variants, subsequent waves of the pandemic, vaccine shortages, export bans and legal threats between countries and manufacturers. Not only has the situation exacerbated, unforeseen supply challenges have emerged for the COVAX facility in the context of the resurgence … Continue reading COVAX counts on dose-sharing to counter vaccine crunch, vaccine diplomacy makes it worse

“A hole in the firewall”: The WHO Foundation & WHO

The governance of global health has changed in radical ways just in the last 12 months. But potentially lasting changes, some would argue long predicted, are defining new ways of financing which may alter the governance in ways that directly run counter to the very goals of public health. These have been normalized and adopted without adequate consultation of member states of WHO, and despite concerns raised by stakeholders in the civil society. The new WHO Foundation, a non-profit legal entity that has been established to fundraise for WHO might have already caused conflicts of interest arising over recent donations … Continue reading “A hole in the firewall”: The WHO Foundation & WHO

Hyo Yoon Kang on the financialization of intellectual property & COVID-19

At Geneva Health Files, we make a concerted effort to use inter-disciplinary reporting approaches given the very nature of global health which straddles so many disciplines. It is, therefore, with great pleasure that we bring you this pertinent interview with intellectual property law expert,  Hyo Yoon Kang, a reader in law at Kent Law School, University of Kent. Kang, who has cross-disciplinary training, has worked at the intersection of law, history of sciences, and science and technology studies. In this enlightening interview she examines the embedded politics in the very foundations of intellectual property law and picks apart the arguments … Continue reading Hyo Yoon Kang on the financialization of intellectual property & COVID-19

WHO & WTO converge on bilateral tech transfer for vaccines. What this means for the TRIPS Waiver

The WTO vaccine equity event showed potential for spare manufacturing capacity and the willingness to finance it. But will this be followed up voluntary technology transfer to address production shortages, or will this be left to the discretion of bilateral deals decided by manufacturers? And was this event meant to draw attention away from the TRIPS waiver talks now reaching a critical stage? There are emerging convergences between the WTO and WHO, on the approaches towards bilateral technology transfer to spur the production of vaccines. This will inevitably have repercussions for the TRIPS waiver proposal. While it is not clear … Continue reading WHO & WTO converge on bilateral tech transfer for vaccines. What this means for the TRIPS Waiver

Make way for the COVAX Manufacturing Taskforce

While the COVAX Facility reached a milestone of making vaccine doses available (38 million) in more than 100 “economies”, as a press statement articulated last week, the questions on its effectiveness and limitations continue to get louder. At the Africa’s Vaccine Manufacturing Virtual Conference, organized by Africa CDC, Andrew Witty, ex-CEO of GSK, and a former special envoy of the ACT Accelerator acknowledged the limitations of the COVAX Facility. To be sure, the uncertainties facing supplies of vaccines have been confirmed at the highest levels. Last week, Seth Berkley, CEO of Gavi – The Vaccine Alliance said that while efforts will made to make … Continue reading Make way for the COVAX Manufacturing Taskforce

WHO’s “Bretton Woods Moment” Dimmed by Member States’ Reluctance To Pay Up More

Notes from the Sustainable Financing Working Group Meeting In its first meeting during March 29-31, the intergovernmental Sustainable Financing Working Group at WHO, kick-started discussions on finding ways to fund essential functions in a flexible and predictable manner. It has also emerged that sustainable financing is a key objective of the proposed international pandemic treaty. Hence the deliberations of this working group will be crucial in setting the direction on financing and as a consequence, governance. In the early stages of this discussions, member states appear reluctant to pay up more in assessed contributions.    WHO’s Sustainable Financing Working Group … Continue reading WHO’s “Bretton Woods Moment” Dimmed by Member States’ Reluctance To Pay Up More

The cautionary tale of the COVAX Facility

With every passing month, the unanticipated challenges facing the COVAX Facility mounts. Take the AstraZeneca vaccine, which has been reckoned as the backbone of the Facility. Rising hesitancy towards this vaccine in the EU and elsewhere because of rare incidents of blood clots, despite the safety of the vaccine vouched by regulators, is only one concern. Following production shortages in the EU that broke out earlier in the year, the barriers to access AZ doses continue – the latest being on account of Indian government’s decision to temporarily hold the export of the vaccine to quell the surge of COVID-19 infections in the country. A press release issued by … Continue reading The cautionary tale of the COVAX Facility

Pathogens-Sharing & The Pandemic Treaty: The Commercial Link

The rules on how information on pathogens and genetic sequences will be shared could be determined under a proposed pandemic treaty. This is important because even though countries may share physical samples of pathogens and genetic sequence data, they could be excluded from having access to vaccines and diagnostics developed based on this information without binding commitments on benefits sharing. COVID-19 shows us, this has happened. Leaders from more than 25 different countries have rallied behind the idea of a pandemic treaty, and want a new instrument to be negotiated under the Constitution of the World Health Organization. They hope that the … Continue reading Pathogens-Sharing & The Pandemic Treaty: The Commercial Link

Views from a vaccine manufacturer: Incepta, Bangladesh

THE GENEVA HEALTH FILES INTERVIEW As we reported recently, the debate around enabling technology transfer is proving to be critical in addressing shortages in the production of vaccines to fight back the pandemic. We wanted to know from manufacturers from developing countries on the challenges they face in making vaccines for COVID-19. Geneva Health Files brings you an interview with Abdul Muktadir, Chairman & Managing Director, of the Dhaka-based company Incepta Pharmaceuticals Limited. Muktadir, an industrial pharmacist by training, leads Incepta, which was established in 1999. A company specialising in biosimilars and vaccines, Incepta employs nearly 10,000 people and produces about 1000 … Continue reading Views from a vaccine manufacturer: Incepta, Bangladesh

What is driving the discussions for a pandemic treaty?

The idea of a pandemic treaty is germinating from the tending of political actors, internal and external drivers at World Health Organization and by diverse custodians of knowledge and influence. The need for a pandemic treaty is firmly rooted in the context of global health security that has effectively displaced every other narrative as a result of COVID-19. Global health security has been defined as “measures that are required to reduce the risk and impact of health events that endanger populations around the world.” The current situation raises many fundamental questions on whether our global health institutions – a legacy of the … Continue reading What is driving the discussions for a pandemic treaty?

WHO donors seek a new tech transfer hub under ACT-A, C-TAP sidelined

A new technology transfer hub to facilitate bilateral licensing arrangements, is being proposed by France and powerful private groups, to be under established in the ACT Accelerator, away from the C-TAP. For a world grappling with acute shortages of vaccines – the panacea to fight the pandemic and to restore the economy – technology transfer has come to emerge as a key to unlock idle manufacturing capacities which can be repurposed to churn out vaccines for an endless global queue of susceptible populations under the threat of SARS-CoV-2 and its variants. One year into the pandemic and more than 2.6 … Continue reading WHO donors seek a new tech transfer hub under ACT-A, C-TAP sidelined

Could Vaccine Nationalism Spur Disputes At The WTO?

Experts believe that the solution to vaccine nationalism is not filing disputes, but negotiations. But lawyers anticipate disputes even if filed simply for political leverage. Vaccine nationalism, a condition that has flourished during COVID-19, is loosely understood as the tendency of countries to hoard vaccines. But protectionist trade practices of hoarding medical supplies began as soon as the pandemic hit. This is now taking a serious turn with export restriction measures adopted by some countries. This could lead to a real possibility of countries taking the legal route to file disputes at the WTO, even if only for political leverage, experts say. … Continue reading Could Vaccine Nationalism Spur Disputes At The WTO?

The COVAX Allocation Algorithm for Vaccine Distribution

The logic underpinning the distribution of COVID-19 vaccines secured by The COVAX Facility The COVAX Facility is using an allocation algorithm to distribute COVID-19 vaccines globally. The underlying logic determines how countries line up to receive vaccines in a period of acute scarcity when less than 250 million vaccine doses expected to be distributed among more than 7 billion people worldwide in the first half of 2021 through the Facility. COVAX published its first round of allocations earlier this week that seeks to deliver 237 million doses of AstraZeneca vaccines to 142 countries. According to WHO’s allocation mechanism, the first phase will … Continue reading The COVAX Allocation Algorithm for Vaccine Distribution

Making Investigative Global Health Journalism Possible

Dear Readers,  We believe you agree that global health is everybody’s business. After all, it is where science meets politics meets money meets law. Geneva Health Files has sought to capture these dynamics.  Now more than ever, global health needs consistent scrutiny and greater accountability. We are keen on contributing towards these efforts. Our in-depth, investigative analyses on global health shine light on important, but under-reported policy changes in Geneva every week. Even after the headlines move on to the next crisis, we will be here. We will continue to bring you the story from Geneva with nuance and responsibility … Continue reading Making Investigative Global Health Journalism Possible

The Third Way: Unblocking the TRIPS Waiver Logjam

The Third Way suggested by Ngozi Okonjo-Iweala, WTO’s new director-general who assumes office on Monday, March 1, may pave the way for negotiations on the TRIPS Waiver proposal, sources in Geneva say. In her remarks recently, Okonjo-Iweala suggested the use of TRIPS flexibilities and the voluntary licensing approach to deftly address the pandemic. This, proponents of the TRIPS Waiver proposal, say, could be a significant moment in these discussions, which could bring to the negotiating table countries opposing the waiver. So far, opposing countries have locked the proponents of the proposal in a so-called “evidentiary loop” without moving towards text-based negotiations. For … Continue reading The Third Way: Unblocking the TRIPS Waiver Logjam

What is holding back the COVID-19 Technology Access Pool (C-TAP)

Production concerns in the manufacturing of COVID-19 vaccines have underscored the need for technology transfer. This means greater relevance for the C-TAP, however it continues to lack support. The shortages of COVID-19 vaccines have brought into focus the importance of technology transfer needed to speed up the production of vaccines to meet unmet demand. This may give a much-needed impetus to WHO’s COVID-19 Technology Access Pool, which was first suggested by Costa Rica in March 2020, subsequently launched in May 2020 by WHO, but an initiative that has failed to take off. So far. A number of factors have ensured … Continue reading What is holding back the COVID-19 Technology Access Pool (C-TAP)

The ACT-A Agenda: The financialization of a pandemic?

Bonds, loans, debt-swaps and taxes The ACT A plan to ride out the pandemic The European Commission-backed ACT Accelerator [ACT A] which has the private sector at the table, has drawn up extensive plans to address the acute scarcity of resources to fund the response to pandemic. Measures include issuing social bonds, grants, a sovereign insurance pool, and even includes the consideration of a “global transaction tax”. These plans were first made public at a meeting of the ACT Accelerator Facilitation Council  earlier this week. The ACT A needs more than US$27 billion to effectively address the pandemic globally. This is a … Continue reading The ACT-A Agenda: The financialization of a pandemic?

Reading the COVAX forecast

Even as Geneva-based health organizations announced forecasts for the supply of COVID-19 vaccines, countries in some parts of the world fear that their promised deliveries for vaccines were now being reprioritized by some manufacturers affiliated with the COVAX Facility. There is not enough clarity yet on how many countries will be affected in the short term. This story parses through the official statements made by health agencies and contrasts it with publicly available information which suggest that bilateral deals between vaccines manufacturers and countries have begun to have an impact on vaccine deliveries for the COVAX facility as many had … Continue reading Reading the COVAX forecast

COVAX & the question of liability: COVID-19 vaccines

Even as uncertainties around vaccines supply to much of the developing world remain, there are complex questions on liabilities awaiting downstream of this massive, global vaccination exercise. Authorities in Geneva claim that the yet unseen challenges on fixing liability issues have been addressed in the form of a no-fault compensation fund that will pay for claims arising out of the introduction of vaccines in the developing world. This expansive analysis takes a close look at some of the technical, political and economic compulsions that have shaped liability discussions within the COVAX Facility. Last week top officials of WHO told the … Continue reading COVAX & the question of liability: COVID-19 vaccines

A pandemic treaty: reforming global health security

For months experts and critics have been exhorting WHO and its member states to use the organization’s constitutional mandate specifically its treaty-making powers to deftly address the urgency of the pandemic. Mostly critics want WHO to use its constitutional powers to quell the pandemic and to address the difficult issue of access to medicines, for example, given the glaring inequities in the access to vaccines during the current pandemic. However, given the inexorable emphasis on global health security, it was perhaps not so surprising when DG Tedros Adhanom Ghebreyesus casually put the idea of a pandemic treaty to member states during the … Continue reading A pandemic treaty: reforming global health security

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The Politics of Pathogens-Sharing

As much of the world awaits vaccines for COVID-19, discussions on how pathogens should be shared continue to evolve at World Health Organization. This is fundamental for the access to vaccines, diagnostics and therapeutics during a disease outbreak, and for preparedness. Like its ubiquitous impact on almost every aspect of health policy, COVID-19 will inevitably change the discourse on the sharing of pathogens. Stakeholders hope that the change will be for the better, including by addressing the crucial matter on benefits for those sharing pathogens and biological materials.   This initial story looks at the state of play in these … Continue reading The Politics of Pathogens-Sharing

W.H.O. EXECUTIVE BOARD MEETING: A CURTAIN RAISER EB 148

We spent some time parsing through these documents for you. Some key items which will be discussed at the meeting next week is highlighted here. Documents can be accessed here. A Preliminary daily timetable has been published by WHO. Image credit: Photo by Oleg Magni from Pexels On special procedures: the virtual nature of the meeting“…the light of the current epidemiological situation, the Members of the Board agreed through a written silence procedure that the 148th session of the Executive Board would take place virtually, using video conference technology.” COVID-19 response: Report by the Director-GeneralThis is an important technical update on WHO’s response to the pandemic. Its activities are truly … Continue reading W.H.O. EXECUTIVE BOARD MEETING: A CURTAIN RAISER EB 148

Competing visions for W.H.O. reforms

Not that member states needed more reasons to urgently consider WHO reforms, but China gave them a fresh impetus just the same, earlier this week. A year after the novel coronavirus was first detected in Wuhan, China, it appears that the gloves are off. Dr Tedros Adhanom Ghebreyesus, WHO director-general, expressed his disappointment on Tuesday this week, when scientists who had been en route to China to begin investigations on the origins of SAR-CoV-2, were turned away as a result of alleged delays in internal procedures. These developments will undoubtedly influence and set the tone on how these reforms discussions will be … Continue reading Competing visions for W.H.O. reforms

Q&A: Dr Thomas Hale, University of Oxford

Dr Thomas Hale, Associate Professor in Public Policy at the Blavatnik School of Government, at the University of Oxford, has been working on analyzing policy responses of governments to the current pandemic. Along with his colleagues, he is a part of the team behind the Oxford COVID-19 Government Response Tracker. The OxCGRT, as it is called, tracks and compares policy responses around the world. The tracker “provides a systematic cross-national, cross-temporal measure to understand how government responses have evolved over the full period of the disease’s spread. (Read the recent paper on theVariation in government responses to COVID-19.) Dr Hale’s research … Continue reading Q&A: Dr Thomas Hale, University of Oxford

Lessons in self-publishing in 2020

We give you a glimpse of what it has been like inside Geneva Health Files. Hope you find this interesting. Write to us with your comments! The Geneva Health Files newsroom: Image credit: Priti Patnaik In April 2020, I started self-publishing. What follows are notes on what I learned through out this year. (in no particular order of importance) Listen to what people are saying and what they are not saying. Make your own judgement and editorial call on what is important – not only dictated by the news cycle. Timing is king, but do not kill yourself with unrealistic … Continue reading Lessons in self-publishing in 2020

COVAX 2021: The Gavi Board Dossiers

COVAX IN 2021: WILL THE PIECES COME TOGETHER? What Gavi’s Board documents say. There is tremendous pressure on Gavi – The Vaccine Alliance and its partners including WHO to deliver vaccines for the pandemic even as the increasing complexity of COVID-19 challenges scientists and policy-makers. The risks facing Gavi and the constraints it faces as the responsible global health agency in making COVID-19 vaccines available to the world, is significant. This is not only about Gavi. At stake are some of the poorest countries in the world for whom the COVAX Facility is the only ticket out of the pandemic. … Continue reading COVAX 2021: The Gavi Board Dossiers

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Moment in the sun for TRIPS Waiver plan

ROAD AHEAD FOR GREATER DELIBERATION IN 2021: TRIPS WAIVER PROPOSAL AT WTO The General Council at WTO, the organization’s highest level decision-making body, this week, discussed the TRIPS waiver proposal first put forward by South Africa and India in October this year. With this, the proponents successfully pushed this crucial proposal for political consideration before the world’s trade policy makers. The stage is now set for further deliberation in the coming weeks early in 2021. South Africa has also requested for an extraordinary General Council meeting to take this forward. The significance of the discussion of this proposal at the General Council, … Continue reading Moment in the sun for TRIPS Waiver plan

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Some of our top stories of 2020

Capturing policy-making on the pandemic in real-time: stories from Geneva Health Files I seek to make this a reader-funded initiative. You can make a contribution using a paypal account: paypal.me/genevahealthfiles Your donations are crucial to keep this effort going! If you wish to share information or have suggestions, write to me: patnaik.reporting@gmail.com Continue reading Some of our top stories of 2020

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Seeking feedback on our newsletter

Geneva Health Files is proud to serve this unique community of readers in global health. In order to make this journalistic initiative sustainable, we are considering a paid subscription model, where our readers will pay for our content to make our reporting possible. This will be a key transition for us over the next few months in 2021. Help us understand your preferences. Please take a minute to complete this short survey – an important feedback from you that will help shape the future of this initiative. Photo by Shotkit from Pexels Since September 2020, Geneva Health Files has switched to a weekly newsletter format … Continue reading Seeking feedback on our newsletter

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No consensus on TRIPS talks

Developed countries shift narrative raising questions on safety and efficacy issues around drugs As images of the elderly in the UK receiving the first vaccine shots to protect against COVID-19 flashed across the world, the reality of the lack of access to vaccines in the poorer countries became stark. It is in this backdrop, that countries discussed the so-called TRIPS waiver proposal, which seeks to temporarily suspend intellectual property protection to hasten the access to COVID-19 medical products. Countries today kicked the can down the road so to speak, even as the world is losing crucial time in its fight … Continue reading No consensus on TRIPS talks

TRIPS COUNCIL INFORMAL MEETING ON TRIPS WAIVER PROPOSAL

An informal meeting was convened at the TRIPS Council today (December 3) to discuss the TRIPS waiver proposal. Discussions on the TRIPS waiver proposal is expected to continue in the TRIPS Council in 2021. We will come back with a fuller report on this next week, here are some details which emerged from today’s meeting. It is understood that the African Group may decide to co-sponsor the proposal after consultations with the capitals. Kenya, Sri Lanka, Jamaica and Argentina are understood to have expressed their support to the waiver proposal at the informal meeting today. South Africa and India have … Continue reading TRIPS COUNCIL INFORMAL MEETING ON TRIPS WAIVER PROPOSAL

Regulatory discoherence: The case of remdesivir

THE NEED FOR REGULATORY COHERENCE: LESSONS FROM REMDESIVIR The story of Gilead’s drug remdesivir, one of the earliest candidates of repurposed medicines that showed promise for the treatment of COVID-19, should hopefully have lessons for regulatory authorities the world over. In reporting this story with my colleagues in the cross-border investigations team working on this project, we spoke to a number of experts from different parts of the world, in trying to understand how regulatory processes work. And what approvals from regulatory authorities mean for governments, for clinicians, for people and for companies. Image credit: Photo by Thirdman from Pexels Continues… To read … Continue reading Regulatory discoherence: The case of remdesivir

TRIPS waiver discussions: moving the needle

TRIPS WAIVER: THE NEEDLE HAS MOVED, BUT THE FIGHT IS ON EU bloc and others, push for TRIPS flexibilities, a defining departure from the past Countries are making slow but sure progress in discussing a proposal to temporarily waive certain obligations under the TRIPS agreement at the WTO. After an informal meeting of the TRIPS Council last week, countries are now having bilateral discussions seeking clarifications from co-sponsors of the proposal including South Africa and India. The waiver proposal seeks to allow all countries to not grant or enforce intellectual property protection for the duration of the pandemic, until widespread … Continue reading TRIPS waiver discussions: moving the needle

Q&A: Ellen Johnson Sirleaf, Co-Chair, the Independent Panel on Pandemic Preparedness and Response

In recent reforms-related discussions at WHO, some countries want independent teams to have access to outbreak sites going forward. Geopolitical pressures and a highly politicized environment has made global health security a defining agenda as a result of the pandemic. In an interview with one of the co-chairs of the Independent Panel on Pandemic Preparedness and Response (IPPPR), we tried to get a sense of the challenges that this panel faces. Q&A: Former President of Liberia, Ellen Johnson Sirleaf, Co-Chair of the Independent Panel on Pandemic Preparedness and Response Ellen Johnson Sirleaf [Image Credit: The Elders] [GHF] 1.       What are the … Continue reading Q&A: Ellen Johnson Sirleaf, Co-Chair, the Independent Panel on Pandemic Preparedness and Response

“Solidarity is not fairness”

The World Health Assembly draws all member states of World Health Organization to discuss health challenges, review actions, debate proposals and set future goals. It entrusts the secretariat to consult and engage with countries and other actors to coordinate vast areas of global health policy. This complex mechanism, some say, is now under threat. In this story, we will see why process matters and how it eventually impacts member states participation during the worst health emergency in a century. In addition, concomitant developments this week, dominated global health agenda. This crowded out the Assembly. Events that unfolded outside of the … Continue reading “Solidarity is not fairness”

The U.S. & Brazil team up to map W.H.O. reform

The U.S. and Brazil have teamed up to lay out a governance reform proposal for WHO in the context of the urgencies that COVID-19 has wrought upon. The timing of such a proposal is bemusing given the uncertainties around American engagement at WHO. It is expected that this proposal, along with others, will be discussed at the margins of the upcoming World Health Assembly next week, Zsuzsanna Jakab, Deputy Director-General, World Health Organization said at an event today. While there are some convergences with the earlier proposal put forth by Germany and France (such as on independent access to outbreak areas), on certain issues … Continue reading The U.S. & Brazil team up to map W.H.O. reform

The World Health Assembly During a Lockdown

The 73rd World Health Assembly resumes virtually next week at a time when large parts of Europe including Switzerland are locked down. What’s more the Director General of WHO, Tedros Adhanom Ghebreyesus is currently in self-quarantine after coming in contact with COVID-19 confirmed case. It is as somber a milieu that one could be faced with, when 194 countries come together to work through health challenges in the midst of this pandemic. And yet, despite the limitations, a fairly productive week awaits the global health community. It is understood countries continue to discuss with WHO on the ways of engagement including special … Continue reading The World Health Assembly During a Lockdown

Philosophers seek to make space in pandemic response

Sridhar Venkatapuram, is an Associate Professor at the Global Health Institute, King’s College London. He has spearheaded the Independent Resource Group for Global Health Justice (IRG-GHJ “URGE”), along with other philosophers and experts to address the some of the biggest questions of the times we are now living in. You can also watch this recent event where these experts lucidly explain what they intend to do in getting organizations to discuss complex global justice matters and the ethical issues that this pandemic has thrown up. He spoke to Geneva Health Files at length on how issues around allocation and distribution of medical products, for … Continue reading Philosophers seek to make space in pandemic response

WHO PQ listing for Remdesivir

A SHORT BLOG: Questions are beginning to emerge as to why WHO proceeded to give a prequalification listing to Remdesivir, when it was aware of the results of its Solidarity Therapeutics trial on the drug’s lack of impact on the treatment for COVID-19. At the bi-weekly presser (on 16.10) last week, WHO’s top officials discussed briefly the independent processes of the prequalification process for Remdesivir (officially announced on the 15th) and the results of the Solidarity trial (highlighted on the 16th.)(See Soumya Swaminathan and Mariangela Simão address this question, half way into the briefing) It is also understood that the results from the Solidarity trial … Continue reading WHO PQ listing for Remdesivir

A peek into COVAX machine

INSIDE COVAX: CONTRACTS & GOVERNANCE A closer look at the model contracts issued by the COVAX Facility and how it will be governed Gavi’s COVAX Facility is gearing into operations mode, from acquiring an approved legal status, to building its governance structure; issuing contracts to participating countries to negotiating deals with vaccine manufacturers; the COVID-19 vaccine machine is here. Contentious issues including liability provisions for participating countries and cost-sharing for vaccines doses for low and middle-income countries continue to hashed out behind the scenes. More than 180 countries are set to have joined the Facility. This story is based on a review … Continue reading A peek into COVAX machine

Inflection Point? TRIPS Waiver proposal

THE TRIPS WAIVER PROPOSAL – AN IDEA WHOSE TIME HAS COME? Picture this, more than half a year into the pandemic of COVID-19, upwards of 38 million infections, a million and more lives lost; vaccine nationalism embraced by politicians of all stripes; hedged bets on numerous bilateral deals; short-termist planning for vaccines for a pandemic that might last years; economies in dire straits; limited manufacturing capacities; inadequate supply of all medical products; all this on the back of rising infections and mortality, with millions still susceptible. We are here. And now consider this, a new legal measure which in one … Continue reading Inflection Point? TRIPS Waiver proposal

“Consult us more”: Countries to WHO

COUNTRIES WANT WHO TO CONSULT MORE: EXECUTIVE BOARD MEETING Countries praise WHO efforts on addressing the pandemic, but want more consultation A number of countries called on WHO for greater consultations on the decisions around the response to the pandemic at the Special Executive Board [EB] meeting earlier this week. From demands on consultations on the allocation framework that will determine access to COVID-19 health products, to the governance structure of the Gavi-led COVAX Facility, countries seemed to suggest that they have been left out of these consultation processes. To be sure, in a repeat of the World Health Assembly in May 2020, countries … Continue reading “Consult us more”: Countries to WHO

COVID-19 Diagnostics: The Full Picture

The pandemic has revealed the entrenched inequities in the world, and the access to diagnostics for COVID-19 is also illustrative of this. As per latest announcements here in Geneva, 80% of the world’s population – living in low- and middle-income countries – will initially receive only 20% of two kinds of antigen-based rapid diagnostic tests, while the remaining 20% – those in high and upper middle-income countries – can essentially procure 80% of these tests. Undoubtedly, it is welcome that 120 million tests for the pandemic will be made available to low and middle income countries over a period of six months. … Continue reading COVID-19 Diagnostics: The Full Picture

Gavi’s Discomfort With Civil Society on Vaccines

The hesitation of letting the door open to include civil society organizations, to effectively contribute to defining discussions on vaccines for the pandemic, especially for a massive immunization agency, is perplexing. Gavi – The Vaccine Alliance has vaccinated more than 820 million children, is backed by the most powerful funders of global health, and has received nearly $2 billion in pledges every year for the last few years[1]. Why is one of the biggest agencies in global health, wary of activists? Geneva Health Files tried to understand the reasons behind Gavi’s insistence on excluding Civil Society Organizations (CSOs) on COVID-19 … Continue reading Gavi’s Discomfort With Civil Society on Vaccines

Reading the AstraZeneca-Oxford Trial. What’s at stake?

Given the scientific, economic, political, commercial and moral compulsions around vaccines for the pandemic, the adverse event in a clinical trial of a leading vaccine candidate has been a humbling moment for citizens, governments, companies and hopefully, politicians. The goal of this expert interview is to help us read the recent pause in a leading clinical trial (AZD1222) following a suspected adverse event and the subsequent news of the resumption of the trial in the UK. A lot has been published already on this trial, already in phase III, but a few aspects worth underscoring. First, that Pascal Soriot, CEO of … Continue reading Reading the AstraZeneca-Oxford Trial. What’s at stake?

German-French Proposal For WHO Could Skew Balance Of Power In Donors’ Favor

The reform proposal led by Germany and France to strengthen WHO’s emergencies response and bolster global health security, could result in a balance of power tilting in favour of donor countries, diplomatic sources in Geneva say. Questions are being raised on whether the proposal truly seeks to empower WHO, or if it is also an attempt to fill the leadership vacuum caused by the retreat of the U.S. from the multilateral institution.   The proposal, being perceived in some quarters, as a genuine effort to strengthen multilateralism in global health, may be focusing too much on global health security; and risks … Continue reading German-French Proposal For WHO Could Skew Balance Of Power In Donors’ Favor

The story of Geneva Health Files

Geneva Health Files sent out the first edition of its newsletter on Substack. Here it is: Dear Subscribers, I am pleased and honored to be writing my first post to you. Welcome to the Geneva Health Files community.   An introduction is due for many new readers. I am an Indian journalist who has been working in Switzerland for the last decade. I publish Geneva Health Files, a website that tracks the governance of global health. Geneva Health Files was born and launched in the midst of the on-going pandemic. Here’s a story of how we got here. Global Health … Continue reading The story of Geneva Health Files

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The Covax Exchange: Gavi’s plans to let countries trade in vaccines

On Gavi’s table: plans to let countries trade “vaccine credits” like stocks Vaccines for COVID-19 are not yet a reality, but plans are afoot to enable trading in stocks of potential vaccines. Gavi says the plan will allow countries to exchange vaccines doses with each other, allowing each economy to optimise to their own needs. In order to get a firm commitment from rich countries to commit to buying vaccines from Gavi’s Covax Facility, the immunization agency is working on a plan for a “Covax Exchange” – where countries can trade their ‘vaccine credits’, according to sources. This is ostensibly … Continue reading The Covax Exchange: Gavi’s plans to let countries trade in vaccines

Sign up! Geneva Health Files Newsletter

Dear Readers, Thank you for your continued support to Geneva Health Files. We have been encouraged by your interest in keeping track of how key decisions in global health are being shaped in Geneva. Soon, we are starting a weekly newsletter. This will bring you deep dives on key global health issues, and relevant, curated content, delivered directly to your inbox. Given fast-moving developments on policies and politics in global health, we have decided to share our stories in a newsletter format so that you do not miss out on important analyses. Early results from our on-going survey on readership, show that … Continue reading Sign up! Geneva Health Files Newsletter

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“Policy Coherence” in the pandemic?

What the trilateral report on public health, IP and trade, says on the pandemic? A range of policy options drawn from different disciplines, is shaping the response to the pandemic, particularly in making medical products more accessible. From the use of flexibilities in copyrights for text and data mining to help drug discovery, to the use of competition policy to improve access to testing; from temporarily relaxing procurement rules, to easing regulatory processes; among many others. Many may lament that the pandemic is yet to witness any meaningful sharing of information and technologies. And yet, these limitations are in part … Continue reading “Policy Coherence” in the pandemic?

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WHO on the checks & balances for COVID-19 vaccines

As Russia approves a vaccine to fight against SARS-Cov-2, it is useful to note what global authorities, including WHO have said about the checks and balances in vaccine development in the context of COVID-19. Here is what Dr Soumya Swaminathan, WHO Chief Scientist has had to say about the processes around vaccine development in a recent conversation online. This was first broadcast by WHO on July 24, 2020, as an interaction on social media, moderated by Dr Margaret Harris. The following has been lightly edited for length and clarity. [There have been developments since, see Draft landscape of COVID-19 candidate … Continue reading WHO on the checks & balances for COVID-19 vaccines

The re-emergence of the WTO as a key forum for global health

ANALYSIS OF THE TRIPS COUNCIL MEETING JULY 30,2020 The coronavirus pandemic is slowly, but surely casting the World Trade Organization as a significant platform that could witness systematic efforts at the multilateral level to ensure better access to health products. This could be in the form of more formal deliberations amongst members to find ways to neutralise barriers to intellectual property, and not just patents, but other types of constraints that have affected access to diagnostics and health technologies. This pandemic has already brought into sharp focus, the inability to quickly provide essential diagnostics and medical products as a result … Continue reading The re-emergence of the WTO as a key forum for global health

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Trade in the time of the pandemic

THE TRADE IN MEDICAL PRODUCTS: THE STATE OF PLAY With every passing week in the prevailing pandemic, there is an urgency to understand and provide for the access to medical products and services. But what constitutes the trade in these crucial products? Who sells, who buys, how does it flow and what happens if it doesn’t? Geneva Health Files looks closely at the story of international trade that makes available medicines and medical services within existing constraints. The pandemic has shown how the restrictions in these pathways, puts the most vulnerable communities at risk of lacking access to both. The … Continue reading Trade in the time of the pandemic

The Three Month Mark: Geneva Health Files

Geneva Health Files completes three months – here’s what was covered In the three months since its inception, Geneva Health Files has published more than a dozen, in-depth, comprehensive, analytical stories on global health matters as they took shape in Geneva. The city is  the epicenter of pandemic-related international health policy-making and this publication is keeping a close watch on how these decisions are being made. While many of these stories are, what are called “exclusives” in journalistic jargon, others were straight-forward curation of routine, but important developments in Geneva. The publication is grateful for the trust shown by its … Continue reading The Three Month Mark: Geneva Health Files

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Elections at the World Trade Organization

Rising protectionism sparks keen interest in saving the multilateral trading system   As home to World Health Organization, Geneva is already at the centre of pandemic-related policy making. Last week saw yet another flurry of activity, on the shores of Lac Léman – at the World Trade Organization. Face-masked officials accompanied interested candidates who were there to present their case to become the next chief of the international trade body. At a time when WTO’s leadership is needed most, when world merchandise trade could fall by a third, the current WTO Chief Roberto Azevêdo will step down at the end … Continue reading Elections at the World Trade Organization

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Giving in to supply constraints: WHO’s Allocation Plan

New Details on WHO’s Draft Allocation Framework – A Deep Dive With more than 13 million cases of COVID19 in mid-July 2020, and rising, WHO has an unenviable and difficult task at hand, to map and decide who gets vaccines and medicines first. As expected, as it works its way on devising an allocation framework (first reported here), it is inevitably having to wrestle with politically contentious decisions in the backdrop of rising vaccine nationalism and countries striking up bilateral deals with drug companies. It will have to decide, and soon, if it will tackle head on – the elephant … Continue reading Giving in to supply constraints: WHO’s Allocation Plan

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COVID-19 Omnibus Resolution at the UN

Institutional responses to the pandemic continue to be shaped by international organizations in an effort to improve coordination and streamline processes to deal with COVID-19 in an uneven world characterised by weak health systems, differing approaches to science and varying commitments to address human rights issues. Under the aegis of the UN General Assembly, countries are working on a draft omnibus resolution on the COVID-19 pandemic. Typically, an “omnibus resolution” longer than usual resolutions, relating to all aspects of a particular issue, containing more information and seeking specific action from governments. While not binding, UNGA resolutions do serve as a … Continue reading COVID-19 Omnibus Resolution at the UN

WHO-led Research & Innovation Forum on COVID-19: July 2

WHO convened a Global Research and Innovation Forum on COVID-19 this week, bringing together 1300 experts virtually including researchers, funders and developers, to discuss the state of the science and to take stock of the six-month old pandemic which has resulted in more than half a million deaths, infected upwards of 10 million people in more than 200 countries, and has devastated lives and livelihoods. The forum was convened in order lay out the existing knowledge gaps, map emerging research priorities and decide on the critical research questions that need to be addressed going forward. The conference follows the first … Continue reading WHO-led Research & Innovation Forum on COVID-19: July 2

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GAVI COVAX FACILITY: Questions on access, pricing & governance

A first look at Gavi’s COVID-19 Global Access COVAX Facility (Preliminary Technical design) Gavi – The Vaccine Alliance, is putting together a plan to devise the supply of COVID19 vaccines when they become available, to those who need it. The question of how should the world work towards equitable access, is an incredibly complex one. Gavi’s plan, does not answer this question, yet. The keys to this question,  may lie in how the politics of vaccines plays out in the coming weeks and months. Gavi’s plan, a work in progress, raises worrying questions on its ability to ensure equitable access, … Continue reading GAVI COVAX FACILITY: Questions on access, pricing & governance

Monkeypox: From Neglect & Endemicity to PHEIC, Beyond Legal Characterizations.

By Axelle Ebode Monkeypox has never been classified among Neglected Tropical Diseases, but the way it has been managed is a case of neglect. As on August 17 2022, a total of 37,736 laboratory confirmed cases and 179, including 12 deaths have been reported to WHO by 93 countries across the world. Never before did monkeypox cases reach such numbers. Despite the declaration of a Public Health Emergency of International Concern (PHEIC) by the Director-General of WHO on 23rd July, 2022, the operationalisation of the response to this outbreak does not seem to be up to expectations, at least for the moment. … Continue reading Monkeypox: From Neglect & Endemicity to PHEIC, Beyond Legal Characterizations.

What does the global health industry mean by “digital health” and why it matters?

On the formation and roles of categories in the global health industry – the case of digital health By Robert D. Smith Throughout the past decade, and particularly during the COVID-19 pandemic, ‘digital health’ has seen an increase in interest and funding from a variety of actors. The World Health Organization has a digital health strategy, many nations have national digital health strategies, a plethora of global health organizations focus exclusively or in part on digital health, The Lancet and Financial Times Commissioned a report on digital health, hundreds of companies claim to focus on digital health and raise millions in investments. Beyond global health organizations, … Continue reading What does the global health industry mean by “digital health” and why it matters?