The evolution of the EU proposal on COVID-19 Response for WHA73: changes in the language on fundamental freedoms, intellectual property, privacy matters, stronger language for dealing with misinformation, and new additions on food and nutrition, among others. 

The COVID-19 pandemic has dramatically catalysed strategies on improving the access to medicines in the context of this crisis, unthinkable even a few weeks ago. The evolution of this draft shows that traditional concerns around incentives and innovation, while ensuring access and affordability, continues in the time of the pandemic.

The EU proposal for a CONSOLIDATED zero draft on a WHA73: “Covid-19 Response” was made public on 15 April 2020, has undergone a fair amount of transition over the last few days.

Knowledge Ecology International had published and discussed the zero draft in a post on April 15, 2020. And subsequently, its statement and response to the draft.

A version of the zero draft dated April 26, 2020, seen by this reporter [received from a credible source], shows significant comments on the draft from a range of member states on matters including IP, privacy, rights-related language and others. I am unable to publish the document in its entirety here, at the time of writing this, but find below excerpts from the text- the earlier version in blue and the latter version in red. This is by no means exhaustive. [Also note, that this is a blog post, not a fully reported news story]

Some of the significant changes in the course of these consultations, which will undoubtedly continue ahead of the Assembly, include:  

SOME OF THE CHANGES IN THE PREAMBULAR PARAS

• Brazil, for example, has emphasised on “…the legitimacy of the response to the pandemic be based on the ability to provide equitable and affordable access to health services and products to all, while respecting human rights…”  [PP2]

 PP2 Recalling the declaration of a Public Health Emergency of International Concern and the temporary recommendations issued on January 30 by the WHO Director General, based on the recommendations of the WHO Emergency Committee; [Version 15^th April 2020]

PP2BIS STRESSING THE NEED TO ENSURE THE EFFECTIVENESS AND LEGITIMACY OF THE RESPONSE TO THE PANDEMIC, BASED UPON THE ABILITY TO PROVIDE EQUITABLE AND AFFORDABLE ACCESS TO HEALTH SERVICES AND HEALTH PRODUCTS TO ALL, WHILE RESPECTING HUMAN RIGHTS, INCLUDING THE RIGHT TO HEALTH; [BRA] [Version 26^th April 2020]

• One also sees some efforts at weakening of language around “fundamental freedoms” by China. [PP6]

PP6 Further recognizing the need to respect the rule of law, fundamental freedoms and human rights of all, including persons in vulnerable situations, all across the spectrum of the response to COVID-19; [Version 15^th April 2020]

PP6 Further recognizing the need to respect the rule of law, [fundamental freedoms][del China] and human rights [comprising the right of healthcare for everyone][JPN] [of all][del JPN], including  [vulnerable groups][CAN] [vulnerable persons and][add ISR] persons in vulnerable situations,[ and stressing that there is no place for any form of discrimination, stigma, racism and xenophobia][China] [, including freedom of expression and the press ][USA] all across the spectrum of the response to the COVID-19 [pandemic; ][add Belarus] [del paragraph Bangladesh] [DEL PARA HAITI] [Version 26^th April 2020]

• It appears the USA has tried to water down some language around commending WHO, to “Noting” WHO’s role [PP9], in addition, in the same para, South Africa pushes strengthening  WHO’s emergencies program.

PP9 Commending the WHO leadership and broad support to Member States in the COVID-19 response [Version 15^th April 2020]

PP9 [Commending][del USA] [Noting][USA] the WHO [‘s crucial leading role][China] [leadership][del China] and [the WHO’s] [add Belarus] broad support to Member States in the COVID-19 response; [and recognising the need for adequate funding and support for WHO to lead a coordinated global response to address the health response and impacts of the pandemic][ETH, KEN] [and recognizing the need for adequate funding and support to strengthen the WHE programme and for WHO to continue to execute its global coordination mandate.”][South Africa] [Version 26^th April 2020]

• Other interesting changes include, in PP12, India suggests weakening of language around protection of ethics and “fundamental” rights. See below

PP12 Recognising the importance of a multisectoral Whole-of-Government, Whole-of-Society and a human rights-based approach, in the Framework of the SDGs, to addressing the COVID-19 pandemic, as well as ensuring protection of personal data, data security, ethics, and fundamental rights; [Version April 15, 2020]

P12 Stressing][RF][Recognising][del RF] [further] [add Belarus] the [crucial role of government in providing an effective response to the COVID-19 pandemic, while taking note of the] [add Belarus] importance of a multisectoral Whole-of-Government, [and][add Bangladesh, India] Whole-of-Society [and a human rights-based][del Bangladesh, China, India] approach, [including][add Bangladesh] in the Framework of the SDGs, to addressing the COVID-19 pandemic, [as well as ensuring protection of personal data, data security, [ethics][Del India], and [fundamental][del India, CAN] rights;][del Bangladesh, CAN] [human rights and fundamental freedpms][CAN] [move to PP4 bis][USA] [DEL PARA HAITI] [Version April 26, 2020]

All of this, illustrate how countries are dealing with lockdowns domestically and towards their own citizens.

• On IP: India pushes for local production, Brazil for affordable prices, and the US for “protecting incentives for innovation, including intellectual property rights”.

PP16 Recognising the need to achieve equitable access and availability of appropriate quality protective and other equipment, medical devices, medicines, vaccines and other health technologies related to COVID-19 and vaccines by scaling up research and development, clinical trials, and production, engaging early with regulators, as well as addressing market and supply-chain failures; [Version 15^th April 2020]

PP16 Recognising the need to[work to][CAN] [achieve equitable access][del Bangladesh] [at affordable prices][BRA] [and to][USA] [ensure][Bangladesh]  [availability][del USA] of [water and hand hygiene products,][ZAM] quality protective and other equipment, [as well as safe and effective][USA] medical devices, [medicines][del USA], vaccines, [therapeutics][USA] and other health technologies [related to][del Bangladesh] COVID-19 [as well as to ensure fair and equitable distribution and access to those commodities.][add Bangladesh] [by scaling up research and development, clinical trials, and [local][add India] production, engaging early with regulators, [including ethics committees][BRA] [protecting incentives for innovation, including intellectual property rights ][USA] [as well as addressing][del USA] [to address][USA] market and supply-chain [gaps and][add india] [capacity][USA] failures][Del Bangladesh]; [through engaging pharmaceutical industry ][ETH] [especially those failures that are allowing substandard, falsified or fraudulent goods into markets;][USA] [DEL PARA HAITI] [Version 26^th April, 2020]

• It appears, language around misinformation is also being progressively strengthened. [PP19]

PP19 Stressing the importance of engagement with and communication to the public to address COVID-19 disinformation and misinformation as well as of countering cyber attacks; [Version 15^th April 2020]

PP19 alt CONCERNED WITH THE PROLIFERATION OF DESINFORMATION AND MISINFORMATION, AS WELL AS CYBER ATTACKS, ABOUT THE PANDEMIC, ESPECIALLY IN THE DIGITAL SPHERE, AND Stressing the importance of PROVIDING OBJECTIVE DATA AND INFORMATION to the public to COUNTER SUCH PRACTICES; [BRA] [Version 26^th April 2020]

• In addition, there are new paragraphs to take into account the impact of the pandemic on food supply chains and nutrition. [COVID-19 is too big a pie for Nutrition to be left behind]

PP23 Recognising the economic impacts and disruptions to food supply chains due to COVID-19 will impact food security and nutrition, especially the poorest and most vulnerable countries, including small island developing states and countries in Sub-Saharan Africa [CAN] [Version 26^th April 2020]

PP24 Recognising the Joint Statement on COVID-19 Impacts on Food Security and Nutrition from the FAO, IFAD, the World Bank and WFP (21 April, 2020) on the occasion of the Extraordinary G20 Agriculture Minister’s Meeting, stressing how COVID-19 is disrupting the food system and jeopardizing food security and nutrition for all people, especially those in the poorest countries.[CAN][Version 26^th April 2020]

SOME OF THE CHANGES TO THE OPERATIVE PARAS

• There seems to be some disagreement on “global public good”, which is instead suggested by the US to read as “global benefit…” see below. There is also a new addition by Brazil.

OP2 Recognizes population-wide immunization against COVID-19 as a global public good for health and the crucial role of quality, safe, and efficacious vaccines therein; [Version 15^th April 2020]

OP2 Recognizes [the need for][USA] [population-wide immunization][del KEN] [development of a vaccine][KEN] against COVID-19 as [a in the][CAN] [shared][USA] global [public good][del USA] [benefit][USA] for health and the crucial role of [rapidly researching, developing, and deploying access to ][USA] quality, safe, [affordable][add Bangladesh, RF, Indonesia, CAN] and efficacious vaccines therein; [ensuring equal and affordable access once being developed][ETH] [Version 26^th April 2020]

OP2 alt alt AFFIRMS THAT ANY SAFE AND EFFICACIOUS VACCINE OR TREATMENT AGAINST COVID-19 MUST BE CONSIDERED AS A LIFE-SAVING TOOL FOR HEALTH WHICH WILL PLAY A DECISIVE ROLE IN HELPING COUNTRIES DEFEAT AND OVERCOME THE CURRENT PANDEMIC AND ITS SOCIAL AND ECONOMIC IMPACTS, THUS REQUIRING THAT SUCH RESPONSES BE MADE UNIVERSALLY AVAILABLE AND AFFORDABLE TO ALL; [BRA] [Version 26^th April 2020]

• A lot of discussion on what essential services must mean

OP3.1 Take necessary measures to ensure the continued functioning of all essential public services and health systems in the COVID-19 response, by securing the safety and access of health professionals and other frontline workers, particularly in humanitarian crises; [Version 15^th April 2020]

OP3.1 Take necessary measures to [ensure][del CAN, USA] [enhance resiliency to support][USA] [support][CAN] the continued [and safe][ISR] functioning of all essential public services [including WASH and][ZAM] and health [care][USA] systems [in the [context of the][BRA] COVID-19 [pandemic][BRA] [to also engage and involve women in all stages of decision-making processes][Haiti] response,][delete Belarus] {[in addition to][KEN] [including][ISR, USA, BRA] [by][del KEN] [securing]][del KEN] [ensuring][KEN] the [proper remuneration, training ][KEN] safety [of][CAN] and access [of to][CAN] [health workers,][add Bangladesh] health professionals and other [relevant] [add Bangladesh] frontline workers, [particularly][del India, Indonesia] [including][India, Indonesia] in humanitarian crises;}{del RF}[ and make all the effort needed to guarantee universal health coverage for their populations.][add Uruguay] [settings crises][Haiti] Version 26^th April 2020]

OP 3.1 alt Take necessary measures to maintain essential routine health services, including maternal, newborn, child, adolescent and sexual and reproductive health services, immunization, nutrition and infant and young child feeding during the pandemic to avoid secondary health impacts from the outbreak [ETH] [Version 26^th April 2020]

• What must “knowledge” mean:

OP3.3 Mindful of their obligation to fully implement the IHR, provide WHO in a timely manner with information related to the COVID-19 pandemic required by the IHR (2005), and share knowledge, data, and lessons learned with WHO and other Member States; [Version 15^th April 2020]

OP3.3[Mindful of their obligation to fully implement the IHR,] [delete Belarus, NO] [Spell out the IHR, RF] [and the importance of transparency and swiftly sharing information][JPN] [and that timely and adequate response and actions at source are most effective in containing the international spread of disease][India] provide  [the][USA] WHO [in a with][USA]timely [and transparent][add Bangladesh, India, Haiti] [manner][del USA] [with][del USA] accurate and complete][USA] information [data (including epidemiological, clinical, and genetic sequence data)^[1],  especially ][USA] related to the COVID-19 pandemic [required by the IHR][del USA] [Spell put the IHR, RF] (2005), [including on the origin, source and reservoir][India] and [swiftly and fully ][JPN] [where appropriate][USA] share [biological material][India] knowledge, [virus isolates][USA] [epidemiological and clinical][India] data, [and][del Bangladesh] lessons learned [as well as best practices][add Bangladesh] with WHO and other Member States [to further the understanding of, response to and research and development on the disease][india];  [Version 26^th April 2020]

• Bangladesh suggests language around protection of migrants

OP3.4 Adopt a human rights-based approach across the whole spectrum of the response to COVID- 19, including during the duration of states of emergency, in particular concerning temporary containment measures such as quarantine, paying particular attention to the needs of the most vulnerable groups, people in vulnerable situations and those in need, avoiding stigmatization and discrimination; [Version 15^th April 2020]

OP 3.4 bis Ensure inclusion of all migrants, irrespective of their migration status, in all aspects of the response to COVID-19, whether looking at prevention, detection, or equitable access to treatment, care or containment measures, or safe conditions of work;  [Bangladesh] [Version 26^th April 2020]

• The expanding meaning of digital…. (and a brilliant addition by Japan – “….including through paying special attention to the freedom of expression and the freedom of the media which hold governments  accountable.)

OP3.7 Ensure access, without discrimination, to reliable information from authoritative sources on the pandemic, on prevention and on access to testing and health services , including to demote misleading content and to address misinformation and disinformation, , including misleading content and explore the opportunities of digital technologies in particular through the use of big data and artificial intelligence, while respecting ethical principles and ensuring data security, and the protection of fundamental rights and personal data; [Version 15^th April 2020]

OP3.7 [Ensure][del CAN, USA] [Enable][CAN] [Facilitate appropriate][USA] access, without discrimination, to [reliable][del Bangladesh] information from [authoritative][del Bangladesh] [reliable][add Bangladesh] sources on the pandemic, [on][del USA] prevention [measures][USA] [and on][del USA] access to testing and health services, [including to demote misleading content][del Bangladesh, USA, Haiti] and to address misinformation and disinformation, , [including misleading content][del Singapore, Indonesia] and explore the opportunities of digital technologies {[in particular][del India] [including][India] through the [re-use][USA] [use][del USA] [existing digital tools, supplementing with][USA]  of big data and artificial intelligence}{del KEN}, [where merited and under close supervision to contribute to response efforts ][USA] [acknowledging the crucial role of digital health tools in empowering patients ][India] while [at the same time ][USA} [ensuring data security and protection of personal data based on ][add Bangladesh] [respecting][del Bangladesh, India] [ethical principles][del India][, human right][Singapore] [and ensuring [digital inclusion][India] [ensuringprotecting, consistent with applicable law,][USA] data security,  [and privacy][USA] and the protection of  [human][India, CAN] [rights and fundamental freedoms][CAN, Haiti]][fundamental][del India, Singapore, CAN] [rights][del Singapore, CAN] [including through paying special attention to the freedom of expression and the freedom of the media which hold governments  accountable][JPN] [including freedom of expression][Haiti] [and  personal data][del Bangladesh] ; [Version 26^th April 2020]

OP3.7 alt STRENGTHEN THE NATIONAL HEALTH INFORMATION SYSTEM AND IMPROVE DATA GOVERNANCE, THROUGH DIGITAL SOLUTIONS, TOWARDS BETTER MEASUREMENT AND ACCOUNTABILITY FOR RESULTS [BRA] [Version 26^th April 2020]

• Language around international treaties and TRIPS Flexibilities. Referencing human rights and trade to promote access – a suggestion by Brazil

OP3.8 As far as existing international treaties allow, remove the existing barriers in access quality protective equipment, medical devices and other technologies, medicines, and vaccines related to COVID-19; [Version 15^th April 2020]

OP3.8 [As far as existing international treaties allow, ] [Delete Belarus, India, Indonesia] [and domestic laws and regulations ][JPN] [Fully use TRIPS flexibilities as well as other international Treaties to][Indonesia] [Remove the existing barriers in][del CAN] [Enable][CAN] access [tp][CAN] quality [personal][CAN] protective equipment, medical devices and other technologies, medicines, and vaccines [related to COVID-19][del Indonesia],[ consistent with international treaties ][India] [ particularly to developing countries and countries with economy in transition, taking into account existing international treaties]; [add Belarus] [Q THL: grammatically, shouldn’t it be “…barriers to accessing quality…”?] [ THL comment :- strongly support]] [Version 26^th April 2020]

OP3.8 alt To work collaboratively to minimise shortages; remove the existing barriers; and strengthen the supply of quality, safe, effective and affordable vaccines, tests and diagnostics, medicines in order to meet the growing demand, including for COVID-19 by reducing prices and increasing global and local production, and to develop further cost effective, and innovative interventions; [Zimbabwe] [Version 26^th April 2020]

OP3.8 alt alt Facilitate access to quality protective equipment, medical devices and other technologies, medicines, and vaccines related to COVID-19 [USA] [Version 26^th April 2020]

OP3.8 alt alt alt  TAKING INTO ACCOUNT HUMAN RIGHTS AND HUMANITARIAN NORMS AND PRINCIPLES, WORK TO REMOVE UNNECESSARY BARRIERS TO TRADE UNDER THE EXISTING INTERNATIONAL LEGAL FRAMEWORK IN ORDER TO PROMOTE AFFORDABLE ACCESS TO QUALITY PROTECTIVE EQUIPEMENT, MEDICAL DEVICES AND OTHER TECHNOLOGIES, MEDICINES, AND VACCINES FOR THE CURRENT AND FUTURE OUTBREAKS [BRA] [Version 26^th April 2020]

• Research and Development – contested as expected

OP3.9 Invest in and support research and development of diagnostics, treatments, therapeutics, medicines, and vaccines as appropriate and to sustainably strengthen national R&D capacities for the current and future outbreaks, and collaborate in order to harmonise efforts as appropriate, with all relevant international actors in this field; [Version 15^th April 2020]

OP3.9 [Invest in and][del USA, BRA] support [both private sector and government-funded][USA] research [and][del USA] development [and manufacture][USA] of diagnostics, [treatments][del CAN], therapeutics, [medicines][del CAN], and vaccines, [and other medical products ][USA] as appropriate, and to sustainably strengthen national [regional and international ][USA] R&D [and manufacturing][USA] capacities for [the current and future outbreaks and][del USA], [andpre-clinical, clinical, and other biomedical and behavioural research regarding emerging and re-emerging infectious diseases, and to share all relevant information, including genomic sequences, viral isolates, clinical samples, epidemiologic information, research results and publications in an unrestricted and timely manner, ensure that research facilities working on zoonotic diseases or other harmful pathogens adhere to appropriate safety precautions, and to][USA] collaborate in order to harmonise efforts[as appropriate,] [delete Belarus] [ACCORDING TO NATIONAL LEGISLATIONS, ESPECIALLY REGULATORY AND ETHICAL ASPECTS, ][BRA] with all relevant [regional and ] [add Bangladesh] [international][del USA] actors in this field [to ensure equitable access and allocation of commodities][ETH]; including to equitably share the benefits][India] [, taking into account the need to achieve equitable access to these products][NO] [Version 26^th April 2020]

OP3.9bis Ensure the equitable and affordable access to diagnostics, medicines and vaccines to all countries; [Version 26^th April 2020]

OP3.9 ter ESTABLISH AND ENFORCE LEGAL MECHANISMS TO ENSURE THAT SUCH INVESTMENTS AND SUPPORT ARE APPROPRIATELY TRANSLATED INTO MORE AFFORDABLE PRICES AND FLEXIBLE PROPRIETARY ARRANGEMENTS TO PRODUCTS RESULTING FROM SUCH COMMON EFFORTS IN THE CURRENT AND FUTURE OUTBREAKS [BRA] [Version 26^th April 2020]

• Also on access – changes in language on historical lines.

OP4.2 Work collaboratively at international level to develop, test and produce safe, effective, quality diagnostics, medicines and vaccines for the COVID-19 response, and to facilitate the equitable and affordable access of people to them, including through voluntarily pooling their intellectual property for all COVID-19-related medical interventions; [Version 15^th April 2020]

OP4.2 Work collaboratively at[the][add Bangladesh, USA, Haiti] international [and national level][BRA] level [, taking into account  national efforts ][USA] to [undertake research][BRA] develop, [PROVIDE CLINICAL TRIALS ACCORDING TO INTERNATIONAL GUIDELINES AND GOOD PRACTICES][BRA] [test and][del BRA] produce [AND DISTRIBUTE AFFORDABLE ][BRA] [and facilitate equitable and affordable access to ][USA] safe, effective, [and][add Bangladesh]quality diagnostics,  [therapeutics][CAN] [medicines][del CAN] therapeutics][USA] and vaccines [for during][USA] the COVID-19 response, and to [facilitate][del THL [ensure][THL] the [timely][add Bangladesh] [their][CAN] [appropriate][USA] equitable and affordable access [for all][USA, Haiti] [of people to them][del CAN, USA, Haiti], [consistent with international legal frameworks under the WTO Agreement on Trade-Related Aspects of Intellectual Property Rights ][CAN]

Either: including through [the consideration of][CAN]  [of TRIPS flexibilities, including voluntary and compulsory licensing as appropriate ][Zimbabwe] voluntarily [pooling][del BRA] [licensing][BRA] [and/or licensing][THL] of their intellectual property for all COVID-19-related medical [supplies and ][India] interventions [and through implementation of the principles of open science][CAN];

Or: including through providing incentives for innovation, voluntary measures needed to share information, supporting industry-led collaboration and mutually agreed-upon knowledge-sharing that may facilitate more rapid development and access;  [USA] [Version 26^th April 2020]

OP4.2 alt NO: (i) Work collaboratively at international level to develop, test and produce safe, effective, quality diagnostics,  medicines and vaccines for the COVID-19 response, [including through  voluntarily pooling their intellectual property for all COVID-19-related medical interventions][Indonesia] [Version 26^th April 2020]

OP4.2 alt NO (ii) and to facilitate the equitable and affordable access to diagnostics, medicines and vaccines][Indonesia] [of people to them, including through  existing mechanisms for voluntary pooling and licensing of intellectual properties for all COVID-19-related prevention, diagnostic and treatment tools][del Indonesia] [Version 26^th April 2020]

• Incentives find their way in

OP4.3 Cooperate closely with relevant regional organisations, Member States, with the WHO, with United Nations system and the other relevant international organizations, to ensure and scale-up the production of, and equitable access to, adequate supplies, basic equipment, diagnostics, therapeutics, medicines and vaccines, in order to achieve an optimal and timely response in all countries; [Version 15^th April 2020]

OP4.3 Cooperate closely with [Member States,  the United Nations system, the WHO [and other] [add Belarus] relevant[ international and] [add Belarus] regional organisations, [Member States, [with][del CAN] the WHO, [WIPO and other specialised agencies in the ][USA] [with][del USA] United Nations system and the other relevant international organizations,] [delete Belarus] [civil society and the private sector][CAN, USA]…

Alt formulation: Cooperate closely with Member States, WHO, United Nations system and the other relevant [regional and][del KEN] international organizations [Bangladesh]…

[to ensure][del CAN, USA] [to promote the rapid and][USA]  scale-up [of][USA] the production of, and [timely, broad and equitable][USA} equitable [and affordable][Indonesia, Haiti] access to, adequate [training][ZAM] supplies [including hand hygiene products and water][ZAM], basic equipment, diagnostics, therapeutics, [medicines][del CAN] and [vaccines][del USA], [irrespective of income status, and based on clear and transparent public health criteria][Add Bangladesh], [in order to achieve an [effective and][BRA] optimal and timely][del USA] [timelyvaccines to meet global demand,  while at the same time supporting and maintaining innovation incentives for the COVID-19 ][USA] response in all [Member States][add Belarus] [countries;] [del Belarus][ with a special focus on low- and middle-income countries][add Bangladesh] [making sure that developing countries are included][NO] [Version 26^th April 2020]

• Stronger protection for academic resources

OP5.15 Continue to work with researchers, research funding organisations, the private sector, philanthropic organisations and further partners to ensure a focussed and coordinated R&D effort to develop and scale up countermeasures, including treatments and diagnostic tests for COVID-19; [Version 15^th April 2020]

OP5.15 Continue to [work][del KEN] [cooperate][KEN] with researchers, research funding organisations, the private sector, philanthropic organisations and [other][add Belarus][ further] [del Belarus] partners to [ensure promote][USA] a focused and coordinated R&D effort [through mutually-agreed upon knowledge sharing ][USA] to develop and scale up [production of critical medical supplies and deploy ][USA] countermeasures, including [evidence-based][BRA] treatments [therapeutics, vaccines ][USA] and diagnostic tests for COVID-19 [and future pandemics and for its equitable sharing including by means of exploring alternative incentive mechanisms and frameworks][India]; [DEL PARA HAITI] [Version 26^th April 2020]

On regulatory strengthening

OP5.16 Ensure that the WHO prequalification programme, working with regulatory authorities in Member States and at the regional level, facilitates the rapid processing and assessment of COVID-19 related requests; [Version 15^th April 2020]

OP5.16 Ensure that the WHO prequalification programme, working with regulatory authorities in Member States and at the regional level, [to streamline processes and leverage stringent regulatory approvals to ][USA] facilitates the rapid [WHO prequalification][USA] processing and assessment of [the safe and efficacious][USA] COVID-19 related [requests][del USA] [requestsvaccines, diagnostics, and therapeutics ; by accepting the decisions of stringent regulatory authorities on products related to COVID-19][USA]; [Version 26^th April 2020]

• How member states and other international actors will work on ensuring access in response to COVID19. (WTO is included in this iteration of the text; and ensuring “appropriate incentives for innovation” also makes an appearance here. New language on making available life-saving technologies free of charge / affordable prices to developing countries.)

OP5.17 Draft a plan, in consultation with Member States, in line with their respective obligations resulting from international treaties and with inputs from relevant international organizations including WIPO, GAVI, UNITAID, the Medicines Patent Pool, CEPI, the Global Fund to fight Aids, TB and Malaria, and UNICEF, to achieve equitable access to quality, safe, and efficacious COVID-19 vaccines and other health technologies necessary for COVID-19 response, for consideration of the WHO Governing Bodies; [Version 15^th April 2020]

OP5.17 [Identify and provide options Draft a plan][CAN], in consultation with Member States , in line with their respective obligations resulting from international treaties [, taking into account the voluntary efforts already undertaken ][USA] [and with inputs from relevant international organizations including [WTO,][Zimbabwe, JPN, CAN, USA]WIPO, GAVI, UNITAID, the Medicines Patent Pool, CEPI, [FIND, the COVID-19 Therapeutics Accelerator ][USA] the Global Fund to fight Aids, TB and Malaria, and UNICEF,][del KEN] [and the private sector to scale manufacturing and distribution capacities needed][USA] to [achieve promote][CAN, USA] equitable [timely and broad][USA] access to quality, safe, and efficacious COVID-19 vaccines [diagnostics and therapeutics ][USA] and other health technologies necessary for the COVID-19 response, [while ensuring there are appropriate incentives for innovation ][USA] [, in particular in developing countries,][China] for consideration of the WHO Governing Bodies; [DEL PARA][BRA] [Version 26^th April 2020]

OP5.17 alt TO DRAFT A PLAN, IN COOPERATION WITH MEMBER STATES AND RELEVANT INTERNATIONAL ORGANIZATIONS AND ENTITIES, TO ENSURE EQUITABLE ACCESS TO QUALITY, SAFE, EFFECTIVE AND AFFORDABLE MEDICINES, VACCINES AND OTHER HEALTH TECHNOLOGIES NECESSARY FOR COVID-19 RESPONSE [BRA] [Version 26^th April 2020]

OP5.17 alt alt Ensure fair and equitable distribution and access to quality, safe, affordable, and efficacious COVID-19 vaccines and other health technologies necessary for COVID-19 response while giving a special focus on low- and middle-income countries, preferably drafting a plan, in consultation with Member States, for consideration of the WHO Governing Bodies, once the safe and efficacious vaccines are available [Bangladesh] [Version 26^th April 2020]

OP5.17 bis HIGHLIGHT THAT LIFE-SAVING TECHNOLOGIES IN RESPONSE TO COVID-19 SHOUD BE MADE AVAILABLE TO ALL AS A MATTER OF PRIORITY: I) FREE OF CHARGE, AND WITH UTMOST URGENCY, TO HEALTH AND HUMANITARIAN WORKERS; II) FREE OF CHARGE TO LEAST DEVELOPED COUNTRIES; AND III) AT HIGHLY AFFORDABLE PRICES TO DEVELOPING COUNTRIES [Version 26^th April 2020]

[This above section on 5.17, was added to this blogpost, a few hours after it was first published.]

• And finally on the evaluation of the COVID-19 response

OP5.18 Plan for an evaluation, to be conducted in consultation with Member States at the earliest appropriate moment, on lessons learnt from the international health response to COVID-19, addressing the long-term consequences on health, , in order to assess, in line with the statement made by G20 leaders, gaps in pandemic preparedness with a view to establishing a global initiative on pandemic preparedness and response capitalizing on existing structures and programmes to align priorities in global preparedness4; [Version 15^th April 2020]

OP5.18 [Plan for a thorough, transparent, swift and independent review ][JPN] [[Organise][India] [Plan for][del India] an [independent, inclusive][South Africa] evaluation][del JPN], [to be conducted][del India, NO] [in consultation with Member States][del NO] at the earliest appropriate moment, on lessons learnt from the international health response to COVID-19, [including the role of the WHO][CAN] [addressing the long-term consequences on health][del India],{ in order to assess [ [, in line with the statement made by G20 leaders][del ISR, KEN, Singapore], gaps in pandemic preparedness [with a view][del ISR] to [establish[ing][del ISR] a global initiative on pandemic preparedness][del BRA] [help countries improve][BRA] [and][del Indonesia] response [, and recovery][Indonesia] capitalizing on existing structures and programmes to align priorities in global preparedness^[2];][del Zimbabwe]}{del JPN} [DEL PARA HAITI] [Version 26^th April 2020]

OP5.18 alt Immediately initiate an independent expert evaluation, in consultation with Member States, to review lessons learned from the WHO-coordinated international health response to COVID-19, addressing: the adequacy of WHO and Member State actions under the IHR since the outbreak began, a full assessment of the timelines, accuracy, and information sharing aimed at containing the outbreak at the source, with any recommendations; the verification of information by the WHO received from Member States and the use of other sources of information pursuant to the IHR, the timing of the Declaration of a Public Health Emergency of International Concern, with appropriate recommendations; identify gaps in national IHR preparedness capabilities; measures to strengthen the mechanisms for monitoring, early warning, and control of infectious outbreaks, including the zoonotic diseases originating from wild animals; the effectiveness of non-pharmaceutical interventions; efforts to speed COVID-19 research towards a vaccine, diagnostics, and therapeutic development and deployment and recommended actions related to the development, manufacturing and deployment of vaccines, diagnostics and therapeutics; and the long-term consequences on health security — in order to assess, in line with the statement made by G20 leaders, gaps in pandemic preparedness with a view to establishing a global initiative on pandemic prevention, preparedness and response, including recommended actions, capitalizing on existing structures and programmes to strengthen, hold accountable, and align priorities in global health security preparedness;^[3] [Version 26^th April 2020]

---

^[1] Countries should share samples of human pathogens for the purpose of rapid detection and in order to ensure rapid containment and response through monitoring.

^[2] Extraordinary G20 Leaders’ Summit Statement on COVID-19

^[3]Extraordinary G20 Leaders’ Summit Statement on COVID-19

If you like this story, do consider supporting Geneva Health Files – a reporting initiative run by this journalist. I seek to make this a reader-funded initiative to keep it going. Get in touch with me on how you can help. You can also make a contribution at paypal.me/genevahealthfiles (You will need a paypal account to do so.)

If you wish to share information or have suggestions, write to me: patnaik.reporting@gmail.com