Values, Policies and Rights

Proposal for a WHO treaty on pandemics raises concerns
Ramakrishnan N; Gopakumar K: Third World Network, 2021

This policy brief critically analyses the option of a new pandemic treaty or other international legal instrument to enhance the pandemic preparedness and response. Part I provides an account of the origin of the idea of the pandemic treaty. Part II examines whether there is any legal vacuum which prevents the needed pandemic preparedness and response. Part III deals with the fragmentation of international health response and raises the concern that the new treaty will exacerbate fragmentation instead of consolidating the response. Part IV explains what to expect from the new treaty and the major process-related issues involved in the new pandemic treaty negotiations. The authors argue that instead of developing a new international instrument it is better to strengthen or amend the existing IHR.

#WHA74 WRAP: Pandemic Treaty Talks Eclipse Prevailing Vaccine Inequities
P Patnaik: Geneva Health Files, Edition #60, Geneva

More than half way into the 74th World Health Assembly, a serious discussion on the efforts to address vaccine inequities is noted in this article to 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. In an issue that recaps the discussions at the current World Health Assembly, the Geneva Health Files in this piece notes "it seems that there has not been enough attention on the here and the now in the midst of all the discussions on preparedness. In our view, this risks looking away from and a silent acceptance to the mounting deaths from COVID-19. It also shows unwillingness to acknowledge and accept the limitations of the current mechanisms that have not met expectations on not only vaccine equity but an overall international mechanism for meeting the needs on diagnostics and treatments for COVID-19". In a packed agenda for the week long remote meeting, the question is raised of why there is no dedicated forum to discuss why vaccines have not been delivered as promised, including to seek accountability for this and to revisit assumptions made about the mechanisms set up for this, including the ACT Accelerator and COVAX.

A New WHO International Treaty on Pandemic Preparedness and Response: Can It Address the Needs of the Global South?
Velásquez G; Syam N: The South Centre, Policy Brief 93, 2021

A recent joint communiqué by 25 Heads of Government and the WHO Director-General have called for the negotiation of a pandemic treaty to enable countries around the world to strengthen national, regional and global capacities and resilience to future pandemics, as a binding instrument to promote and protect health in the context of pandemics. The authors recommend that if WHO Member States decide that an international treaty is the way forward, it would be important to have clarity from the outset on the elements and areas that will be the subject of negotiation, by identifying aspects that the current crisis has revealed are not working. They recommend building on the existing instruments, notably the International Health Regulations and discuss critical issues that should be addressed in such a treaty if negotiations are launched,given that countries differ in needs, levels of development and capacities to implement treaty obligations.

COVID-19: Make it the Last Pandemic
The Independent Panel for Pandemic Preparedness & Response: Geneva, 2021

The Independent Panel for Pandemic Preparedness and Response was set up by WHO to review the state of pandemic preparedness before COVID-19, the circumstances of the identification of SARS-CoV-2 and responses globally, regionally, and nationally, particularly in the early months of the pandemic, and its health system, social and economic consequences. This report of the panel indicates that preparedness was limited and disjointed, leaving health systems overwhelmed when actually confronted by a fast-moving and exponentially spreading virus. The panel concluded addressing this gap not requires sustained investment, and new approaches to peer review of country preparedness, and to the international alert system. The panel suggests that the legally binding International Health Regulations (IHR) (2005) did not facilitate rapid action, and that the consequence of delays in response impacted most on already disadvantaged people.

Peoples Health movement message on Colombia
Peoples Health Movement (PHM): South Africa

In an open letter to the Ambassador Extraordinary and Plenipotentiary, Colombia, the Peoples' Health Movement urged the government to abide by the Constitution, stop the violence, and join hands with citizens in defeating COVID urgently, and enacting policies that promote people’s health, equality and social justice. The PHM wrote: "We note with deep concern the criminalisation of protest and high levels of violence perpetrated on legitimate and peaceful protestors by the Colombian government security forces and armed civilian groupings. Credible sources report the use of lethal weapons, including rifles and semi-automatic guns, against protesters around the country by police. At least 37 people have been killed; some reports give larger numbers. There are also reports of disappearances. As a result of extreme militarisation, some cities, including Cali and Palmira, are running out of food and medicine supplies; Internet signals and social networks essential for communication among citizens and communities have been blocked; and levels of fear and uncertainty are growing among the population. The protests occur against the background of the COVID-19 pandemic. COVID is exacerbating poverty and inequality. The number of Colombian people living in extreme poverty grew by 2.8 million last year. And more and more people face hunger.

Further details: /newsletter/id/64836
The role of gender power relations on women’s health outcomes: evidence from a maternal health coverage survey in Simiyu region, Tanzania
Garrison-Desany H; Wilson E; Munos M; Sawadogo-Lewis T; et al: BMC Public Health 21(909), 1-15, 2021

The authors investigated how gender power relations within households affected women’s health outcomes in Simiyu region, Tanzania. Women who reported being able to make their own health decisions were 1.57 times more likely to use condoms. Women who reported that they decide how many children they had also reported high contraception use. Seeking care at the health facility was also associated with women’s autonomy for making major household purchases. The authors observe that the association between decision-making and other gender domains with women’s health outcomes highlights the need for heightened attention to gender dimensions of intervention coverage in maternal health. They suggest that future studies should integrate and analyze gender-sensitive questions within coverage surveys.

Equitable recovery from COVID-19: bring global commitments to community level
Loewenson R; D’Ambruoso L; Minh Duc D; Hjermann R; et al: BMJ Global Health 6:e004757, 2021

High level speakers at the December 2020 United Nations General Assembly pointed to the growing inequalities and stress to health, social, economic and democratic systems caused by COVID-19, calling for a range of collective interest driven responses and measures for a sustainable recovery. The pandemic, lockdown and other responses, along with underfunded, poorly prepared and overstretched public sector social and health systems in many countries worsened many dimensions of health and well-being that were already facing deficits, generating a rising health and social debt in communities, the scale and long-term consequences of which are as yet unknown, especially for the most marginalised in society. Rather than ‘getting back to normal’, the authors argue that recovery and ‘reset’ demands change to tackle the inequalities, conditions, services, socioeconomic and environmental policies that made people susceptible and vulnerable to COVID-19. Economic recovery should not replicate the features of the global economy that are generating pandemic and other crises. The authors suggest further that for global aspirations to translate into benefit for communities, an equitable recovery should include significant investment in: (1) universal, public sector, primary health care-oriented health services; (2) redistributive, universal rights-based and life course based social protection; and (3) people, especially in early childhood and in youth, as drivers of change.

Immunity certification for COVID-19: ethical considerations
Voo T; Reis A; Thomé B; Ho C; et al: Bulletin of the World Health Organisation99(2),155–161, 2021

Some countries have considered using immunity certification as a strategy to relax restrictive measures by issuing an immunity passport for people certified as having protective immunity against SARS-CoV-2, the virus that causes COVID-19. The World Health Organization has advised against the implementation of immunity certification because of uncertainty about the length of time of immunity and concerns over the reliability of methods for determining immunity. However, even if immunity certification became well supported by science, the authors note many ethical issues in terms of the implementation process, its uses, measures in place to reduce potential harms, prevention of disproportionate burdens on non-certified individuals and potential violation of individual liberties and rights.

Tanzania’s Ministry of Health now urges precaution against Covid-19
Owere P: The Citizen, Tanzania, February 2021

The Tanzanian Ministry of Health has now urged citizens to take all the required precautions against Covid-19 including wearing face masks. The statement issued on Sunday, February 21, 2021 by the Head of the Public Relations Unit, Gerard Chami said the Ministry continues to monitor and stress the implementation of precautionary measures against various non-communicable and communicable diseases including outbreaks and Covid-19. Precautions included hand washing, use of sanitizer, exercising, and protection for all those at risk such as the elderly, obese people, and those with chronic illnesses. The statement also urged Tanzanians to get proper nutrition including fruits and vegetables, use natural remedies registered by the council of traditional healers and as advised by relevant professionals and to visit health facilities on witnessing symptoms of illness.

Unhealthy geopolitics: can the response to COVID-19 reform climate change policy?
Cole J; Dodds K: Bulletin of the World Health Organisation 99(2), 77-168, 2021

The geopolitics of pandemics and climate change intersect. Both are complex and urgent problems that demand collective action in the light of their global and trans-boundary scope. In this article a geopolitical framework is used to examine some of the tensions and contradictions in global governance and cooperation that are revealed by COVID-19. The authors argue that the pandemic provides an early warning of the dangers inherent in weakened international cooperation. The world’s states, with their distinct national territories, are reacting individually rather than collectively to the COVID-19 pandemic. Many countries have introduced extraordinary measures that have closed, rather than opened up, international partnership and cooperation, including in border closures, restrictions on social mixing, domestic purchase of public health supplies and subsidies for local industry and commerce. For the poorest countries of the world, pandemics join a list of other challenges that are exacerbated by pressures of scarce resources, population density and climate disruption, and have a disproportionate impact on those living with environmental stresses. The authors highlight the need for a coordinated global response to addressing challenges that cannot be approached unilaterally.