Nina Schwalbe Profile picture
Feb 10 4 tweets 2 min read
💥Deadly #cholera outbreak continues in Malawi.

According to WHO, there have been nearly 37,000 cases and over 1200 associated deaths.

Every distinct is affected.

In the face of the deadliest cholera outbreak in the country’s history, vaccines are in (too) short supply.

🧵 map of cholera outbreak
Prompted by a severe vaccine shortage, in Oct 2022, the International Coordinating Group on Vaccine Provision (ICG), which allocates cholera vaccines to affected countries, announced that it would provide a single-dose regimen instead of two. headline from WHO decision on one vs. two doses.
A long list of countries report cholera outbreaks.

🗺 Afghanistan, Bangladesh, Burundi, Cameroon, DRC, the Dominican Republic, Haiti, Iraq, Kenya, Lebanon, Malawi, Mozambique, Nigeria, Philippines, Somalia, Syria, and Tanzania.

❌There are not enough vaccines to go around. countries with cholera outbreaks
Because of limited profitability, vaccine manufacturers have never prioritised cholera vaccines.

While there are currently 3 WHO-prequalified suppliers, one is set to end production this year.

Access to clean drinking water and sanitation is also key for prevention and control Screen shot of report that Shantha will stop producing chole

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More from @nschwalbe

Feb 10
🚨 The Intergovernmental Negotiating Body (INB) published the "zero draft" of the #pandemictreaty last week and briefed Member States about it this week.

The draft will be discussed in Geneva from 27 Feb to 3 March.

Summary of the process & highlights on the new text in this 🧵 Photo of INB
During the briefing, Member States expressed concern:

⏰ too little time between now and the next meeting
⌛️ too little time dedicated to complex issues.

Suggestions included postponing discussions on denser issues or inter-sessional work (which may disadvantage smaller states)
The “zero draft” follows the same structure as the "conceptual zero draft.”

✅ Introduction followed by objectives, guiding principles and scope
✅ Four chapters outlining substantive content
✅ Two chapters dedicated to proposed treaty governance.

Read 11 tweets
Feb 9
This week, in preparation for its meeting on 20 February, the Working Group on Amendments to the IHR (WGIHR) published the Technical Review Committee's (TRC) report on proposed amendments.

The TRC report is intended to help inform negotiations.

Update in this 🧵 Screenshot of report
The Director-General appointed the TRC to assess amendments proposed by member states for appropriateness, clarity, consistency, and feasibility.

The TRC also identified "shared values" including advancing equity, solidarity, cooperation, trust, transparency, and sovereignty. Excert from report
The Technical Review Committee's report:

✅ provides article-by-article analysis
✅ summarizes implications of each proposed amendment
✅ provides wording improvements.

There are currently no proposals on requirements or modalities to verify information with state parties.
Read 4 tweets
Feb 1
🔥 The "draft zero" of the #pandemictreaty is out.

There is no plan for an independent accountability mechanism (or any accountability mechanism).

As we explain in @TheLancet and 🧵, this is a serious oversight.

bit.ly/lancettreaty
We reviewed the evidence and interviewed experts from around the world.

Independent accountability is key for compliance with any international agreement.

bit.ly/monitoraccord
So far, the "zero draft" treaty

❌only proposes oversight mechanisms assessing achievements and gaps in preparedness capacity
❌doesn't mention independence
❌ mechanism for monitoring overall compliance won't be designed until (at least) the 1st treaty governing body meeting screen shot from draft zero
Read 5 tweets
Feb 1
💥Today the WHO Executive Board discussed the report by the Secretariat on governance for health emergency preparedness and response.

Brief summary of what happened in this 🧵 Image
Dr Mike Ryan explained that the proposals intended to align with, not circumvent, Member State processes.

He emphasized that countries should be at the centre of emergency response and that international instruments must enable countries to implement national plans. Photo of mike ryan
Dr. Tedros stressed

- the report is intended as a living document (that deliberations help refine).

- proposals will maintain momentum and inform INB and IHR processes without undermining them

- WHO's centrality in anchoring a cross-sectoral response in health. Photo of Tedros
Read 4 tweets
Feb 1
💥 This week holds promise for progress on the #PandemicTreaty.

The WHO Intergovernmental Negotiating Body (INB) will publish a “draft zero”.

In @TheLancet, we explain why there must be explicit provisions for independent monitoring of compliance. 🧵

bit.ly/lancettreaty
Why this matters?

Treaties are only effective if implemented.

And yet the first draft of the #PandemicTreaty lacked ANY reference to independent accountability, punting the issue until after adoption. photo of WaPo article
We analyzed existing monitoring mechanisms and consulted with experts worldwide.

We propose the establishment of an independent monitoring committee to monitor state parties' compliance with and reporting on the #PandemicTreaty. Graphic from report on structure of mechanisms
Read 5 tweets
Feb 1
🗞 UPDATE: The WHO Executive Board (EB) is meeting this week and next.

The 34 members are discussing (among other issues related to WHO's work):

🦠 governance of global health emergencies
💶 WHO's financing

Quick re-cap of the first two days 🧵 Photo from EB
This included a discussion on Tedros' 10 proposals for PPR.

Several states emphasized the WHO Secretariat should not get ahead of Member State negotiations.

Others expressed concern about a proposed high-level Global Health Emergency Council.

Japan and Canada emphasized there is a discussion to be had as to whether a high-level council would be better housed in New York.

The EU hinted at this too.

China and the UK cautioned against fragmentation.

Russia suggested the council would be "premature". Reps from Denmark, US and China with flags raised
Read 5 tweets

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