Nina Schwalbe Profile picture
Feb 10, 2023 11 tweets 4 min read Read on X
🚨 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.

The preamble and principles remain consistent with the conceptual draft, including references to the IHR, Intellectual Property Rights, WTO and TRIPS.

The principles emphasize a central role of WHO and suggest the adoption of Common but Differentiated Responsibilities (CBDR)
Equity is a chapter and theme throughout. Proposals include:

🔗 WHO Global Pandemic Supply Chain and Logistics Network
🏭 increased manufacturing capacity
💰 mandated transparency in publicly-funded research
🔐 access and benefit-sharing (ABS)
💉20% of products set aside for WHO
Strengthening and sustaining capacity priorities, including:

🎯 centrality of Universal Health Coverage
🧑🏽‍⚕️ skilled domestic and global public health emergency workforce
👀 simulation exercises, regular monitoring, and universal peer review
🤝 human rights protections Screen shot of document outline
Coordination, collaboration and cooperation include:

🗺 WHO as the directing and coordinating authority
🌍 Solidarity and protecting the most vulnerable
🦃 One Health, whole-of-government and whole-of-society approaches
📓 Health literacy, addressing mis- and dis-information
Financing suggestions include dedicating:

💶 5% of health expenditure to domestic pandemic preparedness, recover and response (PPRR) funding
💳 a certain percentage (TBC) of GDP to international pandemic PPRR funding Screen shot of document outline
The treaty would be governed by a Conference of the Parties, reviewing implementation every three years, supported by:

🧮 administrative “Officers of the Parties” and a secretariat provided by WHO.

🔗 inclusive consultative body for advice/technical input (not decision-making)
The draft is silent on any oversight or accountability mechanism for the treaty, only to be agreed upon at the governing body's first meeting.

Proposed monitoring and accountability only focus on achievements and gaps.

bit.ly/lancettreaty
🗓 The treaty would enter into force 30 days after the 30th country ratifies. No reservations or exceptions are allowed.

٪ Once adopted, additional protocols would require a two-thirds majority. Screen shot of document outline

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More from @nschwalbe

Apr 17
🚨The proposed WHO #PandemicAccord is released.

💥It has no provision for monitoring compliance or details on state reporting requirements other than “periodically.”

🛑This leaves Member States with no accountability for any of their treaty commitments (weak or strong).

🧵 screen shot of proposal first page
A positive? The Proposal articulates some ambitious intentions (e.g. tech transfer, pathogen sharing).

However, there is a lot of hedging language (e.g “take steps,” “consider supporting,” & “according to national law”)

Details on key issues (e.g. PABS, OneHealth) remain TBC. example of hedging language
An accompanying draft resolution for the World Health Assembly proposes creating working groups on “sticky issues” (PABS, OneHealth, Coordinating financing).

Notably missing is a working group for accountability or any type of Compliance Committee. DG asked to create expert group for PABS
Read 9 tweets
Apr 6
🚨New York’s COVID-19 vaccine strategy failed to prevent deaths among the most vulnerable.

💰Despite shortages, many younger people accessed vaccines ahead of schedule, particularly in high-income areas.

📈Our latest in the Journal of Urban Health



🧵 bit.ly/COVIDZIP
screen shot of study
📊 In the first 3 months of rollout, when vaccines were in limited supply, low-income areas with high proportions of older people had lower coverage rates than wealthier areas.

They also had higher mortality over the year. graphic from study
@CutlandClare @WitsUniversity When vaccines were no longer in short supply, uptake for ALL income groups 65+ rose above 80%.

Bottom line: Scarce doses were misallocated to younger people from wealthier income areas. table from paper
Read 5 tweets
Jun 6, 2023
🚨 The "Zero Draft" political declaration for the UN General Assembly High-Level Meeting on Pandemic Preparedness and Response is out.

There is little new. Most content reiterates ongoing discussions.

At 14 pages, it is not the "short" document many had called for.

Quick 🧵 screen shot of zero draft
The draft lacks any language on independent monitoring or compliance and is nearly silent on accountability for pandemic PPR commitments.

It lists 29 principles, highlighting the impacts of the COVID-19 pandemic, including inequity and disruption to health and other systems. screen shot of principles (...
The draft includes concerns about inadequate financing for pandemic response and points to the need to align with WHO processes to negotiate a pandemic treaty and amend the IHR while linking health to other sustainable development dimensions (economic, social, & environmental). screenshot of text
Read 10 tweets
Apr 21, 2023
The Working Group on Amendments to the International Health Regulations (made up of member states) just wrapped up its third meeting in Geneva.

Progress is being made, but political tensions persist.

More in this 🧵 from the closing (as negotiations are behind closed doors) photo of meeting of WGIHR
Member states discussed proposed amendments related to compliance, implementation, and public health response.

Inter-sessional work ahead of WGIHR4 includes a discussion of amendments, informal consultations and informational briefings. screen shot of provisional ...
African Member States, negotiating through the African Group provided a revised proposal on the “Implementation Committee” and emphasized universal membership and support to countries. definition of the Africa Group
Read 7 tweets
Apr 20, 2023
Confidence in vaccines has dropped in 52 of 55 countries (for which data are available), according to Unicef's just published State of the World's Children.

Overall, the statistics on childhood immunization are grim.

A few highlights (or lowlights) in this 🧵 graph of vaccine confidence
Over the past decade, despite growing efforts to expand immunization, there has been a backsliding in the number of zero-dose children (children who have not received any vaccines).

1 in 5 children remain un or under-immunized. Zero dose children globaly
Backsliding in vaccination coverage during the pandemic resulted in the loss of hard-won growth.

(In much of public health, reaching the last 20 % can be much harder than reaching the first 20%) graph of backslding in immu...
Read 7 tweets
Apr 19, 2023
Tuberculosis and COVID-12 both hit hardest people who are marginalized or in poor health.

There are strong synergies in actions required to prevent, prepare for and respond to both.

That's why we need high-level political UN commitments in September.

Sceptical? Read this 🧵
Both TB and pandemic prevention, preparedness and response (PPR) require:

🕳 Closing the gap in prevention, treatment and access to care.

📚 Implementing evidence-based solutions

🚆 Accelerating research, development, rollout and access to medical countermeasures Screen shot of report cover
⬆️ Ramping up services for the vulnerable

🙋🏽‍♀️ Implementing an equitable, gender-sensitive, rights- and people-centred approach

🦠 Investing in infection prevention and control Image of infection preventi...
Read 9 tweets

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