Nina Schwalbe Profile picture
Apr 19, 2023 9 tweets 5 min read Read on X
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...
As experienced during COVID-19, pandemics pose a significant threat to the gains achieved in TB prevention and control.

TB programs backslid for the first time in decades. TB deaths increased during ...
A concise, action-oriented PPR declaration can lay the groundwork for a healthy future.

We call on governments to:

🌍 Articulate a cohesive, shared, and multisectoral approach at national, regional and global levels. call for multisectoral appr...
🔗 Reinforce other initiatives, including the #PandemicAccord and IHR amendments.

🗺 Create a standing head-of-government and head-of-state level council to drive cohesive, ongoing vigilance and concerted action on current and future pandemic threats. TOR for Threats Council
💉🧫 Secure commitment to a new pandemic countermeasures framework.

💶 Secure commitment to domestic financing for health systems, as well as financing for PPR as a global public good. photo and quote from Elen S...
🪨 Secure commitment to ensure a well-functioning, sustainably financed WHO to support countries to reduce the risk of health emergencies.

📊 Secure agreement on a robust independent monitoring and accountability framework and hold a follow-up summit how an accountability struc...
Read more in our briefing note with @StopTB @PandemicAction @GFadvocates @UNU_IIGH on the outcomes required at the Pandemic Preparedness and Response High-Level Meeting in September.

bit.ly/PPRTBHLM Links between TB and PPR

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More from @nschwalbe

Dec 3
🚨Day 2 of #PandemicAccord talks started with progress!

🤏Co-chairs reported states are “very close” to agreeing on R&D (Art 9) & talks will resume later to finish the text

🔍Latest drafts show only a few words remain unresolved (strengthening or softening obligations)

🧵 picture of progress
🗣️Day 1 talks covered financing (Art 20) & Pathogen Access & Benefit Sharing (Art 12), but INB co-chair didn’t elaborate on progress.

🚛Informal talks on those issues and supply chain (Art 13) continue today.

🐦‍⬛Today's formal talks turn to surveillance & One Health (Art 4/5)
🪄Multiple stakeholders cautioned against an over-reliance on new "innovative finance", noting the most reliable option remains public finance

🏊‍♂️A stakeholder suggested creating a pooling mechanism for funding product development where states opt-in to get tech transfer rights
Read 6 tweets
Sep 9
🔙#PandemicAccord negotiators were back at it in Geneva Monday to iron out sticking points in the draft text.

🔎 Today’s opening (and open) sessions centered on the pact’s legal architecture and its complementarity and coherence with the IHR.

🧵 picture of opening session
⌛️All parties pointed to the urgency of the talks given the rise of Mpox, making clear the importance of covering the full PPR cycle.

⏰To have a deal by the end of the year, chairs noted Nov 12 was the deadline to call a WHA special session in 2024. screen shot of co-chairs
📜The legal architecture question remains: should the pact be adopted under Art 19 or 21 of WHO Constitution?

👐The negotiations are being held on the basis of Art 19, giving it greater authority. But it also has a higher bar for ratification & potentially less universality.
articles 19 and 21 from the WHO Constitution
Image
Read 9 tweets
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

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