Comment on UNGA High Level Meeting

On 20th of September 2023, the UN General Assembly (UNGA) had a High-Level Meeting (HLM) on pandemic prevention, preparedness, and response (PPPR). It was an important opportunity for global leaders to demonstrate their commitment to equitable and effective PPPR.

Health crises like HIV, Ebola and COVID-19 have clearly demonstrated that protection of people’s health must be a top priority for all governments and institutions. Health is a human right and a cornerstone for global security and economic growth. Yet, public health services in many countries suffer from underfunding and privatisation, which increase inequality.

The inequality in access to medical technology has already led to millions dying from HIV and most recently, lCOVID-19 vaccine and medicine apartheid. Access to medical products cannot rely on the current system of total monopoly on knowledge, technology, and products, leading to inequality.

The HLM declaration on PPPR acknowledges leaders’ concern about inequality of access to medical products related to pandemics. To address inequality, the declaration mentions several critical issues including investment in research and development (R&D), technology transfer, local production, and affirms the Doha declaration on health and intellectual property rights. Yet, it uses non-committing language like “promote”, “call on countries” thus avoiding making any commitment for governments’ actions to take serious actions to address these issues.

For example, the declaration promotes technology transfer and know-how and encourages research, innovation and commitments to voluntary licensing, where possible to strengthen local and regional capacities for the manufacturing, regulation and procurement of needed tools for equitable and effective access. This caveat removes any potential commitments by governments or companies.

The declaration calls for improving timely and equitable access through building capacity for local and regional production, especially in LMICs but technology transfer is dependent on “mutually agreed terms”. This means leaving the decision on these fundamental measures in the hands of pharmaceutical companies. The experience of the companies’ continuing refusal to share technology and knowhow with the WHO mRNA technology Transfer Programme, is clear evidence of the danger of relying on voluntary actions by pharmaceutical companies.

The declaration acknowledges the critical role of the pandemic accord and the IHR review that are under negotiation in Geneva and calls on countries to conclude this work by May 2024.

PVA sees that effective PPPR cannot be achieved by keeping the current global system of dealing with health crisis as is. Handing pharmaceutical companies the fundamental decisions on supply, allocation and price, leads to huge inequality as illustrated during HIV and COVID crises. Effective PPPR that protects all people requires implementing transformative actions by all governments, including a commitment to:

1. Adequate financing of health systems including Primary Health Care and health workers.
2. Fair allocation of medical products relevant to health crisis according to health needs not ability to pay especially when supply is short.
3. Enabling local production in the Global South through sharing technology and knowhow, removing intellectual property barriers, and investing in manufacturing.
4. Implementing conditionalities on public funding for R&D and on purchasing agreements that mandate sharing technology and know-how with researchers, developers, and producers in the Global South and removing IP barriers.
5. Implementing transparency and accountability mechanisms for civil society and community to enable public scrutiny of funding decisions and implementation of programmes.
6. Implementing access and benefit sharing principal. Sharing technology, knowledge and intellectual property by manufacturers accessing pathogens and data should be mandatory during a pandemic to ensure equitable access to all medical. This is in addition to a % in-kind contributions that should be provided by manufacturers to WHO during a pandemic.
7. Empowering national and regional decision-making and refraining from creating more global bodies.

The PVA will continue campaigning for the pandemic accord to establish these 7 measures to ensure timely and equitable access to pandemic related medical products in order to protect everyone on the planet.

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