The 73rd World Health Assembly (WHA) was held virtually on 18-19 May 2020, due to the measures put in place globally to arrest the COVID19 pandemic. Heads of state and non-State actors, including PSI, convened to agree on a far-reaching resolution to intensify efforts to control COVID19.
Fourteen heads of states addressed the online Health Assembly, showing the seriousness of the global public health and social-economic crises which the “COVID19 WHA” reflected. They and other heads of delegations spoke about the raging emergency, and spent a considerable time raising more political issues. A major highlight of the Health Assembly was adoption of a resolution to intensify efforts to control COVID19.
Statements and politics
There were the usual brickbats on the appropriateness or otherwise of having Taiwan recognised as an observer at the Health Assembly. Russia and Ukraine also exchanged words on how military annexation of the Crimean region might have affected the COVID-19 response in the region. The impact of US-sponsored sanctions against Cuba, Iran and Venezuela on fighting the pandemic in these countries was also brought to the fore.
In what was probably the most enigmatic speech at the Health Assembly, the Prime Minister of Barbados, Mia Mottley, pointed out that “nations rich and poor are seeking inspiration” as COVID19 “casts a brighter light on the inequities in our society”. And speaking as Chair of the Conference of Heads of Governments and States of CARICOM, she expressed the unalloyed appreciation of the countries and peoples in the Caribbean to Cuba “for its unswerving assistance during this pandemic”.
Arguably, top on the list of this was the delegation of the United States. The country’s president who announced a condemnable cutting off of funding for WHO turned down an invitation to address the Health Assembly, saying it is “a puppet of China. They’re China-centric, to put it nicer". The United States statement was thus delivered by the secretary of health and human services, Mr Alex Azar, who used to be a key lobbyist for the powerful pharmaceutical industry.
He said, “one of the primary reasons this outbreak spun out of control” was the alleged “failure” of the World Health Organization (WHO) “to obtain the information that the world needed”. He then added; “that failure cost many lives”. But not surprisingly, he had not a single word to say on the woeful record of the United States’ presidential bungling from Mr Donald Trump’s dismissal of SARS-CoV-2 as a “Chinese virus” which could have no more impact than the common flu.
Several other countries such as Germany, South Africa and Sweden rose to the defence of the WHO. The German Chancellor, Angela Merkel stressed the need for international coordination to fight the pandemic, and the leading role of WHO in this regard. And she called for improved funding of the WHO to enable its robust fulfilment of this role.
Sweden declared “strong support and appreciation for WHO’s crucial role and irreplaceable leadership in this pandemic.” It further added that; “now, maybe more than ever, is the time to strengthen our international cooperation and show global solidarity.” The South African delegation said: “we must take the opportunity to appreciate the guidance from the technical experts of the WHO.”
The Chinese President Xi Jinping in his speech stressed the fact that “solidarity and cooperation is our most powerful weapon to defeat the virus.” He added, “China will provide 2 billion US dollars over two years to help with COVID-19 response, and with economically affected countries, especially developing countries”. He promised, that his country would make any vaccine it develops for COVID19 a global public good, which means China and Chinese companies will not aim at making any profit from it.
The Qatari delegation made reference to the Doha declaration, stressing that the global response must “include the utilization of compulsory licenses to ensure equitable access to medical products. Intellectual property must not be a barrier to health for all.”
A landmark resolution?
The “COVID19 Response” resolution aimed at bringing the world together to fight the COVID19 pandemic was clearly the landmark decision at #WHA73. It was sponsored by 130 countries out of the 194 member states of the WHO and calls for:
“universal, timely and equitable access to and fair distribution of all quality, safe, efficacious and affordable essential health technologies and products including their components and precursors required in the response to the COVID19 pandemic as a global priority.”
But, as the People’s Health Movement rightly observed:
The resolution contains some encouraging language on TRIPS flexibilities, palliative care and other issues. However, it fails to address some key issues that have become central to the COVID19 response. Gender-based violence, effects of lockdown on hunger and crisis for the migrants are some of them.
It could thus be seen as a victory, including for the PSI which has called for a “people over profit” approach for defeating the new coronavirus and determining the post-COVID world. But there are significant gaps which we must now address. The political gains made with the adoption of this resolution cannot be consolidated without putting comprehensive measures in place to build well-funded, universal and democratically run public services.
Lack of decent housing, water and sanitation, decent employment and income, quality education and early child development, food and nutrition and social protection, undermine people’s access to health and are thus obstacles to an effective global COVID19 response. These all have to be addressed, and with a keen sense of urgency.
The resolution’s take on the protection of health workers on the front lines also lacks an important detail. PSI has stressed that global shortage of personal protective equipment is an emergency within the global public health emergency. But when WHO’s recommendations for respiratory protection of health workers caring for suspected or confirmed COVID19 patients (except in contexts of aerosol-generating procedures) is limited to medical masks, in the face of mounting evidence that this might not be adequate, commitment to “provide health professionals, health workers and other relevant frontline workers exposed to COVID19, access to personal protective equipment and other necessary commodities”, is not enough.
The inadequate consideration of the necessary PPE (i.e. respirators – N95/FFP3/FFP2 masks) to ensure the respiratory protection of health workers and halt the unacceptably high rates of infection and deaths amongst health workers is based more on the economics of availability than the evidence of health workers’ needs.
The main issue of contention in the process of drafting the resolution was the question of access to treatment and a vaccine against the virus. The final draft adopted by the Health Assembly partly reflects compromises emerging from behind-the-scene “duels” and trade-offs during its draft. These were centred on “highly technical, but politically charged language over the rights of countries to override patents for vital health remedies”. The United States, for example, was strongly against the clause on “universal, timely and equitable access” to COVID19 treatments. It wanted a supposedly “balanced approach”. It eventually pulled out of negotiations on the draft and did not support the resolution.
Time and again, we have seen how far such a “balanced approach” benefits pharmaceutical industries, who clearly or subtly sabotage the primacy of people’s needs in favour of maximizing their profits. The sharpest picture of this dynamic in relation to the COVID19 response can be seen on the canvass of the Coalition for Epidemic Preparedness Innovations (CEPI).
Borne out of lessons drawn from the 2014 Ebola outbreak in West Africa, CEPI was conceived in 2015 as “public private partnership” and launched two years later at the World Economic Forum in Davos. It has brought together countries like the United States, Japan, Norway, Germany and subsequently the EU, UK and Australia with pharmaceutical giants like Johnson & Johnson, Pfizer, and Takeda, philantro-capitalist foundations like the Bill and Melinda Gates Foundation and Wellcome Trust and civil society organisations like Médecins sans Frontières.
Big pharma on the CEPI consortium ensured reversal of the original Equitable Access Policy of the coalition, for all vaccine-manufacturing contracts to first secure approval by a public review board. And this was done in a clearly opaque manner in 2018. Médecins sans Frontières raised an alarm, but the corporations still had their way, whilst CEPI insisted, some would say tongue-in-cheek, that this does not remove from its stated aim of ensuring equitable access.
Thus, while we cannot but welcome the modest victory which the COVID19 Response resolution signifies, countries (particularly in the Global South), trade unions, communities and the civil society movement must be fully aware of the landmines that still lie ahead and be ready to fight for the people’s health over corporations’ wealth as the world races towards a vaccine to stop COVID19 in its tracks.
The world is wading through a storm on uncharted waters. The 73rd World Health Assembly marked a significant step forward in the quest for how best to weather the storm. It presents a point of departure for international collaboration in addressing the public health emergency in what has become a general and systemic crisis. But the world can do much more.
While the draft of the “COVID19 Response” resolution was being negotiated, the call for a “People’s Vaccine” was equally made. This call for “Uniting Behind A People’s Vaccine” was made by over 150 dignitaries including serving and former heads of states, notable economists and global policy makers, the need was more clearly stated for:
a global guarantee which ensures that, when a safe and effective vaccine is developed, it is produced rapidly at scale and made available for all people, in all countries, free of charge. The same applies for all treatments, diagnostics, and other technologies for COVID19.
This brings us to the crux of the matter; the need for a fundamentally radical new economy and approach to global governance which unambiguously puts the people over profit. We cannot solve the historic problem we are engulfed in with new improved versions of the logic that brought it to be. The example of CEPI given earlier (which by the way is a key player in the current race for a COVID-19 vaccine) shows that “universal, timely and equitable access” is necessary but not sufficient, particularly for many low- and middle-income countries.
Trade unions, communities and the civil society movement must make the necessary connections – defend whatever concessions we win but fight for much more. We must make clear once and for all who the profiteers are and how the rules of the game must not just be amended but changed, if we are to really work for a better and more just world for all.