TWN Info Service on Health Issues
23 August 2023
Third World Network
www.twn.my

WHO: G20 health ministers refuse to endorse establishment of interim MCM Platform

New Delhi, 23 August (K M Gopakumar) – The Group of 20 health ministers have refused to endorse the establishment of an interim platform for medical counter measures (MCM platform).

The World Health Organization (WHO) and a few developed countries have been aggressively pushing in various international fora, including G20 and the UN General Assembly, to obtain endorsement for the establishment of the MCM Platform.

G20 heath minsters met on 18-19 August in Gandhinagar, India. This year’s G20 Presidency is held by India.

However, the WHO Director-General’s Tweet wrongly conveys that there is consensus on the establishment of an interim mechanism.  The Tweet states: “I welcome @g20org consensus on an inclusive interim mechanism for equitable and timely access to vaccines, tests, therapeutics and other medical countermeasures in the face of pandemics. We encourage continued dialogue among Member States to broaden support on all aspects of the mechanism”.

However, the reading of the actual outcome document of the G20 Health Ministers’ Meeting shows that the consensus is limited to the WHO consultation process for the establishment of an interim mechanism and not for the mechanism per se.

Paragraph 14 of the outcome document reads: “We welcome the role of G20 members (i) in WHO-convened INB and WGIHR processes to ensure linkages between existing networks and partnerships at national, regional and global level; (ii) WHO-convened process to establish the interim mechanism enabling the relevant functions of research & development, manufacturing, procurement, and delivery to the last mile. This will facilitate equitable inclusive, accountable and timely access to safe, effective, quality, and affordable medical countermeasures during health emergencies”.

[The Intergovernmental Negotiation Body (INB) is tasked to develop a WHO convention, agreement or other international instrument on pandemic prevention, preparedness and response (WHO CA+). In parallel there is the Working Group on Amendments to the International Health Regulations 2005 (WGIHR). Meanwhile a High-Level Meeting at the upcoming UN General Assembly will be adopting a political declaration on pandemic prevention, preparedness and response.]

It further states: “We are aware that the next health emergency may occur at any time. Therefore, we support a WHO-led inclusive consultative process for the development of an interim medical countermeasure’s coordination mechanism led by an inclusive decision-making arrangement including effective representation of LMICs and other developing countries and convened”.  (Bold added.)

Thus, the support is limited to an inclusive consultation process. This is clear from the previous version of the draft outcome document, which was under negotiation. The draft outcome document during the last week of July stated: “… we support the timely establishment of a mechanism in the interim to support equitable access and delivery of medical counter measures. We acknowledge the inclusive consultative process initiated by WHO on the agenda”. 

 Many developing country delegates told Third World Network that WHO is extraordinarily keen to establish the MCM Platform as a successor to its Access to COVID-19 Tools -Accelerator (ACT-A), a multi-stakeholder platform aimed to develop diagnostics, therapeutics and vaccines.

According to the WHO discussion paper on the MCM Platform: “WHO is working with Member States, partners and stakeholders to continue to learn the lessons of COVID-19, including those of the Access to COVID-19 Tools Accelerator (ACT-A), and build on best practices to strengthen MCM collaboration and coordination between existing institutions, networks and partnerships to be prepared for a new pandemic threat.”

Further, the paper states: “Drawing on the lessons of ACT-A and building from the ACT-A partners, all countries, including low-income and lower-middle-income countries, as well as regional organisations, agencies, the private sector, academia, civil society and financing partners, should have a role in an interim MCM mechanism”. Thus, it is very clear that the MCM platform is envisaged as an extension of ACT-A.

The concept note envisages the MCM platform to be a network of networks “to facilitate rapid and equitable global access to quality, safe and affordable MCMs against pandemic threats”. The scope of the MCM platform is:

• Pathogens with pandemic potential, including disease X; and
• New and/or scarce vaccines, therapeutics, and diagnostics while retaining the flexibility to develop and deliver other MCM categories as and when needed.

However, the role of WHO in the platform is not very clear.  The concept note proposes that WHO would host a lean Secretariat to carry out day to day functions and these would be scaled up and would be “embedded in the broader response coordination mechanism in the event of an emerging pandemic threat”.

WHO’s enthusiasm to establish the MCM platform citing the urgency of the next pandemic has created suspicion among Member States. TWN learned that many developing countries from Africa, Latin America and Asia have raised concerns on the WHO Secretariat’s rush to establish the MCM platform bypassing the on-going negotiations to amend the International Health Regulations (IHR) 2005 and on a new pandemic instrument.

Many developing countries view that establishment of the MCM platform outside the framework of IHR and the new pandemic instrument as an attempt to bypass a concrete legal obligation to establish regional and national production facilities to ensure equitable access to health produces required for the health emergency response. These countries also point out that the current proposal on the MCM Platform as a multistakeholder mechanism lacks accountability to WHO governing bodies.

Furthermore, developing country delegates also highlight that the concept note provides few details of the functioning of the MCM platform and maintain a strategic silence on the management of intellectual property and technology transfer related to the health products concerned. TWN learned that one of the developing country regional groups expressed concerns on the proposed MCM platform during the G20 Health Ministers’ Meeting.

In addition, the outcome document supports the expansion of the scope of the pandemic instrument to include anti-microbial resistance (AMR) as part of the new instrument, which is a proposal from the European Union (EU). Paragraph 11 of the outcome document states that “… we support the ongoing INB negotiations which are also considering provisions on AMR in the WHO CA+, noting the landmark opportunity these events and instruments provide for progressing work on AMR globally”.

This approach requires the massive expansion of surveillance infrastructure in developing countries without any corresponding obligation from developed countries to facilitate equitable access to newly developed health products to countries to address AMR. Further, developed countries have so far not promised financial and technical assistance to developing countries within the new pandemic instrument framework to establish such surveillance infrastructure.+