TWN Info Service on Health Issues
27 August 2024
Third World Network
www.twn.my

Health:  No consensus yet on Political Declaration on AMR for UN General Assembly

Geneva, 27 August (TWN) – Financing commitments and technology sharing to combat antimicrobial resistance are among issues that key developed countries have objected to, breaking potential consensus in a political declaration to be adopted in September at a High-level meeting of the United Nations General Assembly.

The 9 August 2024 version of the draft political declaration on AMR was put out by the co-facilitators of the negotiation process under the “silence procedure” that is an increasingly common decision-making process to wrap up difficult inter-governmental negotiations at the UN.

[The silence procedure was instituted during the COVID-19 pandemic when in-person meetings were not possible during the closure of the UN Headquarters premises in New York. Under this procedure, if a country supports a resolution (in this case a declaration), it does nothing. If it opposes a resolution, it sends an email breaking the silence; just one such action stops the adoption of the resolution and could trigger an extension of time for revisions or to resolve the objections. For more details see Global Policy Watch.]

TWN has learned that G77 and China, Canada, Australia, New Zealand, the European Union (EU), Mexico, Switzerland, Ukraine, and the United States (US) broke the silence on the draft political declaration and the co-facilitators are planning to table another version this week.

Informal consultations have been taking place since May 2024 with Vanessa Frazier and Francois Jackman, respectively Permanent Representatives of Malta and Barbados to the United Nations, as co-facilitators.

The Political Declaration is structured as follows: Preamble; Part I: Governance; Part II: Financing; Part III: Access; Part IV: Coordinated Multisectoral Approach; Part V: Research and Development, Training, Innovation and Manufacturing; Part VI: Surveillance and Monitoring; Part VII: Follow Up.  Each Part consists of recitals and commitments.

For an earlier assessment of the debate see: UNGA draft AMR declaration silent on TRIPS flexibilities, entrenches MNC hold.

Developed Country objections to the 9 August text

The EU and the US broke the silence on paragraphs on finance. This seems to be mainly on Paragraph 36 related to the target on finance, which states: “Facilitate sustainable funding from international cooperation to support the implementation of national action plans on antimicrobial resistance, with the target of achieving US$ 100 million to catalyse the achievement of at least 60 per cent of countries having achieved funded plans by 2030, through, inter alia, diversifying funding sources and increasing the number of contributors to the Antimicrobial Resistance Multi-Partner Trust Fund”.

This would be consistent with developed countries rejecting quantifiable financing targets as a crucial means of implementation across the US sustainable development agenda, and the mandated new collective quantified goal on climate finance to be determined this year under the Paris Agreement on climate change.

According to sources, Switzerland objected to Paragraph 89 dealing with technology transfer, which states: “Promote the transfer of technology and know-how and encourage research, innovation and commitments to voluntary licensing, where possible, in agreements where public funding has been invested in the research and development of antimicrobials, to strengthen local and regional capacities for the manufacturing, regulation and procurement of needed tools for equitable and effective access to vaccines, therapeutics, diagnostics and essential supplies, as well as for clinical trials, and to increase global supply by facilitating transfer of technology within the framework of relevant multilateral agreements”.

According to observers, the paragraph is already quite weak because it prioritises voluntary licensing, even when public funding is provided to research and innovation. Switzerland, the home of many multinational pharmaceutical corporations, seems to be objecting to the notion of States “facilitating transfer of technology within the framework of relevant multilateral agreements” as developed countries are strongly pushing back on technology transfer commitments in legally binding agreements, including on climate change and biodiversity.

Sources also revealed that both the EU and the US have objected to Paragraphs 69 and 70 dealing with the regulation of use of AMR products in the agricultural food industry including the meat industry. This is a sector that consumes massive amounts of antibiotics, reflecting the vulnerability to disease in the industrial livestock industry.

Paragraph 69 states: “Strive to meaningfully reduce, by 2030, the quantity of antimicrobials used globally in the agri-food system from the current level, taking into account national contexts, by, inter alia, investing in animal and plant health to prevent and control infections, reducing the need for and inappropriate use of antimicrobials, including through investing in and promoting alternatives to antimicrobials and increasing implementation of stewardship guidance, taking into account the Codex Alimentarius and standards, guidance and recommendations of the World Organisation for Animal Health; …”

Paragraph 70 states: “Strive further, by 2030, to ensure that the use of antimicrobials in animals and agriculture is done in a prudent and responsible manner and continue gradually phasing out the use of medically important antimicrobials for growth promotion, in line with the Codex Alimentarius Antimicrobial Resistance Standards and the standards, guidance and recommendations of the World Organisation for Animal Health”.

Apart from these objections, it is understood that Mexico and Ukraine objected to the reference to the BRICS grouping of countries in preambular Paragraph 12 , which reads: “Take note of the contributions by the Ministerial Conferences on Antimicrobial Resistance in 2014 and 2019 in the Netherlands, the Third Global High-level Ministerial Conference on Antimicrobial Resistance in 2022 in Oman, during which 47 Member States endorsed the Muscat Ministerial Manifesto, and Member State-led efforts, such as the First BRICS International Conference on Antimicrobial Resistance in 2024 in the Russian Federation, and the continuous commitment to have One Health and antimicrobial resistance as a priority of the G20 and G7”.

[BRICS was established in 2009 as a platform for cooperation among rapidly developing economies, comprising Brazil, Russia, India, and China, with South Africa joining in 2010. Iran, Egypt, Ethiopia, and the United Arab Emirates joined the group on 1 January 2024. Other developing countries including Malaysia have indicated they would like to be members too.]

G-77 and China

It is learnt that G77 and China also broke the silence on several paragraphs and the Chapeau of the draft political declaration of 9 August.

The Chapeau reads: “We, Heads of State and Government and representatives of States and Governments, are assembled at the United Nations on 26 September 2024, in accordance with General Assembly resolution 78/269, to review progress on global, regional and national efforts to tackle antimicrobial resistance, to identify gaps and invest in sustainable solutions to strengthen and accelerate multisectoral progress at all levels, through a One Health approach, with a view to scaling up the global effort to build a healthier world based on equity and leaving no one behind, and in this regard we: …”

G77 and China has proposed the addition of the word “including” before words “through a One Health approach”. This suggestion is to convey that there are multiple approaches needed to address AMR including “One Health”.

The 2016 Political Declaration of the High-level meeting of the General Assembly on antimicrobial resistance adopted this language: “Develop, in line with World Health Assembly resolution 68.7,1 multisectoral national action plans, programmes and policy initiatives, in line with a One Health approach and the global action plan on antimicrobial resistance, …” (Italics added.)

Another objection is related to the removal of the paragraph referring to unilateral coercive measures (UCM). Paragraph 43 of the 17 July version of the political declaration had stated: “Recognize the need to refrain from promulgating and applying any unilateral economic, financial or trade measures not in accordance with international law and the Charter of the United Nations that impede the full achievement of economic and social development, particularly in developing countries”.

Countries that are facing unilateral coercive measures often find it difficult to fulfil their obligations on the Right to Health. People in those countries are often denied access to life-saving medicines. A Report of the Special Rapporteur on the negative impact of unilateral coercive measures on the enjoyment of human rights clearly says: “Unilateral sanctions and over-compliance have a detrimental impact on implementation of all aspects of the right to health of all people in the countries under sanctions, including access to adequate medicine, healthcare facilities, medical equipment, access to qualified medical assistance, prevention and control of deceases, scarcity of health professionals, access to health facilities, training and access to up-to-date scientific knowledge, technologies, research, exchange of good practices.”

The report found that “In Venezuela more than 85 per cent of world available medicine does not reach the country, including blood products, antibiotics, insulin, dialysis supplies, antiretrovirals, vaccines and medicine against malaria, cancer and other diseases congenital heart disease, tuberculosis, chronic and communicable diseases, including within the programs authorized by PAHO, and sometimes even water”.

[PAHO, the Pan American Health Organization serves as the Regional Office for the Americas of the World Health Organization. Together with WHO, PAHO is a member of the United Nations system.]

The UN press release dated 13 June 2024 on the UN General Assembly debate on ending UCM stated: “The representative of Venezuela, speaking on behalf of the Group of Friends in Defense of the Charter of the United Nations, noted that unilateral coercive measures are applied against over 30 nations worldwide, including many from his group; thus they directly affect the daily lives of over a third of humanity”.

G77 and China also objected to Paragraph 82 with regard to the phrase “that are inconsistent with World Trade Organization agreements”. The rationale is not to limit the scope of barriers that are faced by developing countries as these go beyond WTO rules, especially unilateral trade measures that are increasingly imposed and the inability of WTO rules to address current challenges. Paragraph 82 reads: “Acknowledge the need to remove trade barriers that are inconsistent with World Trade Organization agreements, strengthen supply chains, facilitate the movement of medical and public health goods, and diversify manufacturing capacities across regions, especially during pandemics and other health emergencies among and within countries”.

The next iteration of the political declaration is expected to be presented by the co-facilitators this week.+