As stakeholders reconvene in Geneva for the 12th session of the Pandemic Agreement, AIDS Healthcare Foundation (AHF) has advised on the Global South to carefully analyse the discussions if they are to benefit from the meetings.
The meeting will be held from November 4 to November 15 to fine tune the Pandemic Agreement.
The Pandemic Agreement is a potential international agreement currently being negotiated by the 194 member states of the World Health Organisation.
Many governments and WHO leadership felt it was necessary to develop a new agreement to address some of the weaknesses in capacities and lack of international cooperation that occurred during the global response to Covid-19.
In a telephone interview, the AHF country programme manager, Dr Enerst Chikwati called on the Global South to carefully examine the Pandemic Agreement negotiations which have stretched to three years.
"After the ravaging effects of Covid-19, the agreed time frame was one year.
"Considering the subtle implications and potential consequences of specific provisions, such as technology transfer, financing, and accountability, there is need to identify subtle or hidden messages, intentions, or consequences that may not be immediately apparent.
"The Global South ought to analyse beyond the surface-level or literal meaning and consider the context, tone, and attention to detail to uncover the underlying truth, nuances, or further implications.
"We must ensure enforceable provisions for the transfer of technology and know-how, without restrictive terms like 'voluntary' or 'mutually agreed terms," he said.
These qualifiers can disadvantage low- and middle-income countries (LMICs) by limiting their ability to access essential technologies needed to produce vaccines, therapeutics, and diagnostics.
Dr Chikwati said binding commitments for tech transfer were crucial components to establishing regional production capacity in the Global South.
The Global South should strongly oppose any language that restricts a country's ability to implement non voluntary measures -- such as compulsory licensing -- to address public health emergencies.
High income countries frequently use these measures and including limitations would create a double standard.
The use of "mutually agreed terms" and qualifiers that define Technology Transfer solely as "voluntary" measures could disadvantage low- and middle-income countries (LMICs) that may need to implement non-voluntary measures to address public health crises.
Non-voluntary measures, which can include compulsory licenses and other regulatory actions, are legally permitted and frequently used in high-income countries - including the United States.
These are also the subject of new legislation at the level of the European Union.
These terms can create double standards where high-income countries can employ non-voluntary measures while restricting low and medium income countries to voluntary means or mutually agreed terms for technology transfer.
Insight into PABS
What is PABS?
The WHO Pathogen Access and Benefits Sharing (PABS) system, currently being negotiated under Article 12 of the agreement, is designed to ensure that manufacturers of pandemic-related health products receive timely access to pathogen samples and genomic sequences from Member States.
In return, these manufacturers are required to share certain benefits derived from the use of this information to develop their products.
This is important because a percentage of benefits must be negotiated so that low and medium income countries- particularly those that lack production capacity - can have immediate access to vaccines, diagnostics, and other lifesaving counter measures.
Stakeholders must oppose delaying substantive discussions on PABS by leaving it for a separate protocol that may not be finalised for years. Fundamental aspects of the PABS system must be agreed upon now to ensure timely and equitable access to life-saving countermeasures for low- and middle-income countries without delay.
Fundamental aspects of PABS need to be agreed on now. Delaying the conclusion of negotiations around PABS not only leaves low to middle income countries at risk but also runs the risk of indefinitely dragging out discussion at a loss of LMIC bargaining power.
Insist on Equitable Benefit-Sharing Percentages: Reject the inadequate 5-20 percent range and advocate for a fairer distribution, such as 50/50, to ensure LMICs have sufficient access to essential health products.
Dr Chikwati urged countries to incorporate community-led-monitoring.
"With pandemics mostly tackled from a clinical point of view, Community-Led Monitoring (CLM) proved crucial in Zimbabwe from previous pandemics, the HIV pandemic to Covid-19. Civil society organisations led to ownership and accountability with specific solutions for enhanced responsiveness to local needs. Empowerment of local leaders and stakeholders led to better coordination and collaboration among stakeholders, resulting in more effective use of resources," said Dr Chikwati.
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With commitment from the highest office, President Mnangagwa appointed Dr Agnes Mahomva as Public Health Advisor to the President and Cabinet.
The office is meant to strengthen public health promotion and enhancing the country's response to emergencies.
"Dr Mahomva will advise on evidence-based decision-making and coordination between ministries, departments, agencies, communities, and the private sector," said Dr Chikwati.
Health systems are always in need of strengthening at country to global level.
As the pandemic preparedness negotiations currently stand, they are not giving even half the loaf.
The high income countries seek to repeat the Covid-19 era, which was an error, where they stocked vaccines while the low and middle income countries waited for crumbs.
Taking the same route would now be an error of choice by those who have. It is unacceptable.
A repeat of 2020 would reveal that the world learnt nothing from the effects of a recent devastating Covid-19 pandemic.
