March 9, 2023
By Nellie Bristol
COVID GAP
While negotiations continue at the World Health Organization (WHO) on a new pandemic accord and amendments to the International Health Regulations, plans also are evolving toward a UN high level meeting September 20 aimed at compelling health emergency preparedness to the top levels of government. While the meeting is critical to refocusing the world’s attention, establishing a mechanism to sustain long term political support is essential to successfully countering future threats.
The High-Level Meeting (HLM) on Pandemic Prevention, Preparedness and Response (PPR) was called for in a UN resolution last year. Representatives for Israel and Morocco, who are co- facilitating the meeting’s preparatory process, set out a broad agenda in recently released document as well as scheduling a hearing in May to get input from non-governmental organizations.
Under the resolution, the HLM is expected to result in a “concise and action oriented political declaration” that will commit heads of state to improving the governmental and multilateral capacities required to successfully identify and contain a global health emergency. The aim is to complement ongoing negotiations at WHO while moving the topic beyond the health sector to address the broader array of pandemic-related needs including financing, social protections, and educational supports.
Raising pandemic preparedness and response to the highest political levels was a key recommendation from the May 2021 report of the Independent Panel for Pandemic Preparedness and Response. Commenting on the UN resolution establishing the HLM, former chairs Helen Clark and Ellen Johnson Sirleaf said the panel was “clear that a lack of coordinated political leadership globally had resulted in failures of governments to secure agreements in support of common goals to tackle the health, social, and economic challenges posed by the COVID-19 pandemic. We also stressed that pandemic threats can be managed only through coordinated, multilateral, multisectoral, whole-of-government, and whole-of-society approaches.”
The session could foster mutual responsibility for successful pandemic preparedness and response. “High level leaders would be committed through a particular forum to sustain political attention on the topic of PPR, potentially driving the kind of political will to highlight deficiencies and address gaps,” said Layth Hanbali of Spark Street Advisors. Leaders who make specific commitments through the HLM can be held to account by their peers, as well as civil society, he added.
Kate Dodson, vice president for global health at the UN Foundation, noted that the HLM will occur at a busy time as two other high level review meetings—one focusing on universal health coverage and another on TB—also are planned for this year’s General Assembly, an unprecedented number of health-related sessions for a single year. This is on top of the accord and IHR negotiations at WHO, expected to continue into 2024.
Dodson added that it will be important that the pandemic HLM support the WHO negotiations but also provide additionality. Some of the worst consequences of COVID-19 for many people were not health effects, but economic, educational, and human rights losses. While the Geneva negotiations are hammering out country obligations and responsibilities in developing health capacities, higher level engagement is required to address the totality of pandemic-related needs.
While the HLM is sure to provide a much needed bump in attention to pandemic PPR, longer term commitments also will be needed. A January 2022 paper in PLOS analyzing the outcomes of the five health-related high level sessions called thus far-- HIV/AIDS (2001), non-communicable diseases (2011), antimicrobial resistance (2016), tuberculosis (2018), and universal health coverage (2019)—shows mixed outcomes. While the meetings resulted in a “boost to the political discussion on relevant health topics and augmented the visibility and importance of global health challenges in the international agenda,” only the session on HIV/AIDS was followed by strong political mobilization, funding increases, and reduced mortality. Even then, the authors warned against attributing the surge to the UN event alone noting the strong overall attention to the health threat during the period. To build on the impact of UN health meetings, the authors argue that in addition to working with WHO and health ministries, “engaging the higher political level represented by the UN [General Assembly] and heads of state and government is critical.”
Despite the current flurry of pandemic related negotiations and plans, many of the issues remain complicated and fraught. There is still is a distinct possibility the efforts could fail to bring about the transformational changes needed to establish needed safeguards. Real protections will require sustained attention and focused political will. Toward that end, HLM participants should support a standing high-level panel focused on the issue. For example, the Independent Panel recommended convening a Global Health Threats Council led by heads of state and comprising relevant state and non-state actors. Its role would be to maintain political momentum, promote collective action, monitor progress toward capacity building goals, and ensure accountability.
The fear and disruption brought on by COVID-19 are already fading into memory. But pandemic risks remain and are in fact increasing. While the HLM will refocus attention on the actions needed to prepare, longer term solutions are required to ensure continued progress. For the HLM to have concrete, lasting impact, participants should commit to a high-level standing body like the Global Health Threats Council that will marshal the attention and resources needed to protect the world from the threats to come.
