Participation & Key Priorities of CSOs & Communities in Pandemic Accord Consultations

The Intergovernmental Negotiating Body (INB) to draft and negotiate a WHO convention, agreement or other international instrument on pandemic prevention, preparedness and response (PPPR) will conduct a series of informal, focused consultations (“IFCs”) on key issues related to the proposed accord over the next two weeks. This statement sets out principal CSO and community priorities and questions related to the key issues to be discussed, as well as for the process of the IFC’s themselves.

CSO and Community Expertise Must be Meaningfully Engaged in the IFC’s

Though the WHO and the INB secretariat have committed to the importance of meaningful participation of civil society and community-led organisations throughout the drafting and negotiation process of the instrument, we note with concern that  the process remains a largely exclusionary one; with opportunities for CSO and community engagement either non-existent or mostly tokenistic. The same is true for the IFCs: CSO and community representatives were absent from the panel of technical experts for the first IFC, and were not significantly represented on the panel for the second IFC. We urge member states to ensure that the INB Bureau engages the crucial learnings and expertise from CSO’s and community groups in the IFC technical expert panels moving forward, to advance understanding of the issues and concepts raised in the IFC’s and inform the development of the Conceptual zero draft by member states.

Below are some principal CSO and community priorities and questions related to key issues that will be  discussed in the remaining three IFCs. We urge member states to consider these points during their own consulting engagements.

5th October: IFC on operationalizing and achieving equity

• In terms of operationalization, architecture developed as part of the pandemic accord should build on the successful examples of other pandemic and global health mechanisms by incorporating civil society representation into its planning, implementation and governance. The recently launched Pandemic Fund at the World Bank,  co-hosted by WHO, has incorporated CSO representatives from both the global north & south into its governance board, with these representatives having full voting rights alongside countries on the governance board. This builds on the success of The Global Fund to Fight AIDS, Tuberculosis and Malaria, which similarly incorporates CSO and community representation not just on its governance board as voting members, but also throughout its implementation structure. 
• There has been a grotesquely uneven distribution of COVID-19 vaccines and technologies, repeated more recently in the response to Monkeypox. This echoes the worst years of the HIV pandemic when lifesaving products did not reach people in low and middle-income countries. Any accord developed must be able to address existing inequalities to prevent future pandemics, prioritising rights-based, person-centred approaches, focusing on equity and equitable access, technology co-creation and transfer, as well as creating larger ecosystems for developing and producing supplies.
• We urge that the critical role of community-led responses are recognized as core components of an effective global pandemic preparedness and response framework and for the achievement of UHC as a whole. As demonstrated during COVID-19, stronger accountability and engagement of communities and civil society in key decision-making processes and governance structures are critical in preventing, detecting, and responding to pandemics. This build’s on the WHO’s own policies that “The meaningful participation of communities and civil society in national health planning processes and service delivery brings services closer to people in need; improves service acceptability, uptake and retention; empowers individuals with greater autonomy and self-care possibilities and promotes equity.”
• Health systems that can identify and respond to new disease threats are the foundation of genuine pandemic preparedness.  A pandemic accord which enables financing in resilient and sustainable systems for health, including through investments in community systems and community engagement, will help people access needed health services today and make these systems better prepared for tomorrow. 

7th October: IFC on intellectual property (IP), and access to pandemic response products

• We have seen the inequities of the HIV pandemic repeated again during the response to COVID-19 and Monkeypox ; pharmaceutical companies have and will prioritize profits and intellectual property over human lives. It is vital that any PPPR accord developed, alongside the mechanisms for its implementation and accountability, address rather than exacerbate these systemic challenges. Bold commitments and actions that build on principles of equity are necessary to enable knowledge sharing and effective technology transfers to address inequalities and strengthen health systems. 
• The pandemic accord should have provisions to maximize the production of safe and effective vaccines and other products by suspending relevant intellectual property restrictions  during pandemic outbreaks, and ensuring the mandatory pooling of all related knowledge, data and technologies so that any nation can produce or buy sufficient and affordable doses of vaccines, treatments and tests.
• The pandemic accord should utilise all policy and legal tools possible to ensure vaccines, treatments and tests are sold to governments and institutions at a price as close to ‘true cost’ as possible, as well as accurately reflect the role of public funding in any utilisable technologies. 
• Vaccine distribution plans should follow the WHO Equitable Allocation Framework with priority given to frontline workers, people at risk and resource-poor countries with the least capacity to save lives.
• It is essential that any pandemic accord implemented enables the financial resourcing needed to increase capacity for domestic manufacture and distribution of essential medicines, medical devices, and personal protective equipment (PPE) within countries or a cluster of countries in the region, so that when there is a pandemic, not only are countries protected against disruption of all medical supplies, but they can absorb the transfers of technology required to scale up production and access

14 October: IFC on one-health, AMR, climate, and Zoonosis

• Pandemics begin and end in communities. We know that zoonotic and vector-borne disease outbreaks typically erupt at a community level, and that most vulnerable communities are often located in hard-to-reach areas with poor infrastructure. These community members and organisations are often  the first to recognize an  unusual health event has occurred in their community: enabling, empowering, and equipping community members to recognize and respond to public health concerns forms an essential part of One Health surveillance and global health security. WHO itself states “Community engagement is also critical to promote risk-reducing habits and attitudes, and to support early detection and containment of disease threats.” Within any frameworks developed from the pandemic accord, community–based monitoring and systems should be supported and funded, and must link to  national surveillance  systems. 
• Vulnerable communities, especially in hard to reach areas, also rely extensively on animals for labour, sustenance and livelihood.  Community workers must be provided with the training and tools to allow them to not only report worrying unusual health events, but also to take steps to address them and protect their communities as well as the world at large against emerging pathogens.
• Importantly, this means that for discussion around resourcing and financing of health workforces, it is vital to include the work of peer and community-based health responses that are not part of formalized health systems, and that the work of these community health responses be included under the definition of healthcare workers. 

Signatories

• Frontline AIDS
• African Alliance
• African Vaccine Delivery Alliance (Community Co- Chair)
• Harm Reduction International 
• Vaccine Advocacy Resource Group
• Alliance for Public Health
• Physicians For Public Health
• African Sex Workers Alliance (ASWA)

A PDF copy of the statement can be found here

Signatories 

Signatories