The US Department of Health and Human Services (HHS) is charged with leading the US delegation to the 76th World Health Assembly, and convened a Stakeholder Listening Session on May 3, 2023. The Stakeholder Listening Session is designed to seek input from stakeholders and subject matter experts to help inform and prepare for US government engagement with the World Health Assembly.

AVAC’s Samantha Rick, Manager: Multilateral/Pandemic Preparedness and Response (PPR) Advocacy Specialist, delivered these remarks orally at the Listening Session.

“I am speaking as a representative of AVAC, an international non-profit organization that leverages global partnerships to accelerate ethical development and equitable delivery of effective HIV prevention options, as part of a comprehensive and integrated pathway to global health equity.

As the document for the World Health Assembly for this topic has not been released, we reference the document provided for the EB earlier this year. In regard to the proposals for strengthening the Health Emergency Preparedness, Response and Resilience (HEPR) framework, we have some concerns about implementation. The governance piece relies on the development of the Pandemic Accord under the Intergovernmental Negotiating Body (INB), and the current draft text does not have sufficient accountability measures to ensure that Member States adhere to the provisions set out for actions in health emergencies. In addition, the suggested textual edits, particularly by the US, weaken any language that could compel Member States to take actions for the global good by inserting ‘voluntary’, ‘suggest’, ‘should’, and ‘intend to’ in front of many of the agreements. These negotiations give us less hope that the HEPR framework governance reforms will be effective.

The systems proposals are intriguing, but can only be implemented if there is a recognition that in order to have strong surveillance and reporting mechanisms, we must also guarantee access to benefits of these mechanisms, namely through true access to medical countermeasures developed from the data shared in the course of collaborative surveillance. The EB document references ACT-A as an example of access to medical countermeasures – this is concerning, as the ACT-A system did not provide access broadly, in a timely manner, or in an equitable fashion and relied heavily on voluntary donations. An end-to-end system for access to medical countermeasures must be based on need (both financially and degree to which an outbreak is acute and posing national and regional risk).

Proposal 10 also needs some significant additional thought. The reputation of the WHO within countries and globally is at a low point and more creative communication strategies to strengthen WHO’s position in the center of the HEPR architecture are needed. To that end, a more inclusive WHO would go a long way. The exclusion of NSAs and civil society from the INB negotiations is a glaring example of squandering an opportunity to open up proceedings and dispel any misinformation around the process. Within the WHO, civil society organizations are treated the same as philanthropies and corporations. Expanding the pool of CSOs would help to gain trust in the WHO as a central coordinating body for health emergencies. A key lesson from US support for both PEPFAR and the Global Fund has been the essential role of civil society in governance and accountability, and we now look to the US to champion civil society inclusion in WHO processes.”

About the World Health Assembly

The World Health Assembly is the decision-making body of WHO. It is attended by delegations from all WHO Member States and focuses on a health agenda prepared by the World Health Organization Executive Board. The main functions of the World Health Assembly are to determine the policies of the Organization, appoint the Director-General, supervise financial policies, and review and approve the proposed programme budget.