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the EU and WHO
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Many people don’t know that the World Health Organization has been working on a legally binding international treaty instrument designed to prepare the world for the next pandemic. There has been very little media coverage and public discussion around this monumental treaty which, once ratified, would direct the public health decisions and responses of all signatory countries. It’s vital that Canadians are aware of these global negotiations and the potential far-reaching implications for our own domestic health care responses in the future.
The World Health Organization (WHO) is a UN agency that was formed in 1948 for “the attainment by all peoples of the highest possible level of health” with 55 member states initially coming together and pooling their resources to combat epidemics such as malaria, Ebola, smallpox, and other serious infectious diseases harming those largely in the developing world.
The WHO has 194 members today and its stated aim is to “coordinate the world’s response to health emergencies, promote well-being, prevent disease and expand access to health care. By connecting nations, people and partners to scientific evidence they can rely on, we strive to give everyone an equal chance at a safe and healthy life.”
Governance of the WHO is through the World Health Assembly (WHA), which is composed of all member states and meets yearly to approve policies, the budget and elect the director-general, who serves for a five-year term.
The International Treaty on Pandemic Prevention, Preparedness, and Response (Pandemic Treaty), initiated by the WHO, is a proposed global treaty to prevent and manage future pandemics.
From November 29 to December 1, 2021, the WHA convened a special session to discuss a proposed treaty and begin the drafting process. This was only the second special session since the WHO’s founding in 1948.
The Pandemic Treaty is currently in the negotiation and drafting phase, ultimately due to be signed by May 2024. The WHO established the Intergovernmental Negotiating Body (INB) in December 2021 to spearhead the negotiation, drafting and input into the proposed treaty. Since then, the INB has held several meetings to gather input and discuss proposals for the treaty.
At their last meeting in July, the INB approved an outline for the new treaty, and an initial working draft is published on the WHO website. The WHO has also recently called for video submissions from the public to inform the drafting process. This was the question: Based on your experience with the COVID-19 pandemic, what do you believe should be addressed at the international level to better protect against future pandemics?” You can watch the public’s video submissions at this link: Second round of public hearings (who.int). Negotiations and consultations continue until their next meeting in early December 2022, when they will have a first draft ready for discussion.
The WHO has stated that the treaty could “ensure better preparedness and equitable response for future pandemics, and to advance the principles of equity, solidarity and health for all.”
The proposed accord “could take the lessons learned from the COVID-19 pandemic and use them to build back better. Equity is one of the key principles being discussed as part of the work on the new accord.
“A new accord could promote political commitment at the highest level, through ensuring an all-of-government and whole-of-society approach within countries, and sustained and sufficient political and financial investment within and among countries.”[1]
As proposed, a legally binding treaty would see power given to the WHO to direct the global health management of pandemics. The treaty will likely define and classify what is to be considered a pandemic, and this could consist of very broad classifications including potentially even non-infectious diseases like cancers or heart diseases. Once a pandemic is declared, the WHO would require countries to adopt specific response measures. The working draft of the treaty also proposes a reporting requirement to the WHO and advises that there should be a “global peer review mechanism to assess national, regional and global preparedness capacities and gaps.”
The government has not yet stated its official position on a proposed treaty.
However, when MP Lewis questioned the Prime Minister on the government’s engagement with the WHO on controversial amendments to the International Health Regulations, which would have provided the WHO with expanded powers, Prime Minister Justin Trudeau responded as follows:
“As an active member of the WHO, Canada has always been there to push for better science and to push for better impacts in the way we collaborate around the world. Canada is a leading voice on ensuring not only that we make it through this pandemic, which is continuing to be ongoing, but also that we prepare for future pandemics, which, unfortunately, may well be the reality for decades and generations to come. We will continue to be active, strong participants in international fora around health while always respecting and protecting Canada’s sovereignty and choices to make the right decisions for its own citizens.”
As one of the WHO’s 194 Member States, Canada has the opportunity to provide direct input to the treaty drafting process and will vote on the final treaty at the World Health Assembly (WHA) meeting in May 2024. Each member state will be asked to ratify the treaty, should it be legally binding in international law. The precise obligations and compliance measures to be adopted are yet to be determined.
Happening alongside the drafting of this treaty is a process to propose amendments to the International Health Regulations (IHR), which govern the conduct of countries and provide the legal framework for the WHO to exercise its powers. The IHR were established through the WHO constitution “to prevent, protect against, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade.”
The WHA met the week of May 22, 2022 to discuss the Pandemic Treaty and to vote on controversial amendments to these regulations, which would have given more power to the WHO over member states – essentially a pre-cursor to the kind of powers the proposed treaty would authorize.
MP Lewis had publicly urged the Prime Minister and Minister of Health not to agree to these amendments. Thanks in large part to mounting scrutiny and pressure from civil society, there was no consensus on the amendments, and they did not pass during the May 2022 meeting. However, the “targeted” amendment process to the IHR is ongoing, led by a Working Group, which is holding its first meeting no later than November 2022. We must remain vigilant as amendments that would give teeth to a new Pandemic Treaty are proposed at future meetings. That is why MP Lewis has since publicly requested that the Minister of Health disclose the legal opinion or risk assessment that he was provided to inform Canada’s position on the amendments and future negotiations on a proposed treaty.
It’s important for countries to work together to address global public health priorities, including responding to pandemics; however, there are strong reasons why this treaty should be concerning to Canadians.
Of greatest concern, the treaty could give the WHO the legal ability to direct Canada’s future pandemic response, including mandating any range of measures from lockdowns to social distancing to specific vaccines approved for distribution within Canada. The treaty will likely define and classify what is to be considered a pandemic, and this could consist of very broad classifications, including potentially even non-infectious diseases like cancers or heart diseases.
This means that if such a treaty is ratified, the WHO becomes the ultimate authority over not only what gets declared a pandemic but also how countries need to respond to the pandemic.
The WHO has acknowledged that “any new agreement […] is drafted and negotiated by governments themselves, who will take any action in line with their sovereignty.” In the working draft of the treaty, they have listed “sovereignty” as one of 15 principles to guide the implementation. However, it is uncertain how this principle will be respected in the context of a comprehensive treaty that the INB has already concluded should be legally binding on signatory nations, and would necessarily include compliance measures. Dr. Tedros Adhanom Ghebreyesus, WHO’s Director-General said, “The importance of a legally binding instrument cannot be overstated: it will be our collective legacy for future generations.”
Canada must be careful to not sign anything that could give away our sovereignty on health care, even if there is tremendous international pressure to do so for the sake of pandemic preparedness. It would also be irresponsible of this government to consider signing onto a legally binding treaty governing future pandemic response when Canada has not had a national inquiry into our own pandemic policies and outcomes. We can’t prepare for the future when we haven’t learned the lessons from the past two years.
This global treaty drafting process includes the opportunity for input from all member states. That includes Canada. At the very least, the government needs to engage and consult with our health system stakeholders and the Canadian public in this drafting process. If the government fails to be transparent with Canadians as it ratifies a far-reaching expansion to WHO jurisdiction and powers, it will be undermining the democratic rights of Canadians to determine their own governance. To date, there has been little information – let alone public engagement – from the government with regard to this treaty.
The working draft is currently receiving input from member states, regions, the general public and other stakeholders between now and the next meeting of the INB, scheduled for December 5-7, 2022, when they will consider the “conceptual zero draft” of the treaty. They will deliver a progress report at the World Health Assembly in May 2023. The final treaty will be presented and signed at the 77th World Health Assembly meeting in May 2024. Should it be adopted under Article 19 of the WHO Constitution, the final agreement would require the ratification of two-thirds of WHO member states. If ratified, it will be legally binding according to international law.
The two main ways that changes could be made to the global pandemic response initiated by the WHO is through the Pandemic Treaty process or through the Working Group for Amendments to the International Health Regulations (WGIHR). Below is a timeline of key events in these parallel processes:
Via: International Negotiating Body (INB)
Via: Working Group for Amendments to the International Health Regulations (WGIHR)
August 22, 2022: Regional consultations began (six in total)
May 27, 2022: President Biden’s proposed amendments were defeated. Agreement to form the WGIHR to work on potential amendments to the IHR
September 15, 2022: Deadline for member states to submit written input into the working draft
September 30, 2022: Deadline for member states to submit proposed amendments
September 9-16, 2022: 2nd round of public hearings – period for video submissions on what should be addressed at the international level to protect against future pandemics
November 15, 2022: First meeting of the WGIHR
September 29-30, 2022: Second round of public hearings
January 15, 2023: Deadline for amendment report to be prepared as part of a package of proposed amendments for consideration at the 77th WHA
October 2022: Focused consultations on selected key issues (informal)
May 2024: Adoption of proposed amendments to IHR at the 77th WHA
Mid-November 2022: “Conceptual zero draft” will be circulated to member states
December 5-7, 2022: Third Meeting of the INB where they will consider the conceptual zero draft
May 2023: Progress report delivered and presented at the 76th WHA
May 2024: Final treaty adopted at the 77th WHA
[1] Pandemic prevention, preparedness and response accord (who.int)
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