By Jamil Chade - The Geneva Observer
December 14, 2021
The much-expected preliminary conclusion of the Review Committee on the functioning of the International Health Regulations—think of them as the guidelines to fight an epidemic—during the COVID-19 response are in and they are clear: the IHR need to be overhauled.
Obtained by The Geneva Observer, the preliminary findings by the panel set up last September conclude that:
- While expressing overwhelming support for the Regulations, member states and experts insist that several areas need improving in order for the world to be better prepared for the next pandemic.
- The respective roles and responsibilities of the WHO Secretariat and the States Parties must be made clearer and more transparent. Particularly, a better understanding of the constraints and limitations to the Secretariat imposed by the the provisions of the International Health Regulations (2005) is necessary to optimize the management of a pandemic.
- The panel also points to a lack of high-level political support both at the international and national levels. As a consequence, resources are often insufficient to fully implement the Regulations.
- The COVID-19 pandemic has revealed significant gaps in pandemic preparedness in countries across the world, including in the areas of surveillance, health systems, equipment and training, essential public health functions and the role of national IHR focal points, emergency legislation, risk communication and coordination.
- The panel also concludes that the lack of robust compliance evaluation and accountability mechanisms identified during its review reduces incentives for adequate preparedness and cooperation under the Regulations. At the outset of the COVID-19 crisis, it has deterred timely notifications of events and public health information. Such criticism by member states and experts was primarily raised in regard to the adoption of additional health measures that should have been taken given the global nature of the pandemic and its economic consequences.
The Review Committee was created last September by WHO’s D-G Tedros Ghebreyesus under pressure by key member states as a follow-up to a resolution of the World Health Assembly.
The panel's preliminary conclusions will be submitted on Monday to the Executive Board of the organization. These preliminary conclusions are accompanied by several recommendations. Among the different solutions the group advocates is the creation of a “peer-review” mechanism based on the Universal Periodic Review of the Human Rights Council. It would enhance the pressure on governments to be ready at all times. Such a proposal is bound to be controversial as member states would find it difficult to conceal the true state of their respective preparedness in combatting a pandemic.
“A peer-review mechanism may be useful in improving preparedness and response, as well as compliance with States Parties’ legal obligations under the Regulations,” states the report. “The Universal Periodic Review has been shown to foster intersectoral coordination and whole-of-government approaches, to encourage good practices, and to link implementation of its recommendations with the Sustainable Development Goals and other government agendas—all of which are vital to strengthening IHR core capacities,” asserts the report.
So, was China late in informing the world and the WHO?
Touching on a highly sensitive point, the group also explored how the communication chain between States Parties and the WHO Secretariat in the very early days of the pandemic, zeroing in on practices in the Regulations that may have led to delays.
According to the Committee’s intermediate report, “Initial alerts between China and WHO were based on several sources of information, including ProMED, part of the Epidemic Intelligence from Open Sources (EIOS) initiative, media reports, Chinese television and social media.”
An announcement made by the Wuhan Health Commission of a cluster of pneumonia cases of unknown cause was identified by the Chinese Center for Disease Control and Prevention and the WHO country office through routine epidemic intelligence activities,” it says.
WHO requested verification of these reports on 1 January 2020 and received a response from the China National IHR Focal Point on 3 January 2020. “Such response timings do not seem to be any different in scope and duration from other similar delays (beyond the 24 hours required by the IHR) reported by WHO and some of the national IHR focal points interviewed by the Committee,” it says.
The problem is compounded by the speed at which information of all kind circulates today. “The Committee considers that the timelines required by the Regulations for States Parties’ notification are not realistic given that the speed and ubiquitous presence of social media results in information reaching the public domain before countries have concluded a comprehensive risk assessment. The limited authority and status of the national IHR focal points often leads to delays in notification. Another consideration is that countries may be reluctant to report on events if they perceive consequences, mainly related to travel and trade, deriving from early notification. The current IHR requirements for notification and verification, as well as information sharing by WHO, need further examination,” conclude the writers of the report.