Effect Measure

Yesterday was the fourth and final day of the important Geneva summit on sharing flu virus isolates. Like premature news of Mark Twain’s death, the Reuters report the meeting had failed was exaggerated. On the contrary, the summit appeared to have moved things forward. We have the latest, below. You can find previous happenings and background here, here, here and here.

Status mid-day, Day 4 (3:26 pm Geneva time, November 23), as reported by Ed Hammond:

Some Things That Happened in the Night Session of Day 3 and Morning Session of Day 4

These sessions were the final negotiations before returning to Plenary sessions to review the entire meetings’ work and decide what to do next. A final report will follow, but here, in no particular order, are some observations about these two sessions:

Spin Control

The Chair (Australia) noted that members of the press were calling delegates and WHO for information. The Chair suggested that delegates not speak to the press and that, instead, a Declaration be prepared and released to the media. This NGO had never heard the Chair of any intergovernmental meeting suggest how governments should deal with the press. We’ll reserve judgment on the intent of Australia and the WHO Secretariat until the text of the Declaration appears.

US Deletions and an insertion

While US and EU participation here are most notable for being totally devoid of any new ideas, deletions to text proposed last night (22 Nov) and this morning (23 Nov) say quite a bit about US intent. In discussion of principles with respect to intellectual property rights (i.e. patents), the US proposed to delete everything. According to the US, patents in influenza and influenza vaccines should be discussed elsewhere. This obviously did not meet with approval from other delegations, so the items were bracketed. But with so much support for the language raising concerns about patent claims on influenza, lifting some of the brackets was eventually proposed. Unbowed, the US replied “We are not today and essentially never prepared to remove brackets around whole items.”

And last night (22 Nov), when it came to discussing benefits for developing countries from the WHO system, the US inserted “voluntary” around many kinds of benefits. Given the opportunity to remove “voluntary” today, the US insisted that it stay.

Notable Appearances

#1: Heretofore elusive Vietnam took the floor today and expressed support for proposals by Thailand and Indonesia. (Note this was a generalized expression of support, as there are nuances that separate the positions of the latter two.) In language similar to that of many other developing countries, Vietnam asked for urgent development of a new system for virus access and equitable sharing of benefits based on sovereign rights of member states.

#2: India, which has also been quiet, waded into the fray as well and expressed its displeasure with the current system’s inequities, especially patent claims. India’s proposals on virus sharing were aimed, it said, to ensure that “/nobody takes more than their share of the benefits and takes away from the rights of the contributors /[of viruses].”

#3 And China, which has been engaged but not overly talkative, piped up more on Friday morning, in particular, advocating technology transfer and establishment of WHO Collaborating Centers in developing countries. (Full disclosure: China would like to have a CC itself.)

The Glossary/Dictionary Definitions Game

The WHO Secretariat and some countries have been up to terminology games. The final status of the documents being developed at this meeting is unclear – the range of theoretical possibilities extends from being tossed in the UN garbage can to being enshrined in a new international treaty (something in between is obviously most likely).

Behind the scenes and off the floor of the meeting, the WHO Secretariat, at the request of the Chair, has been drafting paragraphs varyingly described as a “glossary”, “dictionary”, or “definitions”. Whatever they are, they could be very important. For example, consider Canada’s professed inability to comprehend terms like “Material Transfer Agreement”. Is Canada really confused about what an MTA is? In our view it is feigning confusion because the exact definition, in these documents, could become important if they eventually emerge as a binding agreement.

The governments here have not been working on definitions because it’s too soon to define most terms in legal language. Consequently what terms to define and the definitions themselves have not been subject to discussion and consideration. Despite this – and this comes as no surprise – at the end of the penultimate session of the meeting, the Chair informed delegates she intends to insert the Secretariat’s glossary/dictionary/definitions into the final document of the meeting, giving this selective and undiscussed text status as having come under agreement. In our view the choice of terms it contains is suspect, although the details why are too complicated to explain here.

While it my be acceptable to have the Secretariat produce a glossary/dictionary we believe it should not be formalized without discussion. We’ll see what happens to it in the final plenary.

Somewhere around 7 pm Geneva time, Reuters reported the talks had failed, but two hours later (9:45 pm Geneva time) we received this from Ed Hammond:

As of 9:45PM we are still working. We are at am impasse. The impasse does not threaten to collapse the whole meeting result; but concerns a statement on interim measures between now and the time when this process completes a new global system.

Several hours later the impasse was broken:

The meeting ended shortly before 11 PM as a qualified success for all concerned with public health. I regret it’s too late to explain in detail but there was a significant step forward. The IGM will reconvene, likely for 5 days (probably July 2008) to consider the draft text it hammered out here, which is lengthy and detailed, but heavily bracketed [i.e., with designated items still to be clarified]. It includes provisions on prior informed consent, material transfer agreements, patent rights, etc.

There is also a statement that sets out two main actions to be taken “in the interim before final agreement is reached on virus sharing and benefit sharing”: First, a tracking mechanism will be created so that virus movements (and virus piece movements) into and out of WHO CCs [Collaborating Centres, reference laboratories for diagnosis of influenza A/H5 infection] can be tracked. Second, a balanced interim oversight group will be convened by the Director General to look into the functioning of the system and guide on its improvement.

A proper assessment of the final text cannot be given here. The text will not be a formal product of the meeting for another few days because of understandable procedural issues to allow the Chair and some other countries to consult properly with African countries.

However this is positive result. Where there was no prior structure for building solutions to this problem, we now have one. There is agreement on the need to reform the GISN [Global Influenza Surveillance Network]. There is text, heavily-bracketed, that has ideas for doing so. There are interim procedures that affirm the need to share viruses (more on this later) and which enable the Director General to look more closely at how the system can be made more transparent and equitable. The IGM itself will meet again to work out differences.

Qualified but definite good news. We’ll have to see the details, but the bottom line seems to be we have moved forward on this vexing problem.

Comments

  1. #1 anon
    November 24, 2007

    this is too long with all the days and comments,
    so I comment without reading it.

    Even if it turns out that Indo’s position is “BS”,
    that doesn’t mean that giving free/cheap vaccine
    to Indo would be inappropriate.

    Vaccine in Indo could prevent a pandemic.
    Vaccinating Indonese could be cheaper and more
    effective than vaccinating Americans

  2. #2 M.Randolph Kruger
    November 24, 2007

    But then there is who is going to pay for it Anon/Revere? I wouldnt call it a qualified success except to say who is going to pay for it and that is not answered, its not going to be. Its still the developing countries against the developed ones. The above has no teeth only the possibility of the transfers and there are no penalties for not. So we end up with CC’s that produce nothing but what?. That research has been always done in university labs and research hospitals and it creates the possibility of a biowarfare level bug being regionally available to whom?

    This is fraught with no accountability. I saw the CC references and I took away a whole different meaning. The problem with this is not only the inequalities of virus sharing, its the concept that the WHO will be in charge its more political than the UN. And those idealistic centers will be controlled by WHO? I believe that there are already several regionals of the WHO that are mostly ill managed and political. Some things they do well, somethings they do very poorly.

    They all went because of the BF and what it could do. This still didnt address the plain fact that we are YEARS away from being able to deal with it. Might not ever be. Oh there is hope for both the developing countries and slightly more fo the developed ones but this changed nothing and came up with very few ideas.

    So qualified success IMO is based upon a pretty low standard for that. I reiterate, they dont have to do anything except sit and wait.

  3. #3 revere
    November 24, 2007

    Randy: One more installment coming. Working on it. Then you can comment better.

  4. #4 M. Randolph Kruger
    November 24, 2007

    Okay and again kudo’s for Hammond for going. I have been getting emails that while they dont go directly against what he is sending it shows a different bias. There were a lot of sidelinings and the WHO themselves didnt want the members speaking to the press. Wonder why they quit reporting it? Its because there was a full on press to try to put something together and ram it down the throats of the West and thats a term I use for the countries and the industry they represent. The US was doing ALL the talking and I am trying to get a transcript (if anyone has access please advise) because it was obvious what Indonesia and the other little countries were talking about and that was that they wanted to be brought up onto a par with the West, paid for of course by the West. Then using the West paid for technology they might produce BF vaccine if and when it comes available from regionally shared samples. Uh-huh. And what would they be doing in the interim? I am sure they would be out using that technology to take apart the West.

    Anyone want to question why there were so few comments from the French, Brits, Netherlands, Russia, Belge’s, Italy, Spanish? It should be obvious… they’ll have no part of it. I do wait on what you have Revere, it should be interesting.

  5. #5 SusanC
    November 24, 2007

    Anyone want to question why there were so few comments from the French, Brits, Netherlands, Russia, Belge’s, Italy, Spanish? It should be obvious… they’ll have no part of it.

    I salute your naivete. Us Europeans have been freeloaders for many generations now, haven’t you heard? Let them fight it out, let the Americans take the heat, and we’ll sit here and see what we can get out of both sides.

    Classic European diplomacy

  6. #6 M. Randolph Kruger
    November 24, 2007

    Well Susan, if you are the French then you are well known for playing both sides of the field of play. Iraq Jacques for instance. They absolutely love sanctions against any country, that way they can sell to them for 35 dollar a barrel oil and oh such technology they sold to them. The Germans too in their last administration had that problem as well.

    Its not a slam. It goes back some 100 plus years and the UK has pretty much always carried its water some more, some less but always carried it. Its just the way things are, but when the crap hits the rotary grinder most of the time they all do stand up. This is one of them and in this particular case it was better that they sat down. The US’s axe grinding has been a long time in coming. 500 million on one pass, 350 on another and 25 officials are building new homes in Thailand. Fortunately its in Phuket and we can only hope they are beach front properties and someone screams surfs up during a quake.

    The samples thing needed to be resolved and Revere is absolutely right in that respect. How they get there is the problem but our friends the Indons want their cake, to eat it too, take the plate, have us teach them how to make the cake and then sell the cake back to us. Thats the real rub. Its not non existent vaccines. They just want as a huge portion of this earths population for the West to elevate them. They did already by putting Supari on the WHO board and see what we got when we did?

    The next regular meeting will have more fireworks than this and even a new incoming US administration isnt going to go for what Supari wants. They might see regional pandemic distribution centers once there are vaccines but not before. Certainly not manufacturing centers for vaccine. BF is just bringing a problem to the top and sometimes its just better in your national interests not to do anything.

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