KUALA LUMPUR, May 25 – The Malaysian government has expressed “significant concerns” on a proposal to significantly enhance the World Health Organization’s (WHO) executive powers to declare a global public health emergency.
The United States’ proposed far-reaching amendments to the International Health Regulations (IHR) 2005 – which are international legislations that are legally binding on 196 countries to manage public health events that can cross borders – include empowering the WHO to unilaterally declare a public health emergency of international concern (PHEIC) without needing to consult or to get agreement from the country where an infectious disease outbreak is occurring.
The US’ proposed amendments to the so-called “pandemic treaty” – supported by the European Union (EU) and 19 co-sponsor states, including the United Kingdom, Australia, India, Japan, and South Korea – also moot allowing the WHO to consider not just information provided by the country where the outbreak is occurring, but also by other state parties or information available in the public domain, in determining a PHEIC.
The WHO declared the Covid-19 outbreak as a PHEIC on January 30, 2020, subsequently describing the coronavirus as a global pandemic less than two months later on March 11.
“Based on our experience in managing the pandemic, there are gaps within the IHR that need amendments as per the recommendations of the Working Group,” Health Minister Khairy Jamaluddin told a committee meeting at the 75th World Health Assembly yesterday in Geneva, Switzerland.
“However, Malaysia has significant concerns about some of the amendments that have been proposed. We are amid ongoing internal consultation on this matter and will provide official feedback on the proposed amendments from our government.
“It is imperative that WHO considers the Member States’ national legislation and policies when determining the amendments to the IHR.”
When delivering country remarks to the World Health Assembly, which is the decision-making body of the WHO, Khairy said Malaysia supports reforms for an international health architecture to avoid the “moral failures” in the global Covid-19 response.
“However, any amendments to the International Health Regulations will have to respect the principles of equity, accountability and transparency and the sovereign process of member states,” he said.
“Yes, by all means hold member states accountable in disclosing key information of public health concern. But let us also call for the disclosure of intellectual property and manufacturing know-how of vaccines, diagnostics and therapeutics.”
New Public Health Emergency Of Regional Concern, Intermediate Health Alert
The US’ proposed amendments to the IHR include creating two new categories of public health events: a public health emergency of regional concern or an intermediate health alert.
The WHO is proposed to have the power to issue an intermediate public health alert to countries in situations that have not met the criteria for a PHEIC, but where the WHO has determined that heightened international awareness and a potential international public health response is needed.
The US also suggests granting new executive emergency powers to the six WHO regional directors to declare a public health emergency of regional concern.
Default WHO Deployment Missions
America proposes mandating the WHO to offer assistance to a country in a response to public health risks or PHEIC, including the mobilisation of international expert teams for on-site assistance or assessments, without needing a request from that state party.
The state party must accept or reject the WHO’s offer of assistance within 48 hours and, if the offered assistance is rejected, provide the United Nations body the rationale for the rejection that the WHO shall share with other countries.
“Regarding on-site assessments, in compliance with its national law, a state party shall make reasonable efforts to facilitate short-term access to relevant sites; in the event of a denial, it shall provide its rationale for the denial of access,” reads the US’ proposed amendment to Article 13.
WHO Can Share Outside Information Without Verification
The US’ proposal empowers the WHO to assess potential global health risks by relying on information outside a country’s official channels – without the requirement to consult and seek verification from the state party where a disease outbreak is allegedly occurring – and to share this information with other nations.
Countries are only given 24 hours to verify information received by the WHO on a potential PHEIC allegedly occurring in their territory and 48 hours to accept a WHO offer of collaboration in assessing the potential for international disease spread, possible interference with international traffic, and the adequacy of control measures. Such collaboration may include mobilising international assistance for on-site assessments.
Failure by the affected country to accept the WHO’s offer of collaboration within 48 hours will be considered rejection of sharing available information with state parties. WHO is also mandated to “immediately” share information with other countries if the magnitude of public health risk is “justified”.
Assess Public Health Events Within 48 Hours
America proposes mandating countries to assess public health events occurring in their territory within 48 hours of the national IHR focal point receiving the relevant information, a new suggested deadline.
The current IHR also states that each state party shall notify the WHO, within 24 hours of assessment, about all events that may constitute a PHEIC.
The US’ proposal adds genetic sequence data as a piece of information that state parties should share with the WHO where possible.
New Compliance Committee
The US amendments include creating a new compliance committee to monitor countries’ compliance with their obligations under the IHR.
The compliance committee will be authorised to request further information from countries, to undertake – with the state party’s consent – information gathering in that country, and to make recommendations on how a state party can improve compliance, including offering technical assistance and financial support.
The proposed compliance committee will also submit an annual report to each World Health Assembly on any concerns regarding non-compliance with the IHR.
State parties shall appoint six government experts from each WHO region to join the compliance committee that shall be appointed for four-year terms and to meet three times annually.
Six Months To Reject IHR Amendment
The US’ proposal slashes the period for countries to reject an amendment to the IHR from 18 months to six months from the date when the WHO notifies state parties about the World Health Assembly’s adoption of the amendment.
Amendments to the IHR will enter into force for state parties that do not opt out within six months, as any rejection received by the WHO after that period shall not apply.
A delayed trip by a WHO team of international experts to Wuhan, China, in January 2021 failed to conclude, in a report jointly written with China, how the Covid-19 virus first broke out. The joint WHO-China report considered a leak from Wuhan’s virology labs to be “extremely unlikely”, finding that the most likely scenario was that the coronavirus jumped from bats to humans via an intermediate animal.
The New York Times reported in February 2021 WHO’s team of independent investigators as saying, upon returning from its fact-finding trip to Wuhan, that Chinese scientists refused to share with them raw data and information on the early days of the Covid-19 outbreak. The WHO experts were also reportedly not given detailed patient records from early confirmed Covid-19 cases and possible ones before that.
Last July, Beijing refused to cooperate with the WHO’s proposal for the second stage of its investigation into the origins of the Covid-19 pandemic to include auditing laboratories and research institutions in the city of Wuhan where the first human cases were identified in December 2019.