5.1.3 International Health Regulations and Treaties Update

Introduction

The World Health Organization (WHO) has prepared amendments to the International Health Regulations (IHR).

The World Health Assembly (WHA) has agreed on a series of amendments to the IHR in June 2024. These amendments are purported to strengthen global preparedness, surveillance, and response to public health emergencies—including pandemics. Here are the key changes:

1. Pandemic Emergency Definition:

• A new definition for a pandemic emergency has been introduced. This definition covers communicable diseases that pose a high risk of widespread geographical spread, exceed health system capacities, cause significant social and economic disruption, and require coordinated international action. This builds on the existing mechanisms of the IHR, including the determination of a Public Health Emergency of International Concern (PHEIC)

2. Strengthening National and International Capacities:

• The amendments include commitments to bolster national and international capacities for disease surveillance, information sharing, and response. This includes creating a more robust framework for coordinating efforts across countries and ensuring that preparedness is a collective endeavour.

3. Equity and Solidarity in Access to Medical Products:

• A strong emphasis has been placed on equity and solidarity to ensure that access to medical products and financing is strengthened globally. This involves establishing a coordinating financial mechanism to support pandemic prevention, preparedness, and response, particularly to assist developing countries.

4. Enhanced Transparency and Monitoring:

• The amendments stress the importance of transparency and monitoring. An independent body will monitor compliance and accountability, inspired by models used in climate change agreements and international law. This aims to ensure that actions are taken to meet global health goals and standards.

Witness Testimony

James Roguski’s Testimony:

James Roguski, a researcher and activist, raised several concerns about the proposed revisions to the IHR:

1. Assumption of Safety and Efficacy: The revisions assume that the actions taken during the COVID-19 pandemic were safe and effective, which may not reflect the varied outcomes and impacts that were experienced globally.

2. Financial Obligations: Developed countries or nations could be compelled to finance the development of pharmaceutical capacity in less wealthy countries, raising concerns about the financial burden on these nations.

3. Vague Pandemic Emergency Definition: The definition of a pandemic emergency can be considered vague, allowing the WHO Director-General to declare an emergency without stringent requirements for statistics or risk assessment. This could lead to the misuse of emergency declarations.

4. Potential for Emergency Powers: An emergency declaration by the WHO Director-General could be used by local governments to invoke emergency powers, potentially leading to overreach and misuse.

5. Global Authority and Uniform Solutions: There are concerns about a single global authority diagnosing pandemics and prescribing one-size-fits-all solutions, which may not be appropriate for all member states.

Risks to Canadians’ Rights

The proposed amendments to the IHR and the development of a global pandemic treaty pose several risks to Canadians’ rights:

1. Sovereignty and Autonomy: The ability of the WHO to declare emergencies and prescribe health measures could infringe on national sovereignty, limiting Canada’s ability to make independent public health decisions tailored within its specific context.

2. Financial Burden: Obligations to finance global health initiatives could place a significant financial burden on Canada, diverting resources from domestic priorities.

3. Civil Liberties: The potential for emergency declarations to be used by local governments to invoke emergency powers raises concerns about the erosion of civil liberties and the potential for government overreach.

4. Equity and Fairness: While equity in global health is crucial, the mechanism for ensuring it must be fair and transparent. Wealthy nations like Canada must balance global responsibilities with domestic needs.

5. Transparency and Accountability: Ensuring that the WHO’s decision-making processes are transparent and accountable is vital to maintaining public trust. Canadians need assurance that global health decisions are made based on sound science and not influenced by political or financial interests.

The amendments to the IHR and the proposed global pandemic treaty pose significant risks that need careful consideration. It is crucial we ensure that these changes do not infringe on national sovereignty, impose unfair financial burdens, or erode civil liberties. Transparent and accountable decision-making processes along with a fair balance between global responsibilities and domestic needs are essential to protect Canadians’ rights while contributing to global health security.

Recommendations

1. Safeguarding Sovereignty and Autonomy

Recommendation: Ensure National Oversight and Decision-Making

• Implementation: Establish a national review board comprising public health experts, legal advisors, and representatives from civil society to oversee and evaluate any WHO declarations and recommended measures before they are implemented domestically. This board should have the authority to approve, modify, or reject WHO recommendations based on national interests and contextual factors.

• Rationale: This approach requires that international directives are tailored to the specific needs and circumstances of Canada, preserving national sovereignty while participating in global health initiatives.

Recommendation: Advocate for Clear and Specific Criteria for Emergency Declarations

• Implementation: Work with other WHO member states to refine the definition of a pandemic emergency within the IHR. Ensure that the criteria for declaring an emergency are specific, transparent, and based on robust scientific evidence and risk assessment.

• Rationale: Clear criteria will prevent the arbitrary or politically motivated declaration of emergencies and ensure that such declarations are based on concrete data and genuine public health threats.

2. Addressing Financial Burdens

Recommendation: Negotiate Fair Contribution Frameworks

• Implementation: Engage in negotiations to establish a fair and proportional financial contribution framework for global health initiatives. Contributions should be based on each country’s GDP, public health expenditure, and capacity to contribute, thus ensuring that the financial burden is equitably distributed.

• Rationale: This ensures that wealthier nations like Canada contribute fairly without compromising their domestic health priorities and financial stability.

Recommendation: Enhance Accountability and Transparency in Funding Utilization

• Implementation: Implement stringent accountability mechanisms to track and report on the utilization of funds contributed to global health initiatives. Regular audits and public disclosures should be mandatory.

• Rationale: Ensuring transparency in how funds are used will build trust and that contributions are used effectively and efficiently in achieving intended public health outcomes.

3. Protecting Civil Liberties

Recommendation: Enact Strong Legal Safeguards

• Implementation: Develop and enact legal safeguards to protect civil liberties during public health emergencies. These should include strict criteria for the invocation of emergency powers, time limits on restrictive measures, regular reviews by independent judicial bodies, and the imposition of criminal penalties against the offending officials should violations be determined.

• Rationale: Protecting civil liberties ensures that public health measures do not lead to unnecessary or prolonged restrictions on personal freedoms and rights.

Recommendation: Establish Independent Oversight Mechanisms

• Implementation: Create independent oversight bodies to monitor the use of emergency powers and public health measures. These bodies should include representatives from the judiciary, civil society, and human rights organizations.

• Rationale: Independent oversight will help prevent abuse of power and provide measures that are proportionate, necessary, and in line with human rights standards.

4. Ensuring Transparency and Accountability

Recommendation: Promote Open and Inclusive Decision-Making Processes

• Implementation: Ensure that WHO decision-making processes are transparent and inclusive; involve a wide range of stakeholders; and include member states, public health experts, and civil society organizations. Regular public consultations and disclosures should be mandated.

• Rationale: Transparency and inclusivity in decision-making processes build trust where diverse perspectives are considered—leading to more balanced and effective public health policies.

Recommendation: Strengthen Whistleblower Protections

• Implementation: Implement robust protections for whistleblowers who report on public health issues, corruption, or misuse of power within international health organizations and domestic health institutions.

• Rationale: Protecting whistleblowers encourages the reporting of wrongdoing and ensures that issues are addressed promptly, thereby maintaining the integrity of public health responses.

5. Balancing Global and Domestic Responsibilities

Recommendation: Prioritize Domestic Public Health Needs

• Implementation: While contributing to global health initiatives, safeguard priority of public health needs. Establish clear guidelines for balancing international commitments with national health priorities.

• Rationale: Maintaining a balance between global responsibilities and domestic needs ensures that Canadians’ health and well being are not compromised while supporting global health efforts.

Recommendation: Foster Global Partnerships and Collaborations

• Implementation: Develop partnerships with other countries and international organizations to share best practices, resources, and expertise. Participate in joint research and development initiatives to enhance global and national health capacities.

• Rationale: Collaborative efforts can lead to more effective and sustainable public health outcomes, benefiting both Canada and the global community.

By implementing these recommendations, Canada can mitigate the risks associated with the proposed IHR amendments and the global pandemic treaty. These measures ensure that national sovereignty, financial stability, civil liberties, transparency, and accountability are upheld while contributing effectively to global public health efforts.