Intergovernemental meeting on pandemic influenza preparedness: Sharing of influenza virus and access to vaccines and other benefits

Report by Dorothee Wenk-Dersch

This intergovernmental working group has its mandate from World Health Assembly (WHA).
There have already been negotiations previously, in particular at the “Singapore meeting”.

The main topic to treat of this conference is “virus sharing” and “benefit sharing”.

These issues are quite technical, so I will try to explain them:
As I could understand, the main conflict was between developing countries and developed ones.
The issue is that the outbreak of H5N1 (avian influenza, transmitting from bird [in this case particularly from chickens to farmers living close to them]) in the Asian Region.
WHO and developed countries have asked developing countries, where the virus H5N1 was found, to send it to the CC (research centres). So, Vietnam and also Indonesia have sent their virus to analyse them. Then, in Europe (Germany), and afterwards in the US, scientists were researching for a vaccine. Once they had found a vaccine in the US, commercial companies patented the virus, which has not happened until then! The consequence was that affected countries like Indonesia had to buy an expensive vaccine, and afterwards they knew, that it has been produced based on the virus they have sent (from Vietnam and Indonesia).
So their position was that this is an unfair system, exploiting affected countries. They where no longer willing to cooperate with research institutions, unless they accept benefit sharing, implying that they can only produce vaccins with the prior informed consent of the originating country (that has sent the virus sample).
The position of developed countries, particularly the US, later also the EU, was that this is unacceptable to them.
These positions have become entrenched, so neither of them wanted to give up their demands and showing not a lot of willingness in the prior process to this IGM to find a solid (and durable) solution.

The IGM worked from 20-23 November 2007.

The first day consisted in finding the chair and vice chairs. Jaden Holden from Australia was elected chair and Timor-Leste (A. Dick) was elected first vice chair. The procedure was to elect one vice chair for each of the five regions: SEARO, AMERO (E. Palacios, Mexico), EMERO (K. Ahmadi, Iran), AFRO (A. Nasidi, Nigeria) and EURO (S. Hodnesteen, Norway).
After that, the chair tried to help to find the appropriate working document, with the positions papers. The basis documents of the meeting were the following white papers (wp):
(see at Agenda A/PIP/IGM/+ Rev.1)
wp 1 (IGM/wp), wp 1 Rev.1, wp 2, wp 2 Rev.1,wp 3, wp 3 Rev.1
Dictionary, principles and operational aspects.
A/PHI/IGWG/2/2
A/PIP/IGM/5
A/PIP/IGM/6
You can find find all these documents at: http://www.who.int/gb/pip/
In the afternoon of the first day, the amount of work compared to the time available, turned out to be too high. So we had to split in a plenary and a working group. (Working group was lead by Nigeria). Days passed; there were negotiations, but no breakthrough!

I will focus my report on Friday 23, after the planned end of the meeting. That was from about 6 to 11pm. In my eyes it was the most important phase of the IGM:
The idea of the process was that the meeting will not be concluded, but suspend, and reconvened by an open ended working group which is open to all member states.
The recommendation made will go to the Executive Board (EB), to vehicle it to the WHA. (Where the mandate came from).
A one-page agreement was produced, which had to be agreed on in consensus.

There have been hard negotiations. Delegations, particularly Indonesia, have shown enormous goodwill. This exercise of showing goodwill without consulting to capitals was quite challenging for all delegations!
At about 8 o’clock, shuttle diplomacy began and despite of being tired and hungry, delegations have put all their energy in this process, especially to define an interim process.
Sometime later, negotiations seemed quite hopeless; it was considered deleting the most important paragraph about virus sharing, because consensus seemed impossible. But delegations continued, saying we didn’t make all that progress to delete it… !
..but still no agreement.

The chair was doing everything she could to make negotiation more comfortable by telling jokes and encouraging us. She told us that the director general is a fabulous singer.
So the director general of WHO, Dr. Margaret Chan, took the floor and spoke about all the work she put in that meeting, and that IGM was the conference where she attended the most time compared to all other things happening at WHO.
In this spirit she sang a song: “ know each other better, to like you and to work together”. Everybody applauded! Hope had come back to the room.
Some of the people gathered in two groups and had vigorous discussions. On one side was a group around EURO, and on the other side a group around SEARO (in particular Indonesia) centred around the director general.

Finally, the chair continued by taking the floor and giving it to the director general.
She read the agreement found in this difficult procedure.
Kenya took the floor to tell their unhappiness with leaving the African group out of the procedure from the beginning of the meeting. But the delegate stressed that he doesn’t want to oppose to an emerging consensus. He said that the African group was coming back to the chair next week with their comments.
Kenya emphasised that it is crucial that excluding a region like the AFRO region should never happened again.
The chair was thanking Kenya for that statement, responding that we all are learning on that process.

Some delegations took the floor to thank the chair, director general, the secretariat and the interpreters for their excellent work. They all had nice words for each other.

For me it was really a good experience to attend this conference. I learned a lot about WHO and influenza virus. It was a pleasure for me to represent Timor-Leste.
I could make some good contacts with the Indonesian delegation and in particular also the delegation of Thailand.
It was encouraging to see changing the situation from a zero-outcome to a real (as Thai delegate says) SOLID, outcome.

Some statement I won’t forget such as the statement of Portugal on behalf of herself: “If the virus works as slowly as we do, we won’t have a pandemia!!!”, or also the
Director general saying she is a 60 year old woman, “looking young from far away!” and comparing a facelifting with the reform of the 60 year old WHO system!

And of course the reminder of our SEARO region, “What will we do if there is a pandemia tomorrow? We don’t have any mechanism!”

If you have any question to me about WHO or some other subject, please feel free to send me an Email or leave a comment.