The COVID-19 pandemic informed both the content and the format of the 73rd World Health Assembly (WHA) on Monday and Tuesday (May 18–19), as WHO’s decision-making body met via video conferencing technology for the first time and focused on the COVID-19 response and essential governance matters.
U.S. critical of WHO, China
The United States used the event to amplify its criticism of WHO as an ineffective agency beholden to China. U.S. Secretary of Health and Human Services Alex Azar, in remarks to the assembly, cited “a failure by this organization to obtain the information that the world needed.” The U.S. president went further, demanding—in a letter he posted on Twitter—that WHO “demonstrate independence from China” and make other “major substantive improvements” currently under negotiation in the next 30 days or face the permanent freeze of all U.S. funds and possible U.S. withdrawal as a member state.
For his part, China’s President Xi Jinping addressed the assembly and pledged $2 billion over two years to COVID-19 response and economic and social development—with a special focus on Africa—while also vowing to make any Chinese-developed vaccine a “global public good.”
One observer lamented to the Washington Post that the WHA had turned into “a political circus.”
World leaders’ statements in support of WHO
Most world leaders who addressed the assembly focused on collaboration and broadly expressed support for WHO and its global role. Speakers included the heads of state of Barbados, Bhutan, China, Colombia, France, Germany, Italy, Paraguay, Republic of Korea, South Africa, Spain, Switzerland, and Tuvalu, as well as the UN Secretary-General—who faulted “many countries” for ignoring WHO recommendations—and the President of the European Commission, who said a vaccine should be “a universal common good.”
Despite China–U.S. skirmishing, both countries participated in the unanimous adoption of the COVID-19 response resolution. This called for: 1) an independent, comprehensive, stepwise review of the international response to the pandemic at the earliest appropriate time; 2) a scientific investigation into the zoonotic source of the virus; and 3) “transparent, equitable and timely access” to any treatments or vaccines. Also on the theme of access, the resolution endorsed voluntary patent pooling and made three references to the Doha Declaration on the Trade-Related Aspects of Intellectual Property Rights (TRIPS) Agreement and Public Health, which provides for compulsory licensing in the context of public health emergencies. The U.S. submitted a position statement objecting to those references—saying they “send the wrong message to innovators”—and to language on sexual and reproductive health.
Director-General’s opening remarks
In his opening remarks to the assembly, Director-General Dr. Tedros Adhanom Ghebreyesus called for “equitable access to vaccines, diagnostics and therapeutics through the ACT Accelerator.” He also highlighted:
- The Thirteenth General Program of Work (GPW13) Results Report
- The upcoming Gavi replenishment and investments in health generally
- The launch of the WHO Academy, “to provide training for millions more health workers around the world”
- The launch of the WHO Foundation, “to broaden WHO's donor base”
In addition, Tedros drew attention to the interim report on WHO’s COVID-19 response from the Independent Oversight and Advisory Committee for the WHO Health Emergencies Programme, adding that he welcomed the resolution’s request for a thorough review. The interim report made a number of suggestions, including:
- A review of whether the Public Health Emergency of International Concern designation is too broad and should be replaced by “a stepped level of alerts”
- A process for improving health data reporting from member states
- A review by member states of the International Health Regulations, which assign roles and responsibilities to the WHO and its members—responsibilities the report suggested may not be widely understood or fit for purpose
The agenda also included WHO Executive Board elections. The ten new members of the 34-member board are: Botswana, Colombia, Ghana, Guinea-Bissau, India, Madagascar, Oman, Republic of Korea, the Russian Federation, and the United Kingdom.
The Executive Board will convene this Friday remotely for its 147th session, focused on essential business and governance matters (provisional agenda here). The MLP team will share relevant updates with foundation teams as needed following the Executive Board meeting.
Members formally suspended the WHA on Tuesday and will continue the assembly later this year at a date and in a format to be determined by the Executive Board in consultation with the Director-General.
Fourteen member states put forward a resolution giving Taiwan observer status at this year’s WHA. In light of the abbreviated schedule—which omitted the General Committee, when the procedure granting observer status would usually occur—member states agreed to defer the decision until the WHA resumes. The United States did not object to this deferment when it happened, but Secretary of State Mike Pompeo swiftly condemned the decision in a statement.
In closing remarks, Director-General Tedros promised to “initiate an independent evaluation at the earliest appropriate moment,” as requested by the resolution. He also emphasized WHO’s commitment “to transparency, accountability, and continuous improvement,” saying the organization would continue to provide strategic leadership to coordinate the global response.