#143 THE G|O BRIEFING, JUNE 22, 2023
Proposal for a Global Health Threats Council has Geneva debating | Overwhelmed and underfunded human rights system may not be able to deliver on its mission | International Red Cross in Crisis—what would Dunant say?
Friends,
We hope you are well.
Would a pandemic treaty and revised, binding International Health Regulations be enough to prevent a repeat of what happened when COVID-19 hit and caught the world totally unprepared to deal with a catastrophe of this magnitude—the worst global crisis in the last 100 years, affecting billions of people around the world? No, concluded the Independent Panel on Pandemic Preparedness and Response. It suggested the need to set up a Global Health Threats Council. Today in The Geneva Observer, we report on how Geneva’s global health stakeholders are assessing the merits and the risks of such an instrument.
The 53rd Session of the Human Rights Council opened Monday (June 19) with a warning from Volker Türk, the UN High-Commissioner for Human Rights: the system, he said, has reached its limits. As Jamil Chade reports, the UN human rights system is in danger of not being able to deliver on its mission.
What would Henry Dunant, its founder, think of the current profound crisis of the International Committee of the Red Cross, asks Daniel Warner? Dunant believed, Warner argues in his penetrating essay, that if humanitarian and political actions were not kept separate, the former would be jeopardized. The current crisis faced by the ICRC is not only financial, he contends. It is moral.
As always, thank you for reading us.
The promise and perils of a Global Health Threats Council have International Geneva debating
By Philippe Mottaz
The latest round of negotiations over a pandemic instrument at the Intergovernmental Negotiating Body (INB) was “not easy,” its co-chair announced following their conclusion last week. Global health experts had already predicted that 2023 could be a “make or break year” for the WHO and the treaty. In parallel, strengthening the International Health Regulations (IHR), a set of binding guidelines, is also being discussed. It’s an all-out effort from the WHO and its Member States to meet a self-imposed deadline of May 2024 in coming up with a solution that would prevent a repeat of what happened a mere three years ago, when the response to the COVID-19 outbreak was chaotic—going, global health observers say, from panic to neglect.
Name your country’s health minister
Global health stakeholders must now consider a third proposal: establishing a political body, the Global Health Threats Council (GHTC), whose purpose would be to jolt the international community into coordinated and sustained action in case of an infectious disease outbreak. It is now on the UN’s agenda and will formally be debated in New York in September. In fact, it’s an idea that has been floated around for almost ten years in global health circles. It is a solution, its proponents argue, to the lack of clout of national health ministers, who don’t carry as much weight within their governments as their foreign, finance, or defense colleagues. (Switzerland here is an outlier, with a minister in charge of health who can also be president, as is the case this year, due to the country’s rotating presidency system. Alain Berset announced yesterday that he would not run for a fourth ministerial term.)
World Health Organization
If you sit in Geneva, the world’s global health hub, and run the WHO, this state of affairs is a wicked problem. Dr. Tedros, the organization’s chief and great communicator—remember the “catastrophic moral failure”, or the “vaccine apartheid”—addresses the issue, which he considers a hindrance to an adequate response to the next outbreak, in five words: “Health ministers should be empowered.” That alone won't address the problem, but for Tedros it would be a positive first step.
“Pandemic preparedness and response require an all-of-government approach. [...] WHO focuses largely on health ministers, but you need clout and heft. The creation of such a Council is long overdue,” global health expert and Georgetown University Professor Lawrence Gostin agrees, but “it faces serious challenges,” he tells me, also expressing doubts about the political traction garnered by the proposal.
Dr. Tedros believes that “health emergency preparedness and response” (HEPR) should be elevated to the level of heads of state and governments, a recommendation contained in the 2021 report Covid-19: Make it the Last Pandemic, authored by the Independent Panel for Pandemic Preparedness and Response (IPPPR), led by Liberia’s former president Ellen Johnson Sirleaf and Helen Clark, former prime minister of New Zealand.
Johnson Sirleaf, Clark, and their fellow council members advocate setting up the GHTC through a resolution of the UN General Assembly, a decision that could put HEPR under the purview of the UN, partially shifting the global health center of power to New York, away from the expertise of Geneva’s global health hub. Its purpose: “[to] ensure that high-level political leadership and attention to pandemic prevention, preparedness, and response are sustained over time in the service of a vision of a world without pandemics.”
In its composition, the Council would be diverse and inclusive, bringing together governments, civil society, the private sector, and even, the IPPPR suggests, “two prominent global citizens or experts.”
Last month, without reusing the GHTC terminology, Johnson Sirleaf and Clark published an updated and summarized version of their initial proposal.
But here in Geneva, in anticipation of the planned September meeting, the possible establishment of such a body is prompting a spirited discussion. The global health community finds itself engaged in a reality-checking exercise as it dissects the wisdom, impact, and potential consequences of the creation of such a council. Interrogations are many. The first issue is timeliness: “Is this the moment to discuss the creation of a new instrument as negotiations on a pandemic treaty and on a strengthening the International Health Regulations are underway? It’s premature,” a member of WHO’s Executive Board tells The Geneva Observer.
The second is political. Suerie Moon, co-director of the Global Health Centre at the Graduate Institute, was an early proponent of such a body after analyzing the slow response to the Ebola crisis. "There was an independent commission on the Ebola crisis, and we recommended the creation of a committee of the UN Security Council.” The commission’s report (downloadable below) was published in The Lancet when Moon was still at Harvard. “As we saw again during COVID-19, heads of state are very slow to wake up to the threat posed by outbreaks of infectious diseases.” However, she’s now changed her mind: “Today, I no longer think the Council is a good idea. Because what we saw in the COVID-19 crisis, the biggest global crisis in 100 years, was a Security Council missing in action, frozen by geopolitical tensions.” It’s wishful thinking, she tells me, “to believe that heads of state and governments would really be engaged and committed. There is fierce competition between governments, and today’s deep geopolitical divisions will not abate anytime soon. Such an institution might be useful if convened [at] short notice by the UN Secretary-General for purely informational purposes. But if [the aim is to] pass resolutions or consensus on action, it will not fare any better than in 2020.” Driving her point home, she adds: “The technical and universal nature of health often allows [the lowering of] the temperature in the room. For many Geneva global health stakeholders, keeping politics at arms’ length is important.”
Streamline or fragment?
Another substantive critique is that rather than streamlining the global health architecture, a new instrument would further fragment it, possibly ending up weakening WHO itself.
“As proposed, the Council runs against other recommendations of the IPPPR, such as strengthening […] WHO and ensuring more coherence within global health. […] Were the Council established, member states would have to revisit the WHO constitution itself. […] WHO was created to ‘act as the directing and coordinating authority on international health work’ and to establish and maintain ‘effective collaboration with the United Nations, specialized agencies, governmental health administrations, professional groups, and such other organizations as may be deemed appropriate.’ The new Council would almost surely claim some of this authority,” Ilona Kickbush, a member of the Global Preparedness Monitoring Board (GPMB) and chair of the advisory group of the Global Health Centre at the Graduate Institute, wrote recently.
Council on Foreign Relations
How much political traction the proposal is receiving is hard to gauge at this point. A draft document out of New York in preparation for the High-Level Meeting does not explicitly reference it. But the G7 members seemed to support the idea, having noted, in the final communiqué of their Hiroshima meeting in May, “the UN General Assembly (UNGA) High-Level Meeting (HLM) on pandemic [prevention, preparedness and response] in September 2023 and the need to avoid duplication and ensure coherence between these processes, stressing the leading role of WHO.”
“I wouldn’t put too much importance into it,” Lawrence Gostin tells me. “I don’t think that heads of state and heads of government are terribly interested. They are not against it. It’s an easy thing to put out a communiqué and say, ‘oh, yeah, good idea.’ But I don't know of any government actively pushing for it.” The New York meeting, Gostin believes, “will not be transformative. The idea of coordinated action among all the various global actors is unlikely to be sorted out. And then comes the question of where such a body would sit. Is it fully independent? Does it sit in the United Nations General Assembly or in the Secretary General’s office? Does it sit at WHO? And then, let’s say you have a new pandemic. It’s very hard to see heads of state throughout the world just putting everything [aside] and playing nicely with each other. Where countries are aligning are issues like accountability, the sharing of scientific information, sharing the benefits, and equity. But the political lessons of the COVID-19 pandemic have not yet been learned.”
-PHM
An overwhelmed, overstretched, ignored, and under-financed human rights system is being confronted with a stark reality: it may not be able to deliver on its mission
By Jamil Chade
In his last global update to the Human Rights Council this week, High Commissioner Volker Türk offered a blunt assessment of the situation faced by the UN’s Human Rights bodies: In the year that marks the 75th anniversary of the Universal Human Rights Declaration, it has reached its limits.
This is due, first, to the lack of political will from governments to fulfill their responsibilities and report to the several treaty bodies. According to Türk, “a total of 601 reports by States are overdue,” “reports by 78 States have been overdue for more than ten years,” and “only 37 States or regional organizations are currently up to date with all their reporting requirements.” In fact, the positive examples are so few that Türk opted to name them in his speech.
“Regular reporting to the treaty bodies is a key part of each State’s commitments—and it does not require a high GDP,” he said. “Unlike many more wealthy States, Senegal has ratified all core human rights treaties, and is also fully up to date with all reporting obligations. […] Belize, which has also ratified all core treaties, has made significant advances in its reporting, with the assistance of the Office. Samoa has ratified six of the treaties, with discussions underway on a seventh; it also has a very well-functioning follow-up mechanism.”
After applauding these countries for their achievements, Türk admitted that “despite these examples of less wealthy countries that maintain full engagement with the treaty bodies, the system overall faces a significant lack of cooperation from its States parties.”
The Committee on the Elimination of Racial Discrimination bears the unfortunate badge of being the treaty body with the smallest proportion of its reporting up to date. Meanwhile, the Sub-Committee on the Prevention of Torture was last year forced to suspend its visit to Australia, “due to the failure to cooperate by officials at the regional level.” Nicaragua's refusal, this year, of the same Sub-Committee’s planned visit was also mentioned by Türk.
A second issue is the backlog of both State Party reviews and individual communications, which Türk called “alarmingly high”: “As of 30 April,” he says, “there were 385 State Party reports awaiting consideration. It would take the Committees just over three years to clear the backlog, at current resources—not taking into account the new reports that would come in during that time,” he explained.
The situation for individual complaints is also dire, with over 1,800 complainants currently waiting for a decision about their cases. “Clearly, our resources are not commensurate to these important tasks, and we ask for greater support from Member States,” implored the Human Rights chief.
Türk maintains that the process of strengthening the treaty body is at a “critical juncture,” insisting that “it is essential that we build a more sustainable, cost-effective and fit-for-purpose treaty body system.”
Part of his efforts will be focused on the biennial General Assembly resolution on that very system, to be voted on in December 2024, and regarding this he hit a more optimistic note: “My Office has prepared options for a predictable calendar of reviews of States’ reports; harmonization of working methods of the treaty bodies; and a digital leap forward, and I hope very much that you can engage with this process, so that we have a robust result in December 2024,” he explained.
Behind the scenes, the situation is not as upbeat, and missions admit there are questions on how the system might survive. Different proposals have circulated, but none were able to bring governments to a consensus on what would it take to reform the mechanisms.
Last year, at the Third Committee, States adopted the biennial resolution on the Human rights treaty body system. However, during the negotiations, they insisted on changing the wording of the resolution. Unable to agree on “welcoming” the biennial report by the UN Secretary-General on the state of the treaty body system, they only “took note” of it; a sign interpreted by many as opposition to any strengthening of the mechanisms.
Today, the words of last year’s report still resonate in the corridors of the Geneva offices:
“The treaty body system is at risk of being eroded due to insufficient resources, chronic under-reporting and limited coherence.”
The International Red Cross in Crisis: What Would Henry Dunant Say?
By Daniel Warner
With the outbreak of civil war in Sudan, the continuing conflict between Ukraine and Russia, and at least twenty-five other conflicts worldwide according to the Council on Foreign Affairs Global Conflict Tracker, one would think the world’s leading humanitarian organization would be operating at full throttle. Instead, the International Committee of the Red Cross (ICRC) is in full crisis. Significant budget cuts, laying off 1,800 staff now and possibly 3,000 in the future, closing 26 of its 350 offices worldwide and reducing its presence in several troubled areas has led to retrospection about its fundamental mission. The venerable Swiss institution is in a late adult identity crisis.
What would its principal founder, Henry Dunant, say about all this?
First, Henry would be surprised at the recent rapid growth of the organization he founded in 1863 with four colleagues (Louis Appia, Henry Dufour, Theodore Maunoir, and Gustave Moynier). The budget has expanded from 1.15 billion Swiss francs ($1.27 billion) in 2012 to 2.85 billion Swiss francs ($3.15 billion) in 2023. In the same period, the staff has grown from 15,600 to 22,600.
What were the causes of this expansion? The obvious answer would be more conflicts and greater humanitarian needs. According to ICRC President Mirjana Spoljaric, in 2013 there were 140 million people in need of urgent aid; today, there are 340 million.
However, financial contributions have been not been sufficient to meet the stated needs. The projected budget for 2023 has been reduced from 2.85 billion francs to 2.4 billion because of donor reticence. The ICRC, which touts its independence from the Swiss government—although the official Red Cross emblem was designed as the inverse of the Swiss flag—has been forced to go to Bern to ask the Swiss Confederation for more money.
Today's Briefing: Philippe Mottaz - Jamil Chade - Daniel Warner
Editorial intern: David Jenny
Edited by: Dan Wheeler
