Countries gather in Geneva for health conference amid mounting tensions

Switzerland's president Alain Berset arrives with Tedros Adhanom Ghebreyesus, director general of the World Health Organization (WHO), before the opening of the 76th World Health Assembly (WHA) at UN's European headquarters in Geneva, Switzerland, 21 May 2023. (Keystone/Gabriel Monnet)

From pandemic negotiations to the war in Ukraine, this year’s World Health Assembly is set to tackle brewing global health issues as divides between countries deepen.

With the Covid-19 pandemic alert officially in the rearview mirror, countries are turning their attention to preparing for future health crises. The 194 member states of the World Health Organization (WHO) opened their annual gathering in Geneva on Sunday, 21 May. The assembly, which marks the health body’s 75th anniversary, will run until 30 May.

But thorny issues on the agenda coupled with mounting geopolitical tensions among some of its most powerful members are likely to lead to strained discussions and some of the usual confrontations.

Opening the conference, WHO director general Tedros Adhanom Ghebreyesus pointed to “the challenge of being a technical, scientific organization in a political – and increasingly politicized – environment”.

Snail’s pace negotiations

The underpinning theme of this year’s World Health Assembly is “saving lives, driving health for all” – a suiting slogan after three years of countries fighting Covid-19 on unequal footing has prompted calls for equity in access to health. During the pandemic, wealthy countries were first in line to receive millions of life-saving vaccine doses, while poorer countries without the capacity to develop their own had to settle for the scraps. But while the word equity is on everyone’s lips, the jury is still out on the how.

A debate will be held on Monday about the state of ongoing negotiations for a new pandemic accord and how to amend International Health Regulations expected to be concluded in less than a year. Diplomats have signalled that discussions are struggling to make progress with deeply entrenched divisions on a number of issues, namely intellectual property rights over vaccines and other medical products, and sharing of information to better monitor disease outbreaks.

Some point to the lack of a text basis to work from, which has made it hard to move forward, but say they hope that a first draft that the negotiating body is expected to produce soon will provide some clarity.

Heightened tensions

Tensions going beyond health issues will also come into play over the next week and a half. Russia’s invasion of Ukraine is set to draw condemnation from Western countries like last year as the assembly hears an update from Tedros on the health impact of a war that has killed at least 8,836 civilians and injured at least another 14,985 in a little over a year according to the UN Human Rights Office.

Ukraine, which had pushed for the proposal last year, is expected to renew its request at the meeting, possibly attracting pushback from Russia and its allies.

So will a similar report on the health situation in the occupied Palestinian territories. The document, which has already been published, urges Israel to “end the arbitrary delay and denial of access” to the occupied territories by Palestinian patients.

Increasing tensions between the United States and China are also expected to feature early in the conference as a yearly bid to admit Taiwan back as an observer to the assembly is defended by Washington and struck down by China.

Money talks

Differences brushed aside, countries have managed to at least rally behind the notion that the WHO’s budget is in dire need of more sustainability, predictability and flexibility. To that end, discussions will continue on a proposal adopted last year to ramp up states' assessed contributions, or annual fees, to the health agency’s core funding over the next eight years.

At the moment, less than 20 per cent of the WHO’s $4.9bn budget comes from these mandatory contributions by states, while the rest comes from donations from states, foundations and other actors, which often come with specific conditions barring the WHO  from using as it pleases.

But diplomats admit that the economic fallout of the pandemic, compounded by the war and inflation, might set back the initially intended timeline. Details on another proposal to create a replenishment fund to shore up the WHO’s budget will also be discussed. The aim would be to attract new donors through high-level funding events, the first of which would take place in the second half of 2024.

What else is on the table?

Two new proposals are also under discussion, including one led by Latin American countries, the European Union and Switzerland seeking for the WHO to play a bigger role in ongoing negotiations for a treaty on plastic pollution and to create an expert panel on chemicals.

Another proposal announced by Brazil back in January to call for Indigenous peoples’ health to be protected after Covid-19 violently swept through the South American country’s indigenous communities could also be tabled.

Assembly members are scheduled to hear from a report on women, children and adolescents' health, which may spark positioning from countries on reproductive and sexual rights as well as LGBTQI rights on both sides of the aisle. While the document in itself doesn’t mention sensitive issues such as abortion or sexual rights, there has been increasing pushback from a number of conservative countries to scrap any wording that might allude to them.