Cracks are forming in the World Health Organisation’s plans to secure a vast expansion of its powers and resources. Presented as a necessarily urgent response to the empirically unsupported assertion that pandemics are increasing in frequency and severity, negotiations for a broad package of amendments to the International Health Regulations (IHR) and a new parallel Pandemic Treaty had been expected to be over by the end of 2023. Having missed that deadline, in late January the Director-General Tedros Adhanom Ghebreyesus pleaded for WHO member states to give ground so that the negotiations could be completed at all. In the same comments he sought to apportion blame for the unexpected headwinds on those who had misconstrued, or misrepresented, the benign intentions of the WHO and its key supporters (which include China and some wealthy private organisations).
Reading between the lines, it appears that Mr. Ghebreyesus and his supporters may finally have realised that the game could soon be up: the strength of opposition to the ambitions of this unelected technocratic administration has compounded rapidly in recent weeks. That opposition has become more evident not only in smaller less influential countries, but in countries which are major contributors to the WHO. Significantly this has included groups of politicians in the U.K. and the U.S. who are seriously alarmed by the vision of a WHO-centred ‘command and control’ public health system, and by the constitutional and public spending implications of these two proposed international agreements.
The Director-General has perhaps realised that his blind ambition has not only put at risk the negotiations that might have elevated his unelected advisory organisation to the status of a supra-national rule-making authority, but is also now starting to jeopardise the future status, funding and membership of the WHO.
Secrecy, opacity and delay
The original timeline presented by the WHO had envisaged a final text of the proposed IHR amendments – where many of the most contentious proposals reside – being published before January 27th 2024, with a view to their adoption taking place at the World Health Assembly meeting scheduled from May 27th to June 1st 2024, alongside adoption of the proposed new Pandemic Treaty. That timeline, although tight, would have allowed four months for negotiators to brief domestic stakeholders, for national legislatures to debate the combined proposals and for any necessary pre-adoption formalities (approvals, technical scrutiny, cost/benefit analyses, etc.) to be completed prior to a vote at the WHA meeting in May.
Yet, on its own initiative, in October 2023 the Working Group for the negotiation of the IHR amendments unilaterally moved its own goalposts so that in place of publishing a final draft text to be scrutinised well in advance of that WHA meeting, it instead committed to circulate by the end of January a copy of the original set of proposed amendments and an interim ‘working draft’ text showing the current state of play. Negotiations would then continue between February and April 2024. It was – and remains – ambiguous whether this move was compatible with the procedural legal requirements already enshrined in the International Health Regulations, but perhaps member states quietly agreed with the WHO secretariat not to look too hard at that issue.