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.
Notwithstanding this commitment, no interim working draft of the IHR amendments appears yet to have been published, and the U.K. officials involved in the negotiations have been inexplicably reluctant to reveal the current position of the text. Indeed, to date all demands for transparency by U.K. parliamentarians have been ignored or deflected by the ministers responsible for the U.K.’s relationship with the WHO. Astonishingly the U.K. Government has refused even to confirm who is negotiating on the U.K.’s behalf.
We understand that the IHR Working Group anticipates a final text being settled only during April or possibly even into May, but there remains no official deadline for it to publish that final text. It refuses to confirm what the documents say, and it refuses to say when it will reveal those documents. If any further evidence were needed of the disregard and disrespect for democratic process and the sovereignty of national parliaments now alleged of the WHO, then surely this is it.
Out of time
That corrosive secrecy, opacity and delay has left a vanishingly narrow window for domestic public health organisations and parliamentarians to review or comment meaningfully on what may become generationally-significant changes to the U.K.’s relationship with the WHO, with other countries and with the public health business community. It means Parliament will have scant opportunity to scrutinise the IHR amendments and the new international funding and resource-sharing commitments enshrined in the parallel Pandemic Treaty. Yet these are documents with the potential to impact materially on the U.K.’s ability to act autonomously, on freedom of speech and opinion, on health security and on the nature of U.K. democracy itself. They also have the potential to commit future generations to very significant public spending obligations.
Given their significance, the IHR proposals and the parallel Pandemic Treaty require a commensurate degree of examination by Parliament. The current nature of the WHO’s funding, 85% of which now comes from private commercially-interested organisations, creates an additional imperative for rigorous, investigative scrutiny. In November 2023, Human Rights Watch wrote that:
The draft [treaty] reflects a process disproportionately guided by corporate demands and the policy positions of high-income governments seeking to protect the power of private actors in health including the pharmaceutical industry.
Without sight of any working drafts of the revised IHRs, nor of the current state of the draft treaty, scrutiny is completely frustrated. At this late stage in the process, after repetitive calls for transparency seemingly have been ignored, one is left to wonder whether this is precisely the intent of the officials involved.
Deferral is the rational solution
As the window for full, fair, candid appraisal by national democratically-elected legislatures is now all but shut, the logical and necessary solution is for member states to demand that any vote to adopt either of these two international accords is held over to the next WHA meeting in May 2025. This will allow ample time both for the conclusion of the negotiations and for member state-level scrutiny of the proposals served up by the negotiating teams.
If it is truly the case that the WHO and its member officials do not intend for national legislatures to cede rule-making sovereignty to an enlarged WHO technocracy, they will surely accept the need for state-level legislatures to control the timing of this process. Calls for deferral have begun, but more voices will be needed to press relevant political leaders and officials to accept that deferral is the only legitimate response to this situation.
A turning point
Even now, in the face of a chorus of rational legally-grounded concerns raised by U.K. parliamentarians about the substance of the proposed amendments and the opacity of the negotiations, the Government has remained steadfastly unwilling to comment on its negotiating intent and objectives, beyond vague platitudes. Efforts by members of the public, legal experts and parliamentarians to understand the current state of negotiations, and even just the arrangements within the U.K. Government to conduct the negotiations, have been stonewalled. The WHO equally has remained virtually mute and offered no meaningful evidence to support claims that its ambitions have been misunderstood.
This has served only to fuel distrust in this process, in the Government and its senior officials, in the U.K.’s relationship with the WHO, and in the WHO’s relationship with its influential funding providers.
Behaviour of this overtly undemocratic nature indicates that the WHO project has long since lost sight of its noble foundations in post-war benevolent multilateralism, and indeed of its reason for being: health for all in pursuit of global peace and security. Unfortunately, the WHO is now a symbol of all that is wrong with what has become a system of global public health patronage. This shamelessly undemocratic and chaotic power grab is also indicative of an organisation which has reached the end of its useful life, at least in its current guise. We suggest that this sorry episode should become the impetus for the U.K. to revisit its relationship with the WHO, and the relationship of the WHO with its funding providers.
The U.K. will not be an outlier if it does so, but rather a role model and – judging by the breadth and strength of international expressions of antipathy for the WHO’s ambitions – a leader of fast followers. This may well be the U.K.’s best post-Brexit opportunity to be an actor of global significance on the international stage.
Molly Kingsley is a founder and Ben Kingsley is the Head of Legal Affairs at children’s rights campaign group UsForThem. Find UsForThem on Substack. Ben and Molly’s new book (co-authored with Arabella Skinner) The Accountability Deficit is available now at Amazon and other book stores.
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