Dear Friends of ELIANT,

In spring, we informed you about the upcoming Pandemic Agreement, which was to be adopted by the 194 member states at the WHO World Health Assembly in May 2024. Since the countries could not reach agreement, a further 12 months of negotiations were decided. No interim reports have yet been published since then.

The negotiations on amendments to the International Health Regulations (IHR), which were first agreed 70 years ago, were, however, concluded and adopted by the member states in June 2024, despite the two worrying points that call into question the basic principles of democracy:

Broadening of the term “pandemic emergency”
A pandemic emergency is now defined in the context of a “public health emergency of international concern” as “a communicable disease that has, or is at high risk of having, wide geographical spread to and within multiple States, exceeds or is at high risk of exceeding the capacity of health systems to respond in those States . . .”
What is worrying about this new definition is that a pandemic emergency can be declared already on the basis of a suspected risk, thus giving the decision-maker a great deal of discretion.

The power of the Director-General
Since 2005, the WHO Director-General has had extensive powers under the IHR, which have become apparent worldwide as a result of the experience gained in dealing with the coronavirus pandemic. He can establish an Emergency Committee in the event of a pandemic, determine the number of its members and select the members of the Review Committee according to predefined criteria, which include balanced geographical, gender and scientific distribution, among other things. This Committee makes recommendations, the Review Committee can reject the recommendations or express concerns. However, the final decision on whether and how to adopt the Committee’s recommendations lies solely with the Director-General.
Giving a single person so much responsibility and power to make far-reaching global decisions calls into question the fundamental democratic rights of the civilian population. This requires increased vigilance from all of us – because:
The IHR have existed for 70 years and are integrated into the legislation of WHO member states. That is why the debate necessary in each country about the nature and extent of the implementation of the amendments adopted in June 2024 tends to be a routine matter if there is no awareness in civil society and politics of the far-reaching consequences.

Our question is: why has the further implementation of the WHO Ottawa Charter for Health Promotion of 1986 not been addressed?
In 1986, the WHO Health Assembly focused on salutogenesis/health research and promotion, something which was reflected in the jointly adopted Ottawa Charter. It says among other things: “This includes a secure foundation in a supportive environment, access to information, life skills and opportunities for making healthy choices.” At the follow-up meeting, it was also agreed that the states should take concrete action to implement the Charter’s goals.
It was all the more surprising, then, that in the case of the coronavirus pandemic, the protection of the population was seen solely in terms of vaccination. Yet the salutogenic principles and measures for strengthening resilience and immunity mentioned in the Ottawa Charter are equally important. Both are needed for “ensuring equal opportunities and resources to enable all people to achieve their fullest health potential” (quote from the Ottawa Charter). Why are these opportunities – which, moreover, include the democratic values of the right to physical integrity and personal responsibility – no longer being discussed in the IHR debates?

We need a civil society that is educated in health issues.
Since the implementation of the IHR is a matter for the individual countries, local initiatives are needed. We would welcome hearing from you in the various countries about the initiatives that are taking place in your country – and would also provide support where possible. In any event, we would be very grateful if it were possible for you to find time amongst the day-to-day pressures to campaign for the preservation of democratic rights, including those relating to health issues.

We will keep you updated.

With best wishes on behalf of the ELIANT team
Michaela Glöckler
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