The World Health Organization (WHO) on the High-Level Meeting on Pandemic Prevention, Preparedness and Response - Press Conference

Okay. And we should have some journalists online. So, again, thank you, everyone, for coming today to this special press briefing. We're here. We're joined by, of course, Dr. Tedros, the Director General of the World Health Organization. To his right is Professor Muhammad Janabi, who's the Regional Director for WHO Africa. To Dr. Tedros' left is Dr. Nedret Umu-Imir-Oru. How is that? who's running all our work on pandemic prevention preparedness and particularly in the light of the in the context of the pandemic agreement. So at this point I'll hand over to you Dr. Tedros if you'd like to deliver some opening remarks.

Thank you, thank you Paul and good afternoon and thank you for joining us. The COVID-19 pandemic was the most severe global health crisis in a century. It killed at least 20 million people and wiped more than 10 trillion US dollars from the global economy. It exposed and exacerbated fault lines in global health security. It taught the world many painful lessons. It's essential that the world learns those lessons because the next pandemic is not a matter of if, but when. The ongoing Ebola epidemic in the Democratic Republic of the Congo is a reminder that an outbreak can start anywhere, anytime, and pose a threat not only to local communities, but also to neighboring countries and the world at large. The Hantavirus outbreak aboard the MV Hondeuse was another recent demonstration of the need for an international response to an international threat. Thanks to the cooperation of many countries and partners, especially Spain, that outbreak was controlled and stopped. During and since the COVID-19 pandemic, WHO established 12 key initiatives to strengthen global security in six areas. To strengthen national capacity, the Pandemic Fund with the World Bank and the Universal Health Preparedness Review. To strengthen surveillance and early warning, the WHO hub for pandemic and epidemic intelligence in Berlin. To improve equitable access to vaccines and other tools, the Access to COVID-19 Tools Accelerator and COVAX, the International Medical Countermeasures Network, the mRNA Technology Transfer Programme in South Africa, and the Biomanufacturing Workforce Training Initiative in the Republic of Korea. To encourage international sharing of pathogen samples, the WHO BioHub in Switzerland, To strengthen international response capacity, the Global Health Emergency Core, and to strengthen the international legal framework that governs pandemic prevention, preparedness, and response in 2024, our member states adapted a package of amendments to the International Health Regulations. And of course, last year, they adapted the WHO Pandemic Agreement, a landmark instrument of international law. The final piece of the puzzle is the pathogen access and benefit sharing system, which countries are continuing to negotiate. Although differences remain, I'm confident that countries will find common ground, just as they did with the agreement itself. It's essential they do, so the agreement can begin the process of ratification and enter into force. We continue to see significant mis- and disinformation about the WHO Pandemic Agreement, with false claims it's a power grab that cedes sovereignty to WHO. This is completely untrue. The Pandemic Agreement was written, negotiated and adopted by sovereign countries acting in their own national interests. That's because they realized that a shared threat demands a shared response. And every country for itself approach will not work. That same conviction is the basis of the political declaration that countries are discussing at the high-level meeting today. The declaration includes important commitments to concrete, measurable, and urgent action to address gaps. WHO thanks Member States for their commitment, and especially the co-chairs from Andorra and Saint Kitts and Nevis for their leadership and negotiation, from Rwanda and Armenia for their leadership of the negotiations. We look forward to its adoption and to supporting all countries to fulfill the commitments they have made. Thank you, and we look forward to your questions.

Thanks very much, Dr. Tedros. Please, introduce yourself.

Thanks a lot, Paul. I'm Carrie Notten from Radio France Internationale. On behalf of UNCA, the UN Correspondent Association, we thank you for your briefing, Dr. Tedros. A declaration was supposed to be adopted today, a political sign, a non-binding agreement, but still the US, who on top of that are not a member of WHO anymore, have decided to not join the consensus. Can you tell us what will the concrete consequence of this decision be?

Yeah, thank you. Thank you. As you may know, in the past, high-level meetings actually are finalized through consensus. And the first incidence was last year. And last year, the decision was deferred to the Assembly, to the General Assembly, and the General Assembly voted. And of course, it was supported by majority of countries. This is about the NCDs. And there was only one country that objected, actually. So it's again the same process. I think the president of the assembly will follow. This will be deferred to the General Assembly, and we hope that the member states will vote in December. That's what we were informed. I think in December is is it October or December but they so yeah it will pass I don't think there is a problem because it has majority support and this is not a problem by the way it's democracy in in action and there are different opinions and they couldn't resolve it via consensus so going into a vote is not really a problem yeah Yeah. Thank you. Please.

Thank you so much, Dr. Tedros. It's Pamela Falk from U.S. News and World Report. And congratulations on last night, several of the awards you have gotten for your work on the pandemic. My question is, you said something less than -- I mean, not as cautious as you usually are, that the next pandemic is when, not if. What do you see as the possibility of the next pandemic? Some people think a respiratory disease, some people think another coronavirus. And has the world learned anything from the last pandemic? I mean, we were all sort of-- we lived this one. And it was really shocking. What do you see in terms of-- things that might have been learned from this past one? Thank you.

Yeah. So as I said it in my speech, based on COVID lessons, there are several initiatives, around 12 of them, being implemented. And this will prepare the world better. From the 12, by the way, the pandemic agreement is central, because it's about coordination and governance and the equity issues and so on are also addressed. But of course, it covers the whole process from prevention to early detection to response. And the pandemic agreement will help us to be better coordinated and the whole system will be better governed. So I can say with these initiatives, the world can be better prepared. But still, we are very vulnerable because these are the 12 things are under construction yet. and we are still vulnerable and one of the fears is, which wakes me up at night, it could be a respiratory pathogen may emerge and that may again cause all the damage, like the damage that COVID had done. That's why we're asking our members, please conclude the Pubs Annex. the pathogen access and benefit sharing. And please start the ratification process of the pandemic agreement. And let's really prepare the world for any eventualities. But the second question is, have we really learned? That's very difficult to say because there is still this cycle of panic and neglect. As you may remember, when COVID hit, the whole world was panicking and many countries invested a lot of money. But as soon as COVID was declared over, the investment in health and especially in health security started to decline. And the very alarming part is countries are investing a lot of money, trillions, I think last year's military expenditure globally was 2.7 trillion dollars. Trillions in security to kill each other, while investment in health security to prevent the virus or to manage a virus, which is an enemy to all humanity, is being ignored and being neglected. So to be honest, of course there is this investment, there are these 12 initiatives But the world could have done more, bigger, and also with speed. We are saying that two are not there. So the scale is not as big as what we expect, because during COVID, there was that kind of urge, but that has really gone down. So the scale is not as one would expect, and the speed also is not as fast as what we expect. So, on the learning, I think as human beings, maybe we forget and move on, and that's not good because the next pandemic could be a serious one.

Can I just follow up? Would you say the principal piece of the pandemic preparedness would be to share information for countries?

To share information is one, but the whole package, the whole including equity, for instance. Yeah, and prevention even, it should start from prevention. We need to build capacity at national level to prevent and if anything happens, to early detect and respond swiftly. especially the national capacity is important, whether it's surveillance, collecting information, sharing, and all the things they should do at country level, because we are as strong as the weakest link. And unless we invest, especially in countries that are vulnerable, the whole world will be affected by the weaknesses you see in some places. That's why also, you know, investment in health security is not charity, it's actually in the best interest of all countries and whatever income levels they are, because no country can do it alone. It's impossible, because the world is so interconnected, smaller, and the virus can start somewhere and move to another place within hours. It could. So that's why there is no other way, through cooperation and helping each other to strengthen capacity starting from the country level, of course. Thank you.

Thanks very much. I will take one more question in the room, then go online, if that's okay, then we'll come back to other journalists in the room. Just to note that we have 10 minutes, but Dr. Tedros has to be at an event in 10 minutes time. So, questions. Please, sir.

Thank you, Paul. My name is Deepak Arora with the Tribune Online from New Delhi, India. Dr. Tedros, you mentioned the figure of 20 million. in your opening speech. Do you think that's a correct figure, because many countries did not report the actual deaths? That's number one. Secondly, how far do you think is Ebola spreading? Because recently, Indian government has, when you enter back, they ask you if you have been to those countries where Ebola is. I'll ask my next question a little later.

Would you like to to take this.

Yeah, I can top up. So I'll talk about Ebola, how far does it spread. As we speak now in Democratic Republic of Congo, there are seven provinces which are affected, 63 health zones are affected. and two newly affected zones were recently identified just last week. And when we talk of Democratic Republic of Congo, when we say province, it's almost the size of a country. So it is crossing borders. As you know, it was in Uganda. Luckily, it has been controlled. We are watching very closely South Sudan in an area called Dungu and Central African Republic, which because there's a river there, River Bangi, which really crosses all the way to Kinshasa. So we are watching very close and areas near Uganda and other neighboring countries. We have 10 countries which we have put them as a high risk and this is where we are doing a lot of preparedness. for them to be ready just in case. So currently as of 23rd of September we have 7,890 cases which are confirmed and over 3,799 deaths already. The case fatality is still high at 48.1 percent and but We have to look on the good side also. Over 2,000 have recovered. So we are still, the transmission is still active and Ituri remains to be the epicenter and North Kivu remains the second major hot spot with substantial possibility. But as we have said before, we are dealing in a very different place this time. You recall last year in Bulape, in the same DRSE, we managed to contain it in 88 days. But the environment is completely different now with East, with all the insecurity, over a million people displaced, the health infrastructure a little bit shaky. And as you recall, we declared, I mean, the country declared on the 15th of May, but really, we strongly believe that it started early this year, so we are chasing the virus now. So the bottom line from WHO perspective, the outbreak is not yet under control. While some areas show recent declines, the appearance of new affected health zones and spread into additional provinces indicate that transmission chains are still being established in new locations.

And so, there are, yeah, okay, I will.

So on Ebola, Professor Jenab had already raised the important issues, but I just would like to add a few. One of the challenges is when we speak to the communities, we have been there actually together in Bunia. The communities actually believe that Ebola is a lesser evil because they're dying of other health problems and they're dying of even conflict, bullets. And even one of the community members said to me, "I know somebody who died of other things, but not Ebola." And he continued to say, the international community, when Ebola comes, we see a lot of activity. While when we are affected by other health problems and also conflict, we don't get that much support. That's what they said. So, and we said, we know why, it's because you're afraid that Ebola will come to you, but the other problems will not. So it was a very honest discussion. And to be honest, there's nothing I can say except agree. Because they should be supported with the other health problems, and they should be supported with the humanitarian services they need, because there is hunger, and there is displacement. and they should be supported also with, you know, finding a political solution for their problem. And there is one thing they asked us, you know, we have been in turmoil for more than three decades now, we need peace. And that's why we have always been saying, by the way, peace is the best medicine. So that's what the community say. So, I think when we discuss about Ebola, we have to take that into account. And in our response, now the international community should help the communities to strengthen their health system, to address also the other health challenges, to support them with humanitarian services, and also to continue with the efforts to resolve the political problems peacefully. and bring peace. It's very difficult to see Ebola in isolation because even our response in Ebola is affected by the conflict because there is displacement and there is access problem to some areas and you can't go to these places to identify contacts. And if you don't have access and you're missing contacts, then the transmission continues. And there are other problems because of the conflict, like displacement. People move, and that also causes a problem. And then in the internally displaced areas, there is crowding. That's a perfect place, actually, for transmission. And there are other complex-- that adds to the complexity of the situation, other problems. So we have to see the overall. But having said this, there is progress. One is Ebola is contained within the R system. There was some spillover to Uganda, but that was swiftly controlled. It's still for four months since WHO declared the emergency as public health emergency. It's contained in the R.C. That's at least a good news. But still, we are not sure if it will remain the same. So that's why we have to continue to strengthen our response. And the number of cases is declining overall, although we are concerned that in North Kivu there is an increase. So we have to-- we cannot just see the overall. We have to also check, go into details, and see if there are changes, like increase in some of the provinces. But there is progress in contact tracing, safe burials, even community engagement has improved because there is community mistrust in the community. And there was some misinformation which was affecting. And then there is no also incentive for people to come forward because there is no vaccine, there is no treatment. But there are now advances in trials also, vaccine and treatment. Without incentives, it's very difficult to attract people to the centers because, okay, why would I come? You isolate me and then I die alone. Why should I? So we need to have incentives. And that's why we're expediting the trials. Then on the 20 million, the 7 million is the reported and documented. 20 million is the excess mortality. So using the two would help actually instead of one. So documented is seven, but of course all has not been reported. So if you do the excess mortality is actually 22 million. So we need to use both figures that will show how COVID was actually damaging. because it's a serious figure, actually, this level of loss.

Dr. Theotou, there are a lot of cases, for example, in India. We have a flu, and there are different kinds of flu there. So I'm sure you must be monitoring all over the world. Is there anything serious happening, or is it just kind of a routine flu? Some cases are serious in India. So what's your assessment of that?

Yeah, we follow all signals, and when there are serious, it's reported. But so far, actually nothing very serious. We have the Ebola, we have MPOX, Ebola. There was Hanta, it was controlled swiftly. But if there is anything serious, it's reported.

Thanks very much. We need to go to a journalist on the line now. Gabriela Sotomayor from the Mexican news outlet Proceso. Gabriela, please, over to you. Brief question. Thank you. We have to wrap up shortly.

Yes. Thank you so much, Paul. Thank you very much for taking my question. Hola, Dr. Tedros. My question is, you mentioned in your remarks that there are some false claims against the Treaty. If you can elaborate on that, What kind of false claims or what are they saying? And also, which are the sticking points of the treaty? What do you consider it's, you know, and some countries not to engage? And if you can say which countries are the ones that are presenting their doubts about the treaty or what is happening, because I don't see any that thing on this treaty, you know? I mean, but okay, it's my opinion. Okay, thank you.

Thank you very much for the question, and I will take your point on the pubs negotiations related to the pandemic agreement. I think we have seen full engagement from many member states. And actually, during the speeches also today, we have heard a lot of support to the Pubs negotiation being completed and the pandemic agreement opening for signature so that it can be ratified, which is covering, of course, all aspects for prevention, preparedness, response, resilience, as Director General mentioned. What the members discussing at this stage is what are the conditions to have access to the pathogens which might create a pandemic emergency or their sequence information. That's one part. What are the conditions? Then what are the conditions that requires the benefits to be shared which are produced using those materials and sequence information, particularly vaccines, therapeutics, and diagnostics. That, of course, is a follow-up of the COVID lessons learned that we have seen, I think, a record time research and development and the product development, which we were very lucky to have the diagnostics, some treatment options and vaccines available, but it is equitable distribution in solidarity that is the problem. The Pubs is trying to put it in what they call equal footing, so you have access but you share the benefits as well. Those details of the sharing and the benefits are being negotiated by membership at this stage. And as Director General mentioned in his opening, we are confident that the world is going to conclude on time so that pandemic agreement could enter into force.

Now, just to top up, apart from what has just been said, the agreement really is a fundamental about improving preparedness, about sharing information, more rapidly and strengthening the health systems and ensuring that more equitable access to the life-saving tools during future pandemics which have been speculated here. So all this information that the agreement, it does not give WHO any power to impose on lockdown, to deploy troops or override national sovereignty. So countries remains fully sovereign.

And there is a provision actually that addresses these false claims in the pandemic agreement itself, an article saying exactly what Professor Janabi had said. OK.

OK. You had your hand up. Please go ahead. But I have a quick question.

Sure. Thanks so much, Doctor. I'm Nathan Guma from Zimbabwe. I'm a DAKAMASHOD fellow. So several countries in Africa have been rejecting health deals, bilateral health deals with the United States over data sharing concerns. And as a result, this is likely to widen the funding gap. So what could this mean for sustaining progress against HIV across Africa?

Can you repeat, widening gap? Sorry, can you rephrase the question?

Oh, so several countries in Africa, some countries in Africa have been refusing or have been rejecting funding deals, bilateral funding deals with the United States over data sharing concerns, which is likely to widen HIV funding gap in the fight against HIV. So I just wanted to know from you what this could mean to in the fight against HIV since it's also a global pandemic.

Yeah, thank you. So these countries are basically saying the agreement is not in their interest. And this is a bilateral agreement. WHO normally doesn't comment because this is between two sovereign countries. So there are some countries who agreed and signed and some countries who haven't agreed. And Of course, those who prefer to, who didn't want to sign, at the same time, they are doing everything to mobilize national resources. And they're actually saying that we can cover the programs and other expenses, the healthcare needs. I mean, that kind of health sovereignty, I think it's their right, and it may even address the donor dependency that we see. But I'm glad to see countries actually taking responsibility and allocating their own resources. It's, I think, the right path. But on who is refusing to sign or what, since these are Countries who are sovereign, they can-- I think it's up to them. And by the way, the bilateral doesn't affect the multilateral also. Bilateral agreements have always been there. It's not new. There are bilateral agreements. There are multilateral agreements. And I don't think, as a principle, any problem with the US signing bilateral agreements with some countries, no problem at all.

We have one last question, but it can be really quick, please.

Thank you very much for the briefing. My name is Mona Aoutoul. I'm with Al Quds Al Arabi. Earlier today, the Secretary General, he pointed to Ebola in the DRC as a test of readiness. I'm sorry. And he warned that funding and political commitment tend to fade once the outbreak decline. My question is, since you just mentioned prevention as something that is fundamental to prepare for these outbreaks, we know that in the DRC there is an acute malnutrition affecting children. So how is WHO making sure that nutrition and essential services are protected as part of that effort to prepare for an outbreak before it happens? And thank you so much.

Would you like to take or as you wish. So on the I haven't heard what, of course, it's just only the quote from the SG you told me, but unfortunately I didn't follow the speech. But what he said, based on just what you shared with us, continued commitment in terms of political commitment and funding is very important, not just during the outbreak, but during peacetime. Actually, the system is built during peacetime, whether it's promotion, prevention, early detection, the whole system. That's why we have been saying almost the same thing. There are these 12 initiatives that can help the world to be better prepared, including the pandemic agreement, which we are saying you have to finalize now before the next pandemic hits. Ebola will not be a pandemic, but there could be a respiratory pathogen that can become a pandemic. So before that hits, we need to prepare and finalizing the pandemic agreement or the PABS, the pandemic is signed, but the PABS is important. And there is funding component also in that. Of course, together with the World Bank, we established the pandemic fund and to be used by countries based on the gaps they identify. They do peer review mechanism, identify gaps, And then based on the proposal they submit to the World Bank, they get the funding to fill those gaps. Because as I said earlier, capacity at national level is very important. And this is done now, before the pandemic hits. And there are other things. So I fully agree with the Secretary General. The investment should not only continue, it should actually increase. And it's a matter of keeping a balance. Many countries are already spending more money on defense. I think the health security is very important, and they have to invest in health security as well, because this is a shared problem, a virus, and needs a shared response. Thank you.

Thank you, Dr. Taylor. Thank you, everyone, online and in the room, for joining this press briefing. And please contact me if you need any further information. Thank you. Have a good day. Thank you.

Thank you.