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💥 Take Quick Action! Opportunities to create impact with a quick action are marked with a 💥 throughout the Playbook!
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The twelfth meeting of the Intergovernmental Negotiation Body (INB) (Nov. 4-15) is nearing a close this week after much deliberation. What’s happened so far, and what are its implications considering a quickly closing window — a mere 15 days of scheduled negotiations before the 76th World Health Assembly (WHA76) in May 2025 — to make progress on a pandemic agreement?
- Setback. In the biggest outcome, insufficient progress on negotiations and concerns about “sacrificing content for haste” led to the INB’s decision to forgo adopting an agreement at a special WHA in December. Some countries and stakeholders cautioned against speeding up the process, and many hold to this position despite political changes with the U.S. election which could derail the agreement’s adoption. However, advocates expressed disappointment in the decision, calling it “an abject failure of the international system” in a moment when the need for an agreement is exceedingly urgent as the Rt. Hon. Helen Clark underscored.
- More green lights needed. Even though slow, progress on green-lighting text is underway with agreement on regulatory strengthening (Art. 14) and some R&D capacity sections. Still, that leaves us with a still-too-long list of sticky issues to be greened: PABS, financing, and tech transfer, among others. 💥 ICYMI! Catch PAN’s daily recaps from the Geneva negotiations — Day 4, Day 5, Day 6, Day 7, and Day 8 — and check back for more.
- Onward — what’s next? Despite moving past a December deadline, negotiations are not slowing down, and there is still a chance for the INB to hold a special session ahead of WHA76. The INB will gather again Dec. 2-6 for another round of negotiations. On the last day, they will take stock of progress again to determine if finalizing and approving an agreement earlier is possible. In the meantime, PAN and partners will continue to monitor and push for building bridges to finalize a meaningful, actionable, and equitable pandemic agreement.
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Sifting through the COP29 noise.
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COP29 kicked off this week (Nov. 11-24) in Baku. While it is far too early to determine any results, here’s what is emerging through all the noise.
- Red alert. The World Meteorological Organization opened COP with a “red alert.” The State of Climate 2024 Update confirms that this year is on track to be the hottest on record, UN Secretary General António Guterres called out 2024 as “a masterclass in human destruction.”
- Messy finance COP. This year’s conference has been dubbed the “finance COP,” but will it deliver the level of finance needed to deliver robust Nationally Determined Contributions (NCDs) to reduce emissions and build resilience to climate impacts? Current reports call finance talks “a mess.” In Baku, negotiators must agree on a new global climate finance target — a New Collective Quantified Goal on Climate Finance (NCQG) — which will replace the current US$100 billion annual target that was promised in 2009, but was rarely met. 💥 Learn more about the shape of potential finance and why Baku must deliver and read this explainer on the NCQG and its importance.
- Health — more than just a day. Building on last year’s first COP Health Day, stakeholders and advocates are continuing to make progress in integrating health into the COP negotiation process. WHO launched a special report on climate and health along with technical guidance on Healthy NDCs. The message: “The climate crisis is a health crisis,” and we must “abandon the siloed approach to addressing climate change and health.” WHO and COP29 host, Azerbaijan, issued a joint statement yesterday calling on countries to adopt “healthy” NDCs.
- Early win — pandemic debt pause clauses. The World Bank expanded its definition of what qualifies for a debt pause in a disaster. The Bank’s Climate Resilient Debt Clause (CRDC) now covers all natural disasters, including droughts, floods, and health emergencies like pandemics. This allows eligible countries to defer principal and/or interest repayments on International Bank for Reconstruction and Development and IDA loans for up to two years.💥 PAN has been and will remain steadfast in our advocacy to ensure pandemic and epidemic debt suspension clauses be included in new country lending agreements. We need the same principles applied for all LICs grappling with epidemics and pandemics.
- Building bridges. Barbados Prime Minister Mia Mottley shared at COP29 that she has invited U.S. President-elect Trump for a face-to-face meeting to seek “common ground”. She shared, “We have the capacity to meet face-to-face, in spite of our differences. We want humanity to survive.”
- Announcements, reports, and more.
- Take action and engage! 💥 Use the ClimaHealth.info COP29 hub to find health-focused events and resources, including live-streaming options. Note: Key events are not limited to Nov. 18 — the official Health Day.
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New EU Commissioner-designates take the stage. EU Commissioner-designates completed hearings with final approvals possibly in time for a Dec. 1 start — though bad blood between the major political groups has led to last-minute dust-ups. Commissioner-designate for Preparedness and Crisis Management Hadja Lahbib will be leading the development of the EU’s Preparedness Strategy, which covers health. Commissioner-designate for International Partnerships Jozef Síkela underscored his primary focus, scaling up the Global Gateway, raising concerns about the next aid instrument’s social sectors and quality. Meanwhile, concerns about EU ODA’s future were not eased by the Commissioner-designate for Budgets Piotr Serafin, who failed to mention external action in his hearing.
U.S. election ripple effects. The global health community and our network of partners are watching to see how the new U.S. leadership will affect our priorities, as President-elect Trump begins to announce his initial leadership team and policy agendas. While it is too soon to understand specific ramifications, messaging is strong on driving government efficiencies and protecting American interests. As we adjust to a new political landscape, it’s clear that our Network will need to focus, coordinate, and communicate while adapting strategies, partnerships, and messaging to resonate with new leadership. Here’s a snapshot of what we’re reading on the U.S. election impact.
Stop cuts — préserve solidarité. More than 50 civil society organizations, led by Global Citizen and including PAN, published an open letter in Le Monde (English version) calling on the French government to revert the announced 35% cuts in aid and to preserve the earmarking of revenues of solidarity taxes. 💥 Add your support and amplify this call-to-action.
Mpox — still not under control.
- Situation report. As of Nov. 13, 19 African countries reported 12,178 confirmed mpox cases this year. Africa CDC estimates that there are 2,500-3,000 new cases per week, leading Africa CDC’s Dr. Ngashi Ngongo to warn that “the situation is not yet under control.” However, there may be signs that infections have “plateaued” in the hard hit Democratic Republic of Congo’s (DRC) South Kivu province. WHO will convene an Emergency Committee meeting on Nov. 22 to assess the mpox outbreak’s PHEIC status.
- “Full efforts of a global village.” The Access and Allocation Mechanism for mpox announced on Nov. 6 a 899,000 vaccine dose allocation to nine of the hardest hit countries with the bulk of the doses heading to the DRC, where shortages are delaying vaccination campaigns in Kinshasa. While the allocation announcement is welcome, it will take the full effort of a global village to improve equitable access to vaccines. Africa CDC’s Dr. Jean Kaseya called on the new U.S. Trump administration to honor existing vaccine pledges and “fulfill their commitment.” To improve testing access, Africa CDC has endorsed the first locally-produced mpox test — a PCR test from Morocco. Additionally, according to PAN analysis, non-vaccine interventions must be strengthened to curb mpox’s spread in vulnerable communities and high-risk settings. 💥 Get the latest on the mpox situation, analysis, and policy recommendations in the PAN Insights & Actions: Making Sense of Mpox Trackers, now including the Africa CDC tracker.
Marburg countdown. Rwanda appears to continue holding steady at 66 confirmed Marburg cases in its outbreak as no new cases have been reported since Oct. 30. The country initiated on Nov. 9 the 42-day countdown to declare the end of the outbreak if no other cases are identified. As of Oct. 31, more than 1,500 front line workers received the Sabin vaccine, and the Sabin Vaccine Institute announced its distribution of 1,000 more doses. In a Nov. 7 briefing, Africa CDC’s Dr. Jean Kaseya urged the U.S. to lift its Marburg-related travel restrictions on Rwanda, pointing to Rwanda’s control of the outbreak. 💥 Read and amplify this call to action from women health care workers on the Marburg front lines.
H5N1 — moo-dy forecast.
- Situation report. With more identifications of cases in California and Washington state farm workers, the U.S. confirmed H5N1 human cases are at 46 in six states as of Nov. 12. Wastewater surveillance sampling in Los Angeles County detected H5 on Nov. 1, although no human H5N1 cases have been reported in the area. Canada announced its first confirmed positive H5N1 case in a teenage male in British Columbia on Nov. 9. The source of exposure is unknown, and the patient remains in critical condition. Meanwhile, nearly a quarter of California’s dairy herds have been infected. Beyond the Americas, England confirmed an H5N5 outbreak in commercial poultry on Nov. 5 and raised its avian flu risk levels from medium to high.
- Results and responses. The U.S. CDC’s serology tests on H5N1-exposed dairy farm workers showed that 7% of the workers had antibodies, implying recent infections and the existence of undetected cases. Half of those identified recalled illness in line with exposure dates. Separately, the CDC’s Morbidity and Mortality Weekly Report underscored poor PPE usage among workers even when available, due to hot weather, humid conditions, and discomfort. Encouragingly, PPE usage increased nearly 30% after H5N1 detections on farms, and findings from both reports do not support human-to-human transmission concerns. The CDC is changing course given these results and now recommends testing and offering Tamiflu to farm workers exposed to H5N1 regardless of presenting symptoms. But, will the updated recommendations have any impact since the CDC’s legal authority faces limits and reluctant farmers? Separately, the U.S. Department of Agriculture announced plans to improve testing and monitoring through milk samples and farmer outreach.
- Dark clouds ahead? If it was difficult to raise alarm bells for H5N1 response and action before, experts and advocates are rightfully concerned for what lies ahead with U.S. leadership that may fuel anti-public health positions. There are strong calls for urgent action in surveillance, R&D investments, transition plans, and more. Because while leaders may take a path of inaction, we know that viruses will not.
Dziękuję, Polsko! The Government of Poland pledged to increase its contribution to IDA by 100%, compared to its previous contributions. IDA remains the largest source of grants and low-cost loans for the world’s 75 poorest countries, 39 of which are in Africa representing 70% of IDA’s financing commitments. 💥 Read and use our call to action to African Ministers and IDA shareholders.
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With many parts of the U.S. and EU bioeconomy using synthetic nucleic acids (NAs) without standardized screening protocols, NA misuse could lead to catastrophic outcomes of pandemic proportions. PAN, together with The International Biosecurity and Biosafety Initiative for Science, Pour Demain, and RAND Europe, developed a brief detailing key risks, the current landscape, and reasons why the EU should act to ensure better resilience against future health crises and national security challenges. 💥 Read and amplify the brief.
Prepare for next week’s G20 Leaders’ Summit (Nov. 18-19). 💥 Check out the latest on the agenda, which will be focused on social inclusion, global reform, and sustainability. Read the transcript from the Center for Strategic and International Studies’ press briefing, Previewing the 2024 APEC Forum and G20 Leaders’ Summit.
The World Bank’s From Double Shock to Double Recovery: Government Health Spending Trends and Outlook reports declining government health spending in LMICs, leading to major economic and pandemic preparedness setbacks.
The U.K. announced plans to develop a real-time surveillance system that monitors future pandemic threats in partnership with Genomics England, U.K. Biobank, NHS England, and Oxford Nanopore.
Africa CDC launched the Africa HealthTech Marketplace, a platform offering a range of digital health solutions for countries’ custom access, cost, infrastructure, and needs, on the sidelines of the Africa Health-Tech Summit 2024.
Last Mile Health and Integrate Health launched a Framework for Action: Achieving Gender Equity in the Community Health Workforce with 16 actionable recommendations.
What we’re reading:
Nominations are open for the 2025 Global Citizen Prize: Citizen Award. Submit nominations by Dec. 15.
The Lancet Countdown is hiring a director for its upcoming Lancet Countdown Africa Regional Centre. Apply by Dec. 15.
Have something to share with the Network? We accept communications, policy, and advocacy opportunities on a rolling basis.
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