The World Health Organization can make recommendations after the declaration of a global emergency, but it has no control over any nation’s decisions. Yet conservatives in the U.S. falsely claim that amendments proposed by the Biden administration to existing global health regulations, and a new WHO pandemic treaty, will threaten U.S. sovereignty.
The International Health Regulations make up a legally binding agreement signed by 196 countries, including the United States, defining countries’ rights and obligations in handling health events and emergencies of international concern.
The regulations were first adopted by the World Health Assembly in 1969 in response to deadly epidemics in Europe, and revisions were adopted in 2005.
The International Health Regulations require that all members have health system capacities to detect, assess and respond to dangerous public health emergencies, and that they notify the WHO of emergencies that may be of international concern. The agreement is legally binding, meaning the member states must report these events. Still, according to the Centers for Disease Control and Prevention, only about a third of the countries in the world “have the ability to assess, detect, and respond to public health emergencies.”
“It has no control over national health policy, and no enforcement mechanisms,” Lawrence O. Gostin, a global health law professor at Georgetown University, told us about the IHR in an email.
But several conservative media personalities are falsely claiming that 13 amendments to the IHR submitted by the U.S. for discussion at the Seventy-fifth World Health Assembly in Geneva will threaten U.S. sovereignty. The amendments were submitted in an effort to improve a future global response in light of the weaknesses shown during the coronavirus pandemic. The assembly began May 22 and ends May 28.
In an interview with Steve Bannon on May 9, former Minnesota Republican Rep. Michele Bachmann said the Biden administration “is bringing amendments that would propose that all nations of the Earth cede their sovereignty over national health care decisions to the WHO.”
A week later, Daniel Horowitz, senior editor at the conservative media company The Blaze, claimed the amendments “would essentially allow the director-general of the WHO to declare a public health emergency in a country and unilaterally coerce its citizens to take certain actions.”
And on his May 19 show, Fox News’ Tucker Carlson said: “The Biden administration is very close to handing the World Health Organization power over every aspect, the intimate aspects, of your life. So, imagine the civil liberties abuses that you lived through the COVID lockdowns, but permanent, and administered from a foreign country.” Gabriella Stern, WHO’s director of communications, replied to Carlson on Twitter: “News to me.”
Gostin, who directs the World Health Organization Collaborating Center on National and Global Health Law and is an expert on the International Health Regulations, told us there is no truth to these claims.
“WHO has no authority to dictate US health policy whatsoever,” he said. “The Regulations have no control whatsoever over national health care policy or programs. That is entirely a matter for the sovereign nation to decide. The WHO can make recommendations after the declaration of a global emergency, but they are just recommendations and are non-binding. States are legally bound to report dangerous outbreaks, but there is no enforcement mechanism and countries often do not comply. China, for example, failed to promptly report COVID outbreaks, which conservatives in the US roundly condemned.”
The amendments proposed by the U.S. do not change the WHO’s authority over other nations. They are aimed at making the global response to outbreaks faster and more efficient, as we will explain.
“Strengthening the IHRs in no way diminishes U.S. sovereignty or the ability of Americans to make their own health care decisions and claims in that regard are categorically false and dangerous,” said Health and Human Services Secretary Xavier Becerra in a Twitter thread on May 20.
While talking about the IHR amendments, conservatives have also brought attention to another proposal for a different international instrument for pandemic preparedness and response, also referred to as a pandemic treaty.
Horowitz, for example, claimed the treaty will threaten national and individual sovereignty “and make us all lab rats in the hands of wicked global elite oligarchs.”
On his May 19 show, conservative radio talk show host Charlie Kirk urged his audience to ask their representatives to stop the treaty.
Florida Sen. Marco Rubio and Texas Rep. Ronny Jackson, also asked their followers on Twitter to try to stop the treaty. A petition to stop the WHO’s pandemic treaty, which had over 80,000 signatures on May 24, claims the treaty “looks set to be one of the biggest power-grabs in living memory, with unelected globalists seeking the power to declare pandemics, and then control your country’s response.”
But again, none of those claims is correct.
It’s important to note that the amendments to the IHR proposed by the U.S. and the pandemic treaty are different things. Both are being discussed during this month’s session of the World Health Assembly. But as we explained, the IHR are an established set of rules that govern global public health emergencies. The pandemic treaty is a new global initiative to strengthen pandemic prevention, preparedness and response that won’t be ready until 2024.
The need for some kind of international instrument addressing preparedness and response was brought up by 25 global leaders in March 2021 and was later agreed to in a special session of the World Health Assembly in December 2021. In the next two years, an intergovernmental negotiating body, in which each member state is equally represented, will hold public hearings and meet with all countries involved to draft and negotiate the agreement. The negotiating body held its first meeting in February and will meet periodically until 2024, when a final draft will be presented to the assembly.
Although the accord is being called a treaty by some, there is no clarity on what kind of instrument it would end up being — a treaty or another kind of binding agreement, such as the WHO Framework Convention on Tobacco Control, or a nonbinding agreement, such as the Paris Climate Accord. “As with all international instruments, any accord, if and when agreed, would be determined by governments themselves, who would take any action while considering their own national laws and regulations,” a WHO spokesperson told us in an email. If it were a treaty, for example, it would need to be approved by the U.S. Senate.
“This represents the world’s opportunity to plan together, detect pathogens quicker, share data broadly and collectively respond more effectively to the next diseases X or known pathogens,” Dr. Tedros Adhanom Ghebreyesus, the WHO director-general, said of the accord during a COVID-19 media briefing on May 17. “Unfortunately, there has been a small minority of groups making misleading statements and purposefully distorting facts. I want to be crystal clear. WHO’s agenda is public, open and transparent. WHO stands strongly for individual rights. We passionately support everyone’s right to health and we will do everything we can to ensure that that right is realized.”
Although Biden administration officials support the creation of a new pandemic treaty, they have said that a faster way of overcoming the “weaknesses in global health security” revealed by the pandemic is to reform the existing International Health Regulations.
“Some major strides to advance global health security may take years to accomplish, for example, the creation of a new international instrument on preparedness and response, which the WHO and a number of other countries have endorsed,” said Secretary of State Antony J. Blinken and Secretary Becerra, in an opinion piece published in JAMA on Aug. 31, 2021.
Blinken and Becerra added that “immediate steps” could be taken by amending the IHR to improve certain areas, “particularly around early warning systems, coordinating the response, and information sharing.”
“Through targeted amendments following established practice at the WHO, the IHR can be revised to improve risk assessments, advance equity, help create an environment in which the WHO can fulfill its mission, encourage better information sharing, and clarify the roles and responsibilities of different organizations and governments in an emergency,” they wrote.
According to a filing made in April, the U.S. amendments were presented to the WHO on Jan. 18. The U.S. proposals add to and eliminate sections of the IHR, following what Becerra and Blinken had previewed in their op-ed. Broadly, the amendments set out specific deadlines and requirements for the notification of and response to possible public emergencies to streamline the process.
For example, the proposals call for adding deadlines for when a member state shall assess and inform the WHO about threats (within 48 hours) and for when the WHO shall offer collaboration (within 24 hours). The member state would then have another 48 hours to accept or reject that offer. The current version of the rules does not include deadlines for these actions.
Here’s how one of the proposed amendments reads, with new language in bold and suggested deletions in strikethrough text: “If the State Party does not accept the offer of collaboration within 48 hours, WHO shall
may, when justified by the magnitude of the public health risk, immediately share with other States Parties the information available to it, whilst encouraging the State Party to accept the offer of collaboration by WHO. taking into account the views of the State Party concerned.”
Conservatives have distorted this and other amendments to claim the proposal will threaten U.S. sovereignty.
“The Biden administration wants all the emergency declarations to be mandatory and cut out all views of the concerned state,” Horowitz wrote for the Conservative Review. We reached out to ask for support for his claims, but we didn’t hear back from him.
A spokesperson for HHS told us that’s not correct.
“The proposed amendments would strengthen WHO’s ability to use publicly available information from around the world to determine whether a Public Health Emergency of International Concern may be occurring, and based upon that information, inform all nations of the threat in a timely manner, and provide recommendations, not mandates, on how to safely and effectively respond,” the spokesperson said in an email.
Fox’s Carlson, who apparently confused the IHR amendments with the pandemic treaty and falsely claimed the treaty would be adopted during the Health Assembly meeting, also distorted the text. As an example, Carlson cherry-picked a phrase that was deleted in the revised document: “WHO shall consult with and attempt to obtain verification from the State Party in whose territory the event is allegedly occurring.” Carlson then added, “So, as originally written, they couldn’t do anything without the permission of their member countries’ governments. But thanks to the change, that the Biden Administration pushed, effectively there is no limit at all on WHO’s power.”
But the suggested change does not mean that the WHO can “do anything” without member countries’ permission. As we explained, the WHO has no authority over member states and can only make recommendations.
The proposed deletion deals with how quickly the WHO can act on a report that it obtains from a third party about a health event in a member country. The WHO is required to assess such reports and then share that information with the member state where the health event is occurring. The proposal eliminates the requirement of consulting and obtaining verification of those third-party reports before taking action, and adds a deadline for the WHO to seek verification of the third-party report. “Within 24 hours of receiving information, WHO shall request verification from a State Party of reports from sources other than notifications or consultations of events which may constitute a public health emergency of international concern allegedly occurring in the State’s territory,” the proposal reads.
Another key amendment proposed by the U.S. is to shorten the period, from 24 months to 12 months, in which amendments to the IHR can be adopted and entered into force.
“That’s an area to watch,” WHO’s principal legal officer, Steve Solomon, said at a media briefing on May 17. “It’s an area that the [director-general] supports as helping to streamline and make more effective and more agile this important international legal instrument, the IHRs.”
The amendments were first discussed on May 24, according to the assembly’s agenda.
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