← This Week in Global Development
This Week in Global Development
Live from the World Health Assembly
00:22:42
Filmed live from Geneva, Switzerland, on the sidelines of the World Health Assembly, this episode of This Week in Global Development delves into the critical debates unfolding on the ground in Geneva. That includes the tense atmosphere following the...
Loading summary
Transcript23 lines
- [00:00]
A
Foreign My name is Rumbi Chakamba and you're listening to this Week in Global Development, hosted by myself, Adva Saldinga and David Ainsworth. So this Week in Global Development is actually one of my favorite parts of my job. So if you haven't subscribed, please do subscribe. But I rarely get a chance to speak to our reporters in person, so it's always so lovely to have the conversations in real life here today. I know that, like, I've been catching up with both of you on a daily basis, but I know that you've been running around at the Palais, the WHO headquarters, following the discussions that are happening there. And just before WHO actually convened, WHO declared a public health emergency for the Ebola outbreak. And it seems that Ebola has kind of taken over the discussions that are happening right now. Sarah, can you tell us a little bit more about where we stand and what. Discuss what you've heard about the Ebola outbreak so far?
- [00:58]
B
Yeah, it's alarming. Quite a number of people because it's spread a lot further than people even kind of are able to understand right now. It's also a strain of Ebola that doesn't have a vaccine or therapeutic. So that's alarming. Cases have been found in a capital city, Kampala, and that's fairly alarming given kind of the congestion of cities. So over the weekend, Tedros declared a public health emergency of international concern. And this is the first time that he's done this without consultation from the emergency committee. So that kind of gives you a sense of kind of the concern. So it's all hands on deck.
- [01:51]
A
Yeah, I think the latest figures that came out this morning is that they're suspecting around 600 cases. And the concern is that there's just so much movement, so much cross border movement between the areas that are experiencing this. So it seems to have actually taken over a lot of the discussion. But Jenny, you've been like in the plenaries, the committee halls for the past two days. What else are people bringing up? What are some of the big themes that we should be on the lookout for?
- [02:17]
C
Sure. Well, wha is always a pact agenda, right? Like you look at the document, it's always full. But I think for this year we're hearing, I think, three emerging themes that people are really following. One is of course, Ebola. It's on everyone's mind. I heard, you know, yesterday EU and Singapore just announced pledges for cepi and I think it kind of illustrates how funders are kind of saying, okay, we need to be funding institutions, we need to be sending this funding because we need to look out for how do we prepare for these types of outbreaks and crisis. The other thing is on everyone's mind is the reimagining of the global health architecture. And if you're at Palais on Monday, Ghana President John Mahama was actually talking about this. Of course, the president is the face of the Accra reset. But also he called out, like, he really pointed out there's a joint WHO process being proposed to kind of align different initiatives on reforming the global health architecture. And in that document it says they're not going to touch on things like mandates or recommend mergers and consultations. And the first thing that, you know, several experts comment when they saw that was like, so, you know, what is this anyway, like. And I heard someone actually said it's bullshit. But, yeah, but the President was saying if we want to fix the system, we need to be brave enough to look at mandates and mergers. So I think it's really, really something that is on everyone's mind. And one of the things I'd love to hear is how do we move from talks to actually action what changes are happening. We'll have some of that talk in the next two days. Then I think the third one is really something I'm really excited about and I think for some of you are, is the race for the next Director General of the who. And I'm sure you've heard the names being floated around. No one has actually formally announced, but you'll see several of them here in Geneva, like really talking in different panels. And I just, I think I just published a story this morning. I not talking, but I got a chance to ask Dan Dr. Minister Budhi Sadikin of Indonesia whether he can confirm about running for this election. And he said, I'm going to confirm once the country sends a letter. But I think, you know, did not say no. He did not say no. But at the same time he did confirm that the President has talked to me about this. And so I think between now and September, we'll definitely hear more of like, this formal announcements because there are regional meetings happening at who and it's an opportunity for the candidates to be able to, you know, share their platforms to the different member states. So that's something we'll be following this week, but also in the next few months. Hi, I'm Kate Warren, executive editor at devex. If you are listening to this podcast, you are likely working to achieve the sustainable development goals, but are you subscribed to devex Newswire. Global development can be a fast moving, complex sector. Our team of global reporters work every day to bring you the news you need to make sense of it all. In devex Newswire, we keep you up to date on issues ranging from climate change financing to gender equality and global health, to transforming the food system. All in a fun to read free newsletter delivered directly to you five days a week. Join the hundreds of thousands of global development professionals who receive Devex Newswire and visit devex.comnewsletters to sign up to this free newsletter today.
- [06:45]
D
Hi everyone, I'm Alan Robbins, co founder and executive vice president of devex, and I'm happy to be hosting this episode's Spotlight segment, which we've put together in partnership with path, looking at how to best bridge the gap between diagnostics and development finance. I'm joined today by Dr. Melanie Saville, who is PATH's Chief Scientific Officer. She's a physician by training in one of the world's leading virologists. And we'll be talking today about diagnostics and why she thinks they should be high on the development finance agenda. Dr. Savill, thanks so much for joining
- [07:18]
E
today and thank you, Alan. Thank you for inviting me.
- [07:22]
D
Great. And you know, I know path, the organization you work for, often emphasizes financially sustainable health systems over a reliance on sort of traditional grant funding. In this current political moment, where we're seeing grant funding is under tons of strain, how can new financing partnerships ensure that diagnostics in LMICs move from being viewed as a recurring cost to be treated as an essential infrastructure for global health?
- [07:52]
E
Yes, well, PATH is focusing on a more financially sustainable global health ecosystem. So the one that reduces that reliance on traditional aid, and this is really by mobilizing much more in the way of domestic resources, catalytic capital and innovative finance. And actually diagnostics is a great test of this and this commitment because historically they receive only 2 to 3% of global health R and D funding, despite being really essential at every health strategy from antimicrobial resistance through to pandemic preparedness and also equitable access to care. So closing that gap is really beyond a single funder. And that's actually why we actually in March of this year got together a convening on the future of diagnostics in funding, in particular in a roundtable working with our partners, the Wellcome Trust, UNITAID and MED Access. And we brought together over 30 senior representatives from grant funders. So the sort of classic philanthropic funding organizations through to development financing institutions, multilateral development banks, impact investors and procurement agencies, because what we wanted to do in this was really tease out how capital actually flows across the diagnostic pipeline and try and identify where coordinated action will actually unlock some of the progress.
- [09:37]
D
And so coming out of that meeting, what's your takeaway of what's one specific missing link in the data that if we had, would sort of really effectively move that needle for those financiers and other financiers?
- [09:54]
E
Yes, I think the health economic argument for diagnostics is actually quite well understood. There was the 2021 Lancet Commission on Diagnostics which found that if we close the gap on just six tracer conditions, you could potentially avert over 1 million premature deaths in low and middle income countries. So these are six conditions. They are conditions such as hiv, tb, syphilis in pregnancy, so some of those big ones that are important in infectious diseases. So by taking sort of six of those big ones, you could actually, if you really invested in getting the diagnostics out there, you could potentially avert over a million deaths per year, premature deaths a year in lower middle income countries.
- [10:51]
D
And so it sounds like even though the health impacts are understood, one of the big challenges is turning that into what are the risk mitigation you mentioned, what are the long term economic return impacts that we're looking at as well? And what's worked for you so far? How do you reframe that?
- [11:12]
E
Really the first thing that I think we need to do is gather that data. No one is gathering that data because nobody is working across the pipeline in its entirety. So by gathering that data and doing that analysis so that we get to a point of assembling credible independent evaluation and evidence of manufacturing and delivery costs, in particular for Africa and Asia, then we can really start thinking about unlocking some of the conversations that we need to have with some of those downstream funders, the DFIs, the impact investors, which at the moment are getting stuck at due diligence phase.
- [11:57]
D
Dr. Sabeel, unfortunately, that's all the time we have for today. But I want to thank you so much for being here. Thank you path, for partnering with us on this segment. It's been a real pleasure.
- [12:19]
A
Jenny is questioning it a little bit. I would say it's a little bit of stalking. She's been following all the potential DG candidates. So if you are expecting any announcements, I think Jenny will probably be the first to hear. So I suggest you follow her on social media. And we will be asking a couple of people today and tomorrow if they're thinking of running. So stay tuned for that and then speaking about this reminds me of the Sanja Neshta coach that that Kate actually just did. It's now time for us to stop talking and start actually moving. And that brings me to the WHO process. So it's going to be another year of discussions. And then they're saying after this year of discussions, they're not going to make any suggestions about mandates, they're not going to make any suggestions about mergers. So it kind of feels like a bit of a useless process. And it brings you to the question of who's going to take the lead on this. Who's actually going to take the lead on like how we change this architecture and who can. And one of those people that have sort of come up with this is sort of come up as a leader for this is John Mahama. And I know that you've been following what he's been saying and what the ACCA reset is saying. What are the discussions happening around the ACCA reset right now, Sarah?
- [13:26]
B
Yeah, I think one of the big kind of conversations is kind of moving the, you know, the power from places like Geneva to low and middle income countries. And Accra Reset has been in the spotlight as has other African institutions this week. John Mahama has President Mahama has spoken about how, you know, he's been asked whether the Krah reset is just a talk shop. And he said no, we're like we're putting people on panels of experts and these are people that are known to get to work and roll up their sleeves. And so he emphasized that there are kind working and they have different kind of coordination mechanisms to move forward. And another African institution that's been on highlight this year or excuse me, this week is the African Medicines Agency, which is working to harmonize pharmaceutical regulations across the African continent, which will also bring greater sovereignty and kind of push forward domestic manufacturing. And there's been converse that's it's been an institution on highlight in various sessions, side sessions at WHA this week. And one of the issues though is that they have 31 countries ratifying that have already ratified, whereas they're hoping to have 55 countries ratify and kind of have the big economic powerhouses on the continent ratify. So Nigeria just ratified and that's considered a big win or they're in the final processes of ratification. And now AMA is turning to South Africa as well.
- [15:23]
A
That brings me to one of my pet peeves, how slow like UN processes are, AU processes are. And she talked you through what the ratification process actually entails and why it takes so long. Why is that?
- [15:36]
B
Yeah, so that was a question I asked her is, you know, all of this sounds great. Why aren't countries ratifying? And she pulled out her phone and started, like, she pulled out a note on her phone and started rolling through the processes. And it's, you know, it's a signature, and then it's passing through ministries, and it's not just Ministry of Health, it's Ministry of Finance, et cetera, et cetera. And then it has to go through the legislative process. And one thing she said to me is that, you know, governments have other things on their mind. They have to worry about the economic health of their country, elections, you know, other security shocks and whatnot. But there's also other issues of kind of almost like turf wars in that national regulators are concerned that having a continental body could kind of impose on their own, you know, sovereignty and power, whereas experts at WAJ are saying this is a complementary process. So, you know, we should be looking at as this is a way AMA will actually help strengthen your national regulator.
- [16:44]
A
And one thing I'm definitely on the lookout for is WHO finances. And it's actually been interesting because this WHA is kind of happening in the midst of a crisis. So you're seeing countries sort of committing more funds to WHO. Earlier in the week, Germany committed an extra 25 million euros to the well, basically to pandemic preparedness and health security as well. But that was after cutting funding to the pandemic hub earlier on in the year. But you're seeing more of these commitments, and you're hearing people saying that it's really important that we have a functioning WHO in times of crisis, and we need more money coming through. Do you think this is going to sway donors to sort of, like, provide WHO with more financing? And can you talk a little bit more about all the problems around financing? I don't know if we've got enough time, but, yeah, I think it's pretty
- [17:42]
C
obvious to a lot of people who has been having this chronic financial difficulties every year. Look at their financial statements. It's almost the same. They have the same problems of earmarking and flexible contributions being very, very small of the bud. Is it going to sway? Well, member states did agree to gradually increase who's assessed the part of who's assessed contributions, which is more flexible, so WHO can allocate it to where it's needed most. But we've seen there's still an increase in earmarking. Whether they're gonna increase that, I'm not sure, because In January, Tedros mentioned that, you know, we still have like 6, over 600 million gap in our funding for 2026 and 2027. He's singing a different tune. Recently he said 90% of our base budget is projected to be funded. But he did say, like, you know, we still don't know where the 10. Sort of. Sort of, I'm paraphrasing, but sort of where the 10% is coming from. And it's a different fundraising environment for everybody. So it's just. Let's see.
- [19:08]
A
Let's see where we go. I know. I think looking at the 2025 figures, 90% of all voluntary contributions to WHO were earmarked, meaning that they're for a specific thing. So the organization can't decide what to do with the money. And as a result, they also can't prioritize. So people have been saying this is now like some kind of cycle where they want. Where donors say they need the WHO to prioritize and sort of focus on its core mandate. But because they're earmarking funding, it's like they have to focus on what the funding is for and they sort of don't have the say. And we're looking to see if we will eventually get out of that loop. So what are the two. Well, one or two things that you're waiting for towards the end of the week, as we come to the end of this session, Jenny?
- [19:55]
C
For me, it's the discussion and the joint process that WHO is hosting on the global health architecture reform that's looking at the timeline now. It's probably happening around Thursday or Friday, so I'd be interested to see, to hear what actually member states are going to say. Are they going to change that text about not touching on mergers and I mean, not recommending mergers and consolidations. So that's something I'm looking forward to toward the end of the week.
- [20:28]
B
And Sarah, So it feels like the global health space, there's just always been so. Well, over the last year, there's been so much uncertainty. Last year there was uncertainty, this year there's uncertainty. One area that we're looking for more answers on are the US bilateral health deals. I just spoke with Dr. Uma Oluga, the principal Permanent Secretary of the Ministry of Health in Kenya, and they had a legal challenge around their health deal. And he told me, after the courts have given them the way forward. So he told me they're going to start implementation in July, and I think that I'd love to hear more details around the US's involvement in global health and how implementation of these deals is going to roll out who will be the partners and how will these co financing agreements work and what is this changing role of the US in global
- [21:39]
A
health and also interested to hear how that will affect the multilateral processes that are happening. We know that the Pubs agreement has stalled a little bit more. There'll be discussions continuing in July. I don't know if you guys have seen this but walking around Geneva there's this bus there these I don't know if it's just one bus or it's several buses that say no to the pandemic treaty and people are against that. So interested to see how that will play out as well and I'm obviously interested to see if anyone is going to formally say that they will be running for DG next year and interested to hear what their ideas are about changing the organization. So that's what I'm looking forward to but thank you so much.