Draft ‘Rome Declaration’ by G-20 Global Health Summit – Sidesteps Hard Commitments to New COVID Finance & Vaccine Donations
Ursula von der Leyen, President of the European Commission, giving the opening remarks at the civil society consultation ahead of the Global Health Summit.

A draft “Rome Declaration” to be issued at next Friday’s G-20’s Global Health Summit, co-hosted by Italy and the European Commission (21 May), makes a series of 10 sweeping commitments to ensure equitable access to vaccines; expand medicines manufacturing capacity; assure WHO access to sites posing an outbreak risk; and invest in global health systems. 

But the draft manifesto seen by Health Policy Watch, framed as a “statement of principles,” also lacks any concrete targets for COVID vaccine dose-sharing, or medicines and vaccines finance. 

WHO and other global health officials have repeatedly said that COVAX and the other ACT-Accelerator initiatives urgently need some US$18.5 billion from the world’s most industrialised nations to fund purchases of medicines and tests, as well as vaccines. WHO and other global health officials have also begged for more vaccine donations. 

That means that if any such concrete commitments are to be made, they will have to be negotiated up until, and on, the day of the meeting of G-20 leaders. Meanwhile, a placeholder text for “announcements and actions” suggests a mere mention of: “Global dose sharing through COVAX?”  

A weak outcome document would be a major setback to the very immediate concerns around getting needed COVID vaccines and medicines to areas of need in low- and middle-income countries as fast as possible, say observers, with whom the draft declaration was shared.

Key events leading up to the G20 Global Health Summit.

Sidesteps mention of WTO Waiver 

The draft declaration so far also sidesteps mention of another thorny issue – the proposed World Trade Organization (WTO) waiver on intellectual property rights for COVID products, that the United States recently said it would support, in the case of vaccine IP.  

A placeholder text, however, leaves open “{…possible references to ACT-A, WTO activity, WHO, the MPP, C-TAP, and through bilateral arrangements}.” C-TAP is the WHO-sponsored patent pool for COVID technologies – which so far has failed to garner significant support from industry. ACT-A is the still desperately underfunded initiative.

The declaration affirms the importance of supporting developing and least developed countries to “build expertise” and increasing “global, regional, and local manufacturing … and the potential for voluntary and mutually agreed knowledge and technology transfer and licensing partnerships.”

That language, as well, represents code words for encouraging voluntary measures to share COVID-related medicines and vaccines IP and technologies – which pharma voices would find reassuring and access advocates disappointing.

Draft resolution sidesteps mention of the WTO waiver to expand the manufacturing capacity of low- and middle-income countries and improve vaccine equity.

No Pandemic Treaty – Extra Investigative Powers for WHO  

The draft language takes a relatively tough line on the investigation of the origins of SARS-CoV2 and other emerging pathogen threats, saying that countries need to ensure: “international cooperation for WHO-led teams’ access to sites of potential and actual outbreak origin, in full compliance with the IHR and relevant national regulations.”

It stops short, however, of calling for a new Pandemic Treaty, as had been recommended recently by WHO, some two dozen global leaders, and the recent Independent Panel Report for Pandemic Preparedness and Response  – saying rather that countries should “support and enhance the existing international health framework for early warning, preparedness and response, prevention and detection, and recovery capacities.”

Countries also need to invest in stronger “early warning information, surveillance and trigger systems at all geographic levels, as well as laboratory capacity, for human and animal health, “including genomic sequencing capacity…rapid data and sample sharing.”

The declaration also highlights the underlying environmental drivers of pandemics and climate change, calling for a “One Health approach…to address threats emerging at the human-animal-ecosystems interface, and anti-microbial resistance.”

This “should include action to address ecosystem and biodiversity loss, habitat encroachment, illegal wildlife trade and climate change as contributing factors increasing these threats,” the statement adds. 

Fully Funded-Independent WHO 

Finally, the draft Rome declaration also calls for a stronger global health architecture with a “fully funded, independent and effective WHO at its centre”. 

That includes advancing Universal Health Coverage, stronger systems for combatting long-standing infectious diseases like HIV/TB and malaria, as well as “education and promotion of healthy lifestyles in addressing among others non-communicable diseases as factors enhancing resilience.”

That, the declaration acknowledges, requires countries to “invest in the global health workforce, in health systems strengthening to achieve resilient, high quality health systems and public health capacities in all countries, in multilateral mechanisms to facilitate capacity building and the transfer of knowledge, data and expertise, and for dedicated assistance and response capacity building, especially in fragile settings.”

Rome Declaration – Statement of Principles not Actions?

The Rome Declaration is being pitched primarily as a general statement of principles, according to the summit’s advance statement: 

“The Summit is an opportunity for G20 and invited leaders, heads of international and regional organisations, and representatives of global health bodies, to share lessons learned from the COVID-19 pandemic, and develop and endorse a ‘Rome Declaration’ of principles. 

“Principles can be a powerful guide for further multilateral cooperation and joint action to prevent future global health crises, and for a joint commitment to build a healthier, safer, fairer and more sustainable world.”  

Italy, as co-chair of the G20, is hosting the Global Health Summit on 21 May. 

“It will provide a timely opportunity to share the lessons learned during the COVID-19 pandemic. We will discuss how to improve health security, strengthen our health systems and enhance our ability to deal with future crises in a spirit of solidarity,” Italy’s Prime Minister, Mario Draghi, is quoted as saying. 

Mario Draghi, Italy’s Prime Minister, speaking at the G20 Tourism Ministers’ Meeting in early May.

The summit will include G-20 members along with Spain, Singapore and the Netherlands as guests; leaders of WHO and other related UN agencies, as well as global health actors such as Gavi, The Vaccine Alliance, the Global Fund and the Coalition for Epidemic Preparedness Innovations (CEPI), which has been investing in key aspects of COVID vaccine R&D. 

According to the statement, the preparation of the Rome Declaration’s summit principles is supposed to involve civil society consultation and debate. Indeed, a public consultation with key civil society stakeholders was held on 20 April. 

But just a week before the meeting, the draft declaration has not yet been widely circulated among civil society groups.

G20 Global Health Summit, set to commence on the 21 May.

Image Credits: European Commission, European Union, Flickr, Governo Italiano.

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