The IMF, WTO, World Bank, and WHO all come around? Multilateral Unity Against Inequitable Global COVID Vaccine Distribution, but still sans Human Rights

Sometimes, they do come around, albeit so narrowly. Back in February 2021, I argued that international law (specifically based on the International Covenant on Economic, Social, and Cultural Rights, and the Right to Development presently being codified in the draft Convention on the Right to Development) compels States and non-State actors to design equitable COVID Vaccine Distribution and access as expeditiously as possible.  It was with a sigh of relief for many that on 1 June 2021, the leaders of key multinational organizations such as the International Monetary Fund (Managing Director Kristalina Georgieva), the World Trade Organization (Director-General Ngozi Okonjo-Iweala), the World Bank Group (President David Malpass), and the World Health Organization (Director-General Tedros Adhanom Ghebreyesus) released a joint statement ahead of the G7 Summit to be hosted by the United Kingdom next week.  The Joint Statement is titled “A new commitment for vaccine equity and defeating the pandemic“, and discusses “a coordinated strategy…to the vaccinate the world” that centers mainly on logistics: 1) financing the COVAX global vaccine access programme; 2) investments into vaccine production capacity; and 3) calling for accelerated negotiations for a “pragmatic solution around intellectual property”:

“A recent proposal from IMF staff puts forward a plan with clear targets, pragmatic actions, and at a feasible cost. It builds on and supports the ongoing work of WHO, its partners in the Access to COVID-19 Tools (ACT) Accelerator initiative and its global vaccine access programme COVAX as well as the work of the World Bank Group, the WTO and many others.

At an estimated $50 billion, it will bring the pandemic to an end faster in the developing world, reduce infections and loss of lives, accelerate the economic recovery, and generate some $9 trillion in additional global output by 2025. It is a win for all — while around 60 percent of the gains will go to emerging markets and developing economies, the remaining 40 percent will benefit the developed world. And this is without taking into account the inestimable benefits on people’s health and lives.

What does it entail?

First, increasing our ambition and vaccinating more people faster: WHO and its COVAX  partners have set a goal of vaccinating at least 30 percent of the population in all countries by the end of 2021. But this can reach even 40 percent through other agreements and surge investment, and at least 60 percent by the first half of 2022. 

To do so requires additional financing for low- and middle-income countries, with a very significant proportion in the form of grants and concessional financing. To urgently get more shots in arms, doses need to be donated immediately to developing countries synchronized with national vaccine deployment plans, including through COVAX. Cooperation on trade is also needed to ensure free cross-border flows and increasing supplies of raw materials and finished vaccines.

Second, insuring against downside risks such as new variants that may necessitate booster shots. This means investing in additional vaccine production capacity by at least one billion doses, diversifying production to regions with little current capacity, sharing technology and know how, scaling up genomic and supply-chain surveillance, and contingency plans to handle virus mutations or supply shocks.

All blockages to expanding supply must be removed, and we call on WTO members to accelerate negotiations towards a pragmatic solution around intellectual property. A number of low- and middle-income countries are also making moves to invest in their own local manufacturing capacity, which is key not to just end this pandemic but to prepare for the next one.

Third, immediately boosting testing and tracing, oxygen supplies, therapeutic and public health measures, while ramping up vaccine deployment, and the ACT-Accelerator initiative. WHO, UNICEF, the World Bank and Gavi have been conducting vaccine readiness assessments in over 140 developing countries, and providing on-the-ground support and financing to prepare for vaccine rollout.” (Emphasis in the original.) 

While this degree of cooperation among the multilateral organizations is arguably unprecedented and certainly laudable, what is most interesting from the Joint Statement is how it presents a version of “inequitability” that rests almost simplistically on just getting as many shots in the arms and greater volumes of public health and medical supplies around the world.  This view, while presenting one key logistical step, is ultimately short-sighted and dangerous for shaping future policies to prevent and stop future global pandemics such as COVID-19. The Joint Statement does not, unlike the United Nations’ commitment throughout this pandemic, commit to a human rights-centred global response to the pandemic.  And that, in my view, remains a costly short and long term-myopia that will not insulate us from future pandemics, infectious diseases, and the corresponding emergency measures that have proliferated all over the world.  Regardless of the much-debated origins of this pandemic, this pandemic proliferated and persisted throughout the world as long and as unevenly as it has precisely because of the dearth of global commitments – at the State and non-State level – to human rights to: 1) scientific information, governmental transparency, and autonomous control over or privacy of personal information; 2) public participation in governmental and intergovernmental decision-making affecting one’s health, education, housing, food security, water and an adequate standard of living, which is at the core of contribution, enjoyment, and participation in the right to development; and 3) effective remedies against human rights violations normalizing from emergency measures all over the world.  

Vaccines do not immunize against the continuing human rights deprivations that multidimensionally enable and perpetuate the COVID-19 pandemic, failed emergency measures (even by authoritarian regimes that pride themselves on social controls), and the ensuing economic upheavals, social impacts and individual vulnerabilities arising from interrelated unemployment, poverty, social security, lack of education, water, food security, housing, and discrimination that will continue to cyclically prolong this global pandemic.

Human Rights to Information, Transparency, and Privacy

Among the many ironies of this pandemic is the mass harvesting of individual personal information and data as part of COVID-19 responses, without standardized governmental commitments as to data privacy and individual control over the storage and multiplier use of such data.  Governments have normalized wide-ranging mass surveillance as part of ‘public health’ emergency responses, but without affording counterpart checks and balances such as transparency of data management and privacy policies on the institutional present and future use of such individual information and personal data mined from all of us during this pandemic.  The irony here is that the pandemic outbreak in Wuhan could not be contained because of a lack of rapid transparency towards the international system by the local and national governmental authorities of the People’s Republic of China that, for six key days, apparently did not immediately notify global public health institutions about the outbreak and still permitted international travel from their territory to the rest of the world and reportedly suppressed and censored information of the coronavirus outbreak. World Health Organization investigators on the origins of COVID-19 themselves expressed their frustrations about many delays to their entry to China, the ‘refusal to give data’ to the WHO team of investigators, which led to one of the recommendations in its Report on its mission to China to “further enhance the systematic and real-time sharing of epidemiologic data, clinical results and experience to inform the global response.” (Report, p. 21, italics added.).

The contagion of COVID-19 to countries around the world was further aggravated by a lack of public information and governmental transparency, ultimately leading to governance failures. As of this writing, the indifference to human rights to information, public transparency, and the protection of individual privacy and individual control over one’s data and information continue to impede the effectiveness of COVID-19 responses around the world.  The 1 June 2021 Joint Statement of the IMF, World Bank Group, WTO, and WHO is unfortunately silent on the public information transparency as to their financing, purchasing, and distribution decisions in regard to COVID-19 vaccines, the timeline for delivery and criteria for identification of the most vulnerable recipients that need access and distribution of vaccines and medical supplies (especially given intersectional and discriminatory impacts of race, poverty, gender, education, birth status, citizenship, among others).  The same Joint Statement does not address the human right to information privacy and autonomy over any uses of public health individualized or aggregated information used as the basis for the financing and distribution decision-making of the IMF, World Bank Group, WTO, and WHO.

Human Right to Public Participation in Governmental and Intergovernmental Decision-Making

The 1 June 2021 Joint Statement does not provide for any public consultation or public participation mechanism relating to the vaccine and medical supplies financing and distribution coordinated strategy of the IMF, World Bank Group, WTO, and WHO.  This is problematic for evaluating the accuracy, responsiveness, and adaptability of these multilateral institutions’ supposedly coordinated financing and distribution plans for COVID vaccines and medical supplies around the world. Some emerging studies have pointed out the centrality of public participation at large especially in usefully and appropriately informing governments as to the nature and pace of COVID-19 lockdowns and restrictions.  The World Bank observed that citizen engagement and stakeholder consultations could enable “real-time course correction” for COVID crisis decision-making.  The Task Force on Public Participation in Decision-Making in relation to the Aarhus Convention Compliance Committee saw the urgency of public participation for ensuring the accuracy of community needs assessment, the effectiveness of the design of COVID-19 responses by local and national authorities, and for continuous monitoring for negative externalities and review for adaptability of COVID responses. 

If the IMF, World Bank Group, WTO, and WHO truly desire to end this global pandemic, they cannot do so by just aiming to “vaccinate the world”, however noble the goal may be.  They have to commit as well to intentionally engaging the public to determine community needs for vaccines and medical supplies, and to adjust planning according to those needs, as well as to properly evaluate their own institutionally-coordinated financing and distribution plans for more targeted effectiveness that takes into account local community contexts, and to also be cognizant of avoiding responsibility simply by relying on individual States to appropriately use resources such as vaccines and medical supplies, especially where such States have proven governance, human rights, transparency, and corruption failures during this pandemic.

The fact that multilateral organizations commit to ‘equitable’ COVID vaccine and medical supply access is not a matter of charity or humanitarian policy (where leadership winds can blow differently from one day to the next), but ought to be recognized as a matter of international law and international legal obligations, such as the duty to cooperate under the Right to Development, the International Covenant on Economic, Social, and Cultural Rights, and Articles 55 and 56 of the Charter of the United Nations.

Human Right to Effective Remedies Against Human Rights Violations

The 1 June 2021 Joint Statement is completely silent on the vacuum of effective remedies for those who have been hit hardest by COVID-19 restrictions and denied timely and expeditious access to vaccines and medical supplies around the world.  It does acknowledge the vast inequality but simply treats this inequality as a fact of the international system, not a matter for institutional redress and systemic response by multilateral institutions:

“In fact, even as some affluent countries are already discussing the rollout of booster shots to their populations, the vast majority of people in developing countries — even front-line health workers — have still not received their first shot. The worst served are low-income nations which have received less than 1 percent of vaccines administered so far. 

Increasingly, a two-track pandemic is developing, with richer countries having access and poorer ones being left behind.

Inequitable vaccine distribution is not only leaving untold millions of people vulnerable to the virus. It is also allowing deadly variants to emerge and ricochet back across the world. As variants continue to spread, even countries with advanced vaccination programs have been forced to reimpose stricter public health measures, and some have implemented travel restrictions. In turn, the ongoing pandemic is leading to deepening divergence in economic fortunes, with negative consequences for all.”

Noticeably, these key multilateral institutions all have some measure of accountability mechanisms.  The IMF Accountability Factsheet examines checks and balances, risk assessment, independent evaluation, ethics and staff conduct, and public engagement as central features of the IMF’s accountability policy for its surveillance, technical assistance, and lending policies.  The World Bank has an Accountability Mechanism, while the World Trade Organization has a Dispute Settlement Understanding for disputes between its Members and a Trade Policy Review Body to ensure consistency of national trade and regulatory policies with WTO commitments.  The WHO launched its Multisectoral Accountability Framework for TB but has not done so for COVID-19. 

Beyond the barefaced commitments to “vaccinate the world”, these multilateral institutions could demonstrate their own commitments to institutional accountability by financing or supporting effective remedies for those who have suffered from the legally unjustifiable inequitability of vaccine and medical supply access.  Guaranteeing effective remedies is not just a matter of humanitarian charity for millions around the world called to endure this pandemic – and all its associated hardships, burdens, and mortalities – far longer than those vaccinated in the developed world.  It is a matter of international law accountability for the normalization of human rights violations that began with the inequitability prohibited under international law.