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July 8, 2024 Ms. Riina Sikkut Minister of Health The Ministry of Social Affairs Estonia RE: Call to Ensure Equity and Inclusivity in WHO Pandemic Agreement Negotiations Dear Riina Sikkut, We write to you regarding the ongoing negotiations of the WHO pandemic agreement. As decided during the 77th World Health Assembly (WHA), Member States have voted to extend the mandate of the Intergovernmental Negotiating Body (INB) and will be meeting in July 2024 to agree on a workplan and meeting schedule as well as to update the INB’s method of work. We urge your government to use this opportunity to champion critical issues of equity and inclusivity in these negotiations.

Since the establishment of the INB in December 2021, equity has been a priority for countries. However, the failure to reach a deal that can deliver on the promise of equity threatens our collective ability to prevent another global health catastrophe like the COVID-19 pandemic. We continue to stand shoulder to shoulder with countries fighting for the inclusion of concrete and enforceable provisions to ensure equitable and timely access to pandemic-related health products, regional hubs for R&D and manufacturing capacity, and funding for capacity building in low- and middle-income countries.

Furthermore, it is imperative to address the lack of transparency and inclusivity in the current negotiation process, which has hindered meaningful engagement of relevant stakeholders – including civil society. Despite their significant contributions in addressing an array of global health emergencies and inequities, these voices remain sidelined from INB processes. Transparent and inclusive processes are essential for fostering trust and accountability in global health governance. This is why we ask for your support in ensuring official involvement of relevant stakeholders in all remaining negotiations within the INB process and timely access to all relevant documentation. Lastly, to foster genuine multilateralism and ensure that the voices and priorities of those most affected by inequities in global health are heard, we advocate for member-states to call on WHA special session to be held in a developing country to approve the agreement prior to the end of 2024. Hosting the session in a developing country would exemplify a true commitment to global health equity and inclusivity. Therefore, we urge that the modalities chosen for negotiations prioritize the resolution of specific issues where there is an impasse so that an agreement can be reached without undue delay. Failure to achieve a truly equitable and inclusive pandemic agreement risks repeating the same mistakes that led to the COVID-19 catastrophe, which has resulted in over 18 million excess deaths and trillions of dollars lost. Equity is not just an ornament but a proven instrument for fast and effective control of disease. Containing outbreaks at the source requires that all countries attain the capacity to prevent, prepare for,

and respond to health emergencies because a global system is only as strong as its weakest link in the chain.

Your leadership is crucial to ensure that we do not miss this opportunity to create a resilient and equitable global health architecture that can protect all communities worldwide. Our technical team is committed to this effort and stands ready to collaborate, share insights, and provide support. Should you have any questions, please don't hesitate to reach out to [email protected].

Sincerely,

Daniel Reijer AHF European Bureau Chief AIDS Healthcare Foundation

July 8, 2024 Ms. Riina Sikkut Minister of Health The Ministry of Social Affairs Estonia RE: Call to Ensure Equity and Inclusivity in WHO Pandemic Agreement Negotiations Dear Riina Sikkut, We write to you regarding the ongoing negotiations of the WHO pandemic agreement. As decided during the 77th World Health Assembly (WHA), Member States have voted to extend the mandate of the Intergovernmental Negotiating Body (INB) and will be meeting in July 2024 to agree on a workplan and meeting schedule as well as to update the INB’s method of work. We urge your government to use this opportunity to champion critical issues of equity and inclusivity in these negotiations.

Since the establishment of the INB in December 2021, equity has been a priority for countries. However, the failure to reach a deal that can deliver on the promise of equity threatens our collective ability to prevent another global health catastrophe like the COVID-19 pandemic. We continue to stand shoulder to shoulder with countries fighting for the inclusion of concrete and enforceable provisions to ensure equitable and timely access to pandemic-related health products, regional hubs for R&D and manufacturing capacity, and funding for capacity building in low- and middle-income countries.

Furthermore, it is imperative to address the lack of transparency and inclusivity in the current negotiation process, which has hindered meaningful engagement of relevant stakeholders – including civil society. Despite their significant contributions in addressing an array of global health emergencies and inequities, these voices remain sidelined from INB processes. Transparent and inclusive processes are essential for fostering trust and accountability in global health governance. This is why we ask for your support in ensuring official involvement of relevant stakeholders in all remaining negotiations within the INB process and timely access to all relevant documentation. Lastly, to foster genuine multilateralism and ensure that the voices and priorities of those most affected by inequities in global health are heard, we advocate for member-states to call on WHA special session to be held in a developing country to approve the agreement prior to the end of 2024. Hosting the session in a developing country would exemplify a true commitment to global health equity and inclusivity. Therefore, we urge that the modalities chosen for negotiations prioritize the resolution of specific issues where there is an impasse so that an agreement can be reached without undue delay. Failure to achieve a truly equitable and inclusive pandemic agreement risks repeating the same mistakes that led to the COVID-19 catastrophe, which has resulted in over 18 million excess deaths and trillions of dollars lost. Equity is not just an ornament but a proven instrument for fast and effective control of disease. Containing outbreaks at the source requires that all countries attain the capacity to prevent, prepare for,

and respond to health emergencies because a global system is only as strong as its weakest link in the chain.

Your leadership is crucial to ensure that we do not miss this opportunity to create a resilient and equitable global health architecture that can protect all communities worldwide. Our technical team is committed to this effort and stands ready to collaborate, share insights, and provide support. Should you have any questions, please don't hesitate to reach out to [email protected].

Sincerely,

Daniel Reijer AHF European Bureau Chief AIDS Healthcare Foundation