Amendments to WHO’s International Health Regulations

Written by Meryl Nass MD on April 5, 2023. Posted in Current News

The Covid-skeptic world has been claiming the World Health Organization (WHO) plans to become some sort of global autocratic government, removing national sovereignty and replacing it with a totalitarian health state.

The near-complete absence of interest by mainstream media would suggest, to the rational observer, that this is yet another ‘conspiracy theory’ from a disaffected fringe.

The imposition of authoritarian rules on a global scale would normally attract attention. The WHO is fairly transparent in its machinations.

It should therefore be straightforward to determine whether this is all misplaced hysteria, or an attempt to implement an existential change in sovereign rights and international relations.

We would just need to read the document. Firstly, it is useful to put the amendments in context.

The changing role of WHO

The WHO was set up after the Second World War as the health arm of the United Nations, to support efforts to improve population health globally. Based on the concept that health went beyond the physical (encompassing “physical, mental and social well-being”), its constitution was premised on the concept that all people were equal and born with basic inviolable rights.

The world in 1946 was emerging from the brutality of colonialism and international fascism; the results of overly centralized authority and of regarding people to be fundamentally unequal. The WHO constitution was intended to put populations in charge of health.

In recent decades the WHO has evolved as its support base of core funding allocated by countries, based on GDP, evolved to a model where most funding is directed to specified uses, and much is provided by private and corporate interests.

The priorities of the WHO have evolved accordingly, moving away from community-centered care to a more vertical, commodity-based approach.

This inevitably follows the interests and self-interests of these funders.

More detail can be found on this evolution elsewhere; these changes are important to putting the proposed IHR amendments in context.

Of equal importance, the WHO is not alone in the international health sphere.

While certain organizations such as UNICEF (originally intended to prioritize child health and welfare), private foundations and non-government organizations have long partnered with the WHO, the past two decades have seen a burgeoning of the global health industry, with multiple organizations, particularly ‘public-private partnerships’ (PPPs) growing in influence; in some respects rivals and in some respects partners of the WHO.

Notable among PPPs are the Gavi – the Vaccine Alliance (focused specifically on vaccines) and CEPI, an organization set up at the World Economic Forum meeting in 2017 specifically to manage pandemics, by the Bill & Melinda Gates Foundation, Wellcome Trust and the Norwegian Government.

Gavi and CEPI, along with others such as Unitaid and the Global Fund, include corporate and private interests directly on their boards. The World Bank and G20 have also increased involvement in global health, and especially pandemic preparedness.

The WHO has stated that pandemics occurred just once per generation over the past century and killed a fraction of those who died from endemic infectious diseases, but they nonetheless attract much of this corporate and financial interest.

The WHO is primarily a bureaucracy, not a body of experts. Recruitment is based on various factors, including technical competency but also country and other equity-related quotas.

These quotas serve a purpose of reducing the power of specific countries to dominate the organization with their own staff, but in doing so require the recruitment of staff who may have far lower experience or expertise. Recruitment is also heavily influenced by internal WHO personnel, and the usual personal influences that come with working and needing favors within countries.

Once recruited, the payment structure strongly favors those who stay for long periods, mitigating against rotation to new expertise as roles change. A WHO staffer must work 15 years to receive their full pension, with earlier resignation resulting in removal of all or part of the WHO’s contribution to their pension.

Coupled with large rental subsidies, health insurance, generous education subsidies, cost-of-living adjustments and tax-free salaries, this creates a structure within which protecting the institution (and thus one’s benefits) can far outlive initial altruistic intent.

The DG and Regional Directors (RDs – of which there are six) are elected by member states in a process subject to heavy political and diplomatic maneuvering. The current DG is Tedros Adhanom Ghebreyesus, an Ethiopian politician with a checkered past during the Ethiopian civil war.

The amendments proposed would allow Tedros to independently make all the decisions required within the IHR, consulting a committee at will but not bound by it. Indeed, he can do this now, having declared monkeypox a public health emergency of international concern (PHEIC) against his emergency committee’s advice, after just five deaths globally.

Like many WHO employees, I personally witnessed, and am aware of, examples of seeming corruption within the organization, from Regional Director elections to building renovations and importation of goods.

Such practices can occur within any large human organization that has lived a generation or two beyond its founding.

This is, of course, why the principle of the separation of powers commonly exists in national governance; those making rules must answer to an independent judiciary according to a system of laws to which all are subject.

As this cannot apply to UN agencies, they should automatically be excluded from direct rulemaking over populations. The WHO, like other UN bodies, is essentially a law unto itself.

WHO’s new pandemic preparedness and health emergency instruments

The WHO is currently working on two agreements that will expand its powers and role in declared health emergencies and pandemics. These also involve widening the definition of ‘health emergencies’ within which such powers may be used.

The first agreement involves proposed amendments to the existing International Health Regulations (IHR), an instrument with force under international law that has been in existence in some form for decades, significantly amended in 2005 after the 2003 SARS outbreak.

The second is a new ‘treaty’ that has similar intent to the IHR amendments. Both are following a path through WHO committees, public hearings and revision meetings, to be put to the World Health Assembly (WHA – the annual meeting of all country members [‘States parties’] of the WHO), probably in 2023 and 2024 respectively.

The discussion here concentrates on the IHR amendments as they are the most advanced. Being amendments of an existing treaty mechanism, they only require approval of 50 percent of countries to come into force (subject to ratification processes specific to each member State).

The new ‘treaty’ will require a two-thirds vote of the WHA to be accepted. The WHA’s one country – one vote system gives countries like Niue, with less than two thousand residents, equal voice to countries with hundreds of millions (e.g. India, China, the US), though diplomatic pressure tends to corral countries around their beneficiaries.

The IHR amendments process within the WHO is relatively transparent. There is no conspiracy to be seen. The amendments are ostensibly proposed by national bureaucracies, collated on the WHO website.

The WHO has gone to unusual lengths to open hearings to public submissions. The intent of the IHR amendments to change the nature of the relationship between countries and the WHO (i.e. a supra-national body ostensibly controlled by them), and fundamentally change the relationship between people and central supranational authority – is open for all to see.

Major amendments proposed for the IHR

The amendments to the IHR are intended to fundamentally change the relationship between individuals, their country’s governments, and the WHO. They place the WHO as having rights overriding that of individuals, erasing the basic principles developed after World War Two regarding human rights and the sovereignty of States.

In doing so, they signal a return to a colonialist and feudalist approach fundamentally different to that to which people in relatively democratic countries have become accustomed.

The lack of major pushback by politicians and the lack of concern in the media and consequent ignorance of the general public is therefore both strange and alarming.

Aspects of the amendments involving the largest changes to the workings of society and international relations are discussed below. Following this are annotated extracts from the WHO document (REF). Provided on the WHO website, it is currently under a process of revision to address obvious grammatical errors and improve clarity.

Resetting international human rights to a former, authoritarian model

The Universal Declaration on Human Rights, agreed by the UN in the aftermath of World War Two and in the context of much of the world emerging from a colonialist yoke, is predicated on the concept that all humans are born with equal and inalienable rights, gained by the simple fact that they are born.

In 1948 the Universal Declaration of Human Rights was intended to codify these, to prevent a return to inequality and totalitarian rule. The equality of all individuals is expressed in Article 7:

“All are equal before the law and are entitled without any discrimination to equal protection of the law.

All are entitled to equal protection against any discrimination in violation of this Declaration and against any incitement to such discrimination.”

This understanding underpins the WHO constitution, and forms a basis for the modern international human rights movement and international human rights law.

The concept of States being representative of their people, and having sovereignty over territory and the laws by which their people were governed, was closely allied with this. As peoples emerged from colonialism, they would assert their authority as independent entities within boundaries that they would control.

International agreements, including the existing IHR, reflected this. The WHO and other international agencies would play a supportive role and give advice, not instructions.

The proposed IHR amendments reverse these understandings.

The WHO proposes that the term ‘with full respect for the dignity, human rights and fundamental freedoms of persons’ be deleted from the text, replacing them with ‘equity, coherence, inclusivity,’ vague terms the applications of which are then specifically differentiated in the text according to levels of social and economic development.

The underlying equality of individuals is removed, and rights become subject to a status determined by others based on a set of criteria that they define. This entirely upends the prior understanding of the relationship of all individuals with authority, at least in non-totalitarian states.

It is a totalitarian approach to society, within which individuals may act only on the sufferance of others who wield power outside of legal sanction; specifically a feudal relationship, or one of monarch-subject without an intervening constitution.

It is difficult to imagine a greater issue facing society, yet the media that is calling for reparations for past slavery is silent on a proposed international agreement consistent with its reimposition.

Giving WHO authority over member States

This authority is seen as being above states (i.e. elected or other national governments), with the specific definition of ‘recommendations’ being changed from ‘non-binding’ (by deletion) to ‘binding’ by a specific statement that States will undertake to follow (rather than ‘consider’) recommendations of the WHO.

States will accept the WHO as the ‘authority’ in international public health emergencies, elevating it above their own ministries of health.

Much hinges on what a Health Emergency of International Concern (PHEIC) is, and who defines it.

As explained below, these amendments will widen the PHEIC definition to include any health event that a particular individual in Geneva (the Director General of the WHO) personally deems to be of actual or potential concern.

Powers to be ceded by national governments to the DG include quite specific examples that may require changes within national legal systems. These include detention of individuals, restriction of travel, the forcing of health interventions (testing, inoculation) and requirement to undergo medical examinations.

Unsurprising to observers of the COVID-19 response, these proposed restrictions on individual rights under the DG’s discretion include freedom of speech.

The WHO will have power to designate opinions or information as ‘mis-information or disinformation, and require country governments to intervene and stop such expression and dissemination.

This will likely run up against some national constitutions (e.g. the US) but will be a boon to many dictators and one-party regimes. It is, of course, incompatible with the Universal Declaration of Human Rights, but these seem no longer to be guiding principles for the WHO.

After self-declaring an emergency, the DG will have power to instruct governments to provide WHO and other countries with resources – funds and commodities. This will include direct intervention in manufacturing, increasing production of certain commodities manufactured within their borders.

Countries will cede power to the WHO over patent law and intellectual property (IP), including control of manufacturing know-how, of commodities deemed by the DG to be relevant to the potential or actual health problem that he /she has deemed of interest.

This IP and manufacturing know-how may be then passed to commercial rivals at the DG’s discretion. These provisions seem to reflect a degree of stupidity, and unlike the basic removal of fundamental human rights, vested interests here may well insist on their removal from the IHR draft.

Rights of people should of course be paramount, but with most media absent from the fray, it is difficult to see a level of advocacy being equal.

Providing the WHO DG with unfettered power, and ensuring it will be used

The WHO has previously developed processes that ensure at least a semblance of consensus and an evidence-base in decision-making. Their process for developing guidelines requires, at least on paper, a range of expertise to be sought and documented, and a range of evidence weighed for reliability.

The 2019 guidelines on management of pandemic influenza are an example, laying out recommendations for countries in the event of such a respiratory virus outbreak.

Weighing this evidence resulted in the WHO strongly recommending against contact tracing, quarantine of healthy people and border closures, as the evidence had shown that these are expected to cause more overall harm to health in the long term than the benefit gained, if any, from slowing spread of a virus.

These guidelines were ignored when an emergency was declared for COVID-19 and authority switched to an individual, the director general.

The IHR amendments further strengthen the ability of the DG to ignore any such evidence-based procedures. Working on several levels, they provide the DG, and those delegated by the DG, with exceptional and arbitrary power, and put in place measures that make the wielding of such power inevitable.

Firstly, the requirement for an actual health emergency, in which people are undergoing measurable harm or risk of harm, is removed. The wording of the amendments specifically removes the requirement of harm to trigger the DG assuming power over countries and people.

The need for a demonstrable ‘public health risk’ is removed, and replaced with a ‘potential’ for public health risk.

Secondly, a surveillance mechanism set up in every country under these amendments, and discussed also in the pandemic preparedness documents of the G20 and World bank, will identify new variants of viruses which constantly arise in nature, all of which, in theory, could be presumed to pose a potential risk of outbreak until proven not to.

The workforce running this surveillance network, which will be considerable and global, will have no reason for existence except to identify yet more viruses and variants. Much of their funding will originate from private and corporate interests that stand to gain financially from the vaccine-based responses they envision for infectious disease outbreaks.

Thirdly, the DG has sole authority to declare any event rated (or potentially related) to health an ‘emergency.’ (The six WHO Regional Directors (RDs) will also have this power at a Regional level).

As seen with the monkeypox outbreak, the DG can already ignore the committee set up to advise on emergencies.

The proposed amendments will remove the need for the DG to gain consent from the country in which a potential or perceived threat is identified.

This is taken from a long document. Read the rest here substack.com

Bold emphasis added

Header image: Denis Balibouse / Reuters

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