Civil society coalition urges Indonesian government to ensure vulnerable groups' rights are accommodated in the Pandemic Agreement

Jakarta, 15 May 2024

The coalition of civil society organisations urges the government of Indonesia to ensure the fulfilment of the rights of vulnerable groups in the draft of the Pandemic Agreement. Recognising vulnerability and meaningful community engagement in pandemic prevention, preparedness, and response are among the coalition's input. 

On 2-3 May 2024, a coalition of 16 civil society organisations met in Jakarta to formulate the Indonesian government's stance on the Pandemic Agreement negotiations in Geneva, Switzerland. The Center for Indonesia's Strategic Development Initiatives (CISDI) initiated and coordinated the coalition.

Member states are currently negotiating for the Pandemic Agreement, which is an agreement to strengthen cooperation between countries in pandemic prevention, preparedness, and response. This negotiation is hosted by a body representing 194 WHO member states called the Intergovernmental Negotiating Body (INB). 

"The Pandemic Agreement concerns the lives of all people. However, the main negotiation process only involves the government, so the major criticism of the INB process is the lack of civil society involvement," said CISDI Founder and CEO Diah Satyani Saminarsih.

In February 2023, INB released an initial or zero draft entitled "WHO Convention, Agreement, or Other International Instrument on Pandemic Prevention, Preparedness, and Response" (WHO CA+ on PPPR). The INB plans to finalise its latest draft at the 77th World Health Assembly in Geneva, Switzerland, at the end of May 2024.  

During the negotiation process, a coalition of civil society organisations in Indonesia has several notes regarding the draft Pandemic Agreement. The coalition hopes that the recommendations submitted to the government after the meeting in early May can encourage a fair agreement between countries in dealing with the next pandemic.

In principle, the coalition agrees to encourage Indonesian representatives in the negotiation to hold a position based on the principles of equity, social inclusion, and gender responsiveness. The Indonesian delegations should consider these key principles to realise equitable global pandemic governance reforms that reflect the needs of affected individuals and/or communities, including those living in countries in conflict.

"There is something overlooked or missing from the Pandemic Agreement, which is gender equality. It is not mentioned in the draft, as if the pandemic affects all groups proportionally," said Nur Jannah from Yayasan Inisiatif Perubahan Akses Menuju Sehat (IPAS), one of the coalition member organisations.

Here are some specific notes from the coalition of civil society organisations regarding the draft of the Pandemic Agreement:

Firstly, the coalition urges revising the definition of “persons in vulnerable situations” in the draft. In the draft, vulnerable people are only mentioned as groups that are prone to infection. The coalition hopes that the Pandemic Agreement can identify vulnerable groups based on disability, gender, indigenous status, socio-economic class, conflict, geographic location, and others. Revision to the definition of vulnerable groups is aimed at ensuring that the accessibility articles are responsive to the situations and needs of multiple vulnerable groups.

Second, the coalition encourages the Pandemic Agreement to guarantee access to reproductive health services, primary health services, and mental health, especially for women and gender minorities during the pandemic.

Third, the coalition encourages fair access to drugs, vaccines, and medical devices for pandemic prevention and response. Currently, there is still an unequal power relation between countries in the Global North and Global South that affects technology transfer between countries. The Coalition encourages the contents of the Pandemic Agreement to ensure fair access to health technology that can help prevent and respond to pandemics. 

The Pandemic Agreement negotiations should be able to agree on a Pandemic Access and Benefit Sharing System (PABS) mechanism, namely the utilisation of pathogen samples and increasing access to drugs, vaccines, and medical devices, that is fair, adaptive, and responsive. So far, the PABS mechanism has been a contested topic discussed in the negotiations. Some countries are reluctant to be obliged to provide drugs, vaccines, and medical devices as compensation for the countries that have provided pathogen samples. Meanwhile, Global South countries perceive this mechanism can ensure fair access to drugs, vaccines, and medical devices.

In a broader context, the coalition encourages states involved in the negotiations to agree to optimise the utilisation of financing sourced from various global funding facilities. The Pandemic Agreement can strengthen the complementary role of the Pandemic Fund as a global financing platform for pandemic prevention, preparedness, and response.

Domestically, the coalition sees the need for a clause on strengthening domestic financing to strengthen the resilience of the national health system in facing a pandemic. Innovative financing instruments are included, but must be accompanied by adequate and participatory monitoring mechanisms. For example, the use of a debt swap mechanism for health sector investment by the Global Fund can be utilised by the Indonesian government to strengthen the resilience of the health system.

Finally, the coalition sees the importance of a clause on the establishment of an independent implementation and compliance committee as part of the Conference of the Parties (COP) mandate. The committee should also allow civil society and vulnerable groups to become representatives who oversee the country's compliance in implementing the Pandemic Agreement.

The coalition has submitted the concerns and recommendations above to the Ministry of Health and the Ministry of Foreign Affairs. The coalition hopes that the involvement of civil society in pandemic prevention, preparedness and response efforts is not only a formality.

In addition to communicating with the ministries, CISDI will take the civil society coalition's inputs through several global World Health Assembly side events held in Geneva, Switzerland.

Two side events in the form of discussions will be held in person on 28 and 29 May 2024. The first event will discuss the global situation in achieving universal health coverage (UHC) by 2030, which can be followed here. The second discussion will address civil society involvement in the governance for global health, which can be followed here.

The coalition hopes that the Indonesian government representatives can convey these inputs during the Pandemic Agreement negotiation process, which will end on 24 May 2024. Given the lessons learned from the pandemic, the Pandemic Agreement should be the top priority of the current government and should be continued by the next government because it concerns the sustainability of health for all.

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About CISDI

Center for Indonesia’s Strategic Development Initiatives (CISDI) is a non-profit organization aimed at advancing the development of the health sector and strengthening the Health System through impact-based policies, research, advocacy, and inclusive and participatory innovative interventions.