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Key Ask #Key Ask language Secured in PD scoreWhere in PD (reference paragraph) Supporting comments
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1Community-based and community led health systems and health literacy
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1.1Include reference to ‘community-based and community-led health systems’ and ‘community health workers’ as distinct building blocks of PPPR whenever formal health systems and health workers are referencedSomewhat SecuredPP27Two uses of 'community-based, but reference to 'community-led' in Rev.2 has been removed.
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1.2Commit governments and international donors to investing in community systems, leadership, and engagement, including mechanisms to fund civil society and communities, as part of PPPR effortsSomewhat SecuredOP34, PP18No particular concrete commitments on funding civil society and community mechanisms, but mention of inclusion and engagement.
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1.3Reference the right of individuals and communities to effective, culturally competent, and linguistically accessible health literacy and health communication so that they might meaningfully engage in maximizing health outcomesSomewhat SecuredOP35Referenced, but not as a right.
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2Equitable access to medical countermeasures
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2.1Clearly commit, particularly in times of global crisis, to mandatory sharing of knowledge, intellectual property waivers, and technology transfer of all medical technologies relevant to the pandemic diseases including vaccines, therapeutics, diagnostics, and other tools such as PPE through full use of TRIPS flexibilitiesSomewhat SecuredOP10, OP12All references to technology transfer, IP waivers, and knowledge sharing are couched with 'voluntary' or 'on mutually agreed terms'.
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2.2Commit to including mandatory conditions on sharing of data, technology transfer, and transparency of costs and net prices in public financing of R&D and purchasing agreements of medical countermeasuresNot securedOP10Mandatory conditions have been removed from the clauses on publicly-funded R&D.
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2.3Support increased local manufacturing capacity for low-and middle-income countries (LMICs), including through financing and logistical support for initiatives such as the World Health Organisation mRNA Technology Transfer HubsMostly SecuredPP11, OP10, OP11, OP13There's little detail on mechanisms for support, but many references to the importance of diversified manufacturing. Would be secured with financing targets and mechanisms to transfer tech in order to keep manufacturers 'warm'.
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2.4Commit to funding and expanding vaccination, diagnostics, and therapeutics infrastructure and capacity, including R&D, manufacturing, genomic surveillance, and community-based test and treat strategies, recognising that pandemic preparedness and response and routine primary healthcare services are delivered by the same systemSomewhat SecuredPP13, PP27, PP28, PP29, OP31, OP44, OP46, OP47There are references to the need to enhance ODA, find innovative sources of financing, and secure surge financing, but there are no targets or concrete commitments, and the only vehicle mentioned by name is the Pandemic Fund. There are also several references to primary health care as the necessary foundation to PPR.
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2.5Commit to implementing global and regional resources for fair allocation of developed medical countermeasures according to population needSomewhat SecuredOP1, OP2, OP13, OP14References to "ensure equitable access to medical countermeasures" but no information on a proposed mechanism to do so or how countries will be compelled to equitably allocate; no commitments, use of "urge". The problematic understanding of benefits has been removed, with implied intention to discuss in the INB process.
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2.6Ensure timely WHO guidance on use cases and delivery of medical countermeasures (including self-tests and clinical guidance) to ensure LMICs are able to access at the same time as high-income countriesNot securedNo reference to WHO guidance.
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2.7Accelerate and strengthen WHO Prequalification and Collaborative Registration mechanisms, and support national and regional regulatory agencies to streamline the regulatory approval process across countries and regionsSomewhat SecuredPP11, OP32"Need to support developing countries in building expertise in...regulatory capacity", "Strengthen...regulatory frameworks"; no mention of WHO Prequalification or specific mechanisms to streamline regulatory approval processes.
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2.8Commit to developing a “library” of countermeasures against pathogens of pandemic potential in accordance with the goals of the 100 Days MissionNot securedNo reference to library or 100 Days Mission.
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3One Health
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3.1Commit to building and supporting fit-for-purpose animal health systems through improving access to animal health services for communities, increasing and upskilling the animal health workforce, guaranteeing access to veterinary medicines and vaccines, and improving animal disease surveillanceSomewhat SecuredPP19, OP39, OP40Reference to strengthening coordination with animal health services, but no concrete commitments or reference to specific actions.
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3.2Complete risk assessments based on the drivers of zoonoses and produce a tailored package of interventions as part of a pandemic prevention planNot secured
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3.3Establish, sustain, coordinate and mobilize an available, skilled and trained One Health workforceNot secured
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3.4Meet existing minimum standards for animal health services as set out by Quadripartite partners, including WOAH’s Animal Terrestrial Animal Health Codes and Manuals Secure benefit sharing mechanisms in all surveillance so that sharing pathogens is accompanied by sharing technologies, knowledge, products and sale profits Integrate capacities for One Health with investments in community-based primary health care, particularly for health-related aspects such as surveillance of emerging pathogensNot secured
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4Civil society & community participation and leadership in decision-making and governance of the global and national health architecture
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4.1Enable meaningful community and civil society participation in governance and decision-making across policies, programmes, and resource allocation Somewhat SecuredPP18, OP26, OP34, OP38No particular concrete commitments on engaging civil society and community in governance or decision-making, but mention of inclusion and role.
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4.2Specify the populations most left behind and restricted in accessing health services to include the most stigmatized populations using the agreed language in paragraphs 25, 60 and others of the 2021 UN Political Declaration on HIV and AIDS referring to these 3 populations being people living with HIV, men who have sex with men, sex workers, transgender people, people who use drugs, particularly those who inject drugs, and people in prisons and other closed settingsSomewhat SecuredPP7List of populations includes "people living with co-morbidities, underlying chronic conditions, communicable and non-communicable diseases, older persons, people living in poverty, people living in rural areas, women and girls, children, Indigenous Peoples, People of African Descent, migrants, refugees, internally displaced persons and persons with disabilities, as well as those who are vulnerable or in vulnerable situations"; lacking specification of LGBTQ+ populations or people in closed settings.
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4.3Guarantee gender equality in health systems and decision-making at all levels SecuredOP19, OP22
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4.4Ensure the operations and governance of new and existing global health mechanisms and agreements are co-created with communities and civil society with permanent representation in the governance structure, provision of voting rights, and funding to support engagement with broader civil society and communitiesNot secured
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4.5Provide for transparent information-sharing and inclusive processes that will allow for the meaningful engagement and integration of communities and civil societyNot secured
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5Accountability
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5.1Develop an overarching accountability framework for all global architectures for health emergency prevention, preparedness, and response. The framework should clearly identify roles and responsibilities of relevant stakeholders and clarify relationships between relevant initiatives and their relation to the leadership from regions and countries, and explicitly integrate the meaningful engagement of civil society and community groups across these initiativesNot securedPP26, OP1, OP2, OP15, OP16, OP26
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5.2Define the leading role of regions and countries in the event of an outbreak or pandemic, or public health emergency of international concern (PHEIC) Mostly SecuredOP30This clause can be interpreted in two ways - countries are leaders in the pandemic response (yes), but can also see it as saying there aren't standards that countries need to uphold and they can design their own response without regard to internationally agreed upon needs.
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5.3Prioritize efficiency and avoid duplication of efforts or reinvention of platforms and groups across the current global health architectureSomewhat SecuredPP26, OP2, OP14, OP27Reference to INB, but unclear what goes in this document vs. what goes in INB.
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5.4Include commitments to creating and maintaining safe, open, and enabling mechanisms on national and global levels in which civil society and communities can fully contribute to the implementation of the political declarationNot secured
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6Financing
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6.1Develop an explicit plan for financing PPPR capacity development and resilient health systems, with clear expectations of national governments and multilateral institutions and ensure that such a plan conforms to the “all contribute, all benefit, all decide” principles of Global Public InvestmentNot secured
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6.2Mobilize financing for PPPR that includes allocation to support the key role of community-based health systems and community-led effortsNot secured
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6.3Contribute full, long-term funding that meets the need of existing multilateral institutions already contributing to PPPR, including the WHO assessed contributions, Unitaid, and the Global Fund to Fight AIDS, TB, and Malaria (of which more than a third of its investments advance global pandemic prevention and preparedness)Not securedThere are references to the need to enhance ODA, find innovative sources of financing, and secure surge financing, but there are no targets or concrete commitments, and the only vehicle mentioned by name is the Pandemic Fund.
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6.4Commit to common but differentiated responsibilities which recognise the different available resources and different needs of all countriesNot secured
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7Digital Health
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7.1Recognise that the global and, in many cases, national governance of data and digital technologies is currently inadequate for safeguarding human rights, including the right to privacy and right to non-discrimination, and is failing to address digital inequities Commit to establishing new norms, guidance, and laws, grounded in human rights and civil society participation, that strengthen and enforce the governance of data and digital technologies, including artificial intelligenceSomewhat SecuredPP14Lacks specficiation of the right to privacy and right to non-discrimination, but includes reference to "ensuring personal data protection".
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7.2Recognise the particular risks for marginalized and vulnerable communities and commit to overcoming the digital divide, particularly for women and girls, by investing in digital literacySomewhat SecuredOP35Need for public health literacy and access to digital tools in the same clause, but not specifically digital literacy.
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7.3Invest in the meaningful engagement of civil society and communities in decision making at all levels, including the design, implementation, evaluation, and governance of digital technologyNot secured
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8Synergies between disease-specific programs and PPPR
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8.1Recognise the interconnectedness between the high-level meetings taking place in 2023 on PPPR, universal health coverage (UHC) and tuberculosis (TB)Not secured
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8.2Commit to continued support and resources for ongoing pandemic and epidemic responses, including HIV, TB, malaria, COVID-19, and others, as the base for strong health systems and PPPRSecuredOP38, OP39
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8.3Commit governments and international agencies to provide cross-disease training for health and community workers in order to leverage surveillance and detection capacities built in disease-specific programmingMostly SecuredPP17, OP19, OP29, OP43No 'commit', but substantial reference.
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8.4Enable engagement of civil society and communities in PPPR processes and deliberations on consultation & delegation structures as established in the HIV, TB, malaria, and UHC movementsNot secured