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Resolution 2329 (2020)
Lessons for the future from an effective and rights-based response to the Covid-19 pandemic
1. In 2015, the World Health Organization
(WHO) developed a special tool for determining which diseases and
pathogens to prioritise for research and development in public health
emergency contexts. In 2018, “Disease X” was added to this list,
to represent the knowledge that a serious international epidemic
could be caused by a pathogen at that time unknown to cause human
disease.
2. Following the Ebola epidemic of 2015 and 2016, the Parliamentary
Assembly adopted Resolution 2114 (2016) on
the handling of international public-health emergencies. In this
resolution, the Assembly made a number of recommendations – which
remain valid – to better prepare the world for the inevitable next international
pandemic, urging new ways of working to face international health
crises before they happen. The Assembly’s call unfortunately went
largely unheeded.
3. “Disease X” hit the largely unprepared world in the form of
Covid-19, provoked by a novel coronavirus: 2019-nCoV (also called
SARS-CoV-2). First reported to the WHO Country Office in China on
31 December 2019, the outbreak was declared a Public Health Emergency
of International Concern on 30 January 2020, and a pandemic on 11
March 2020. The virus spread to six continents, infecting millions
and killing hundreds of thousands within months.
4. Unfortunately, in the face of a rapidly spreading virus and
stark mortality predictions, some States opted for nationalist isolation
and repressive and authoritarian responses, instead of effective
action that was cool headed, warm hearted, evidence based, internationally
co-ordinated and compliant with human rights. Many States also seem
to have realised the danger they were in too late (or did not want
to face up to the danger). Even at the European and international
level, including at WHO, the impression that the reaction was too
late is hard to ignore.
5. The price of the initial inaction, the subsequent slow response,
rushed measures and premature re-openings may well be paid in lives
lost, as well as in potentially lasting damage to our political,
democratic, social, financial and economic systems, and in non-respect
for several of the rights guaranteed by the European Convention
on Human Rights (ETS No. 5) and other Council of Europe legally
binding instruments, as well as United Nations conventions, such
as the Convention on the Rights of Persons with Disabilities. Public-health
control measures for disease mitigation with human rights implications
(such as quarantining, physical distancing, contact tracing, border
controls and travel restrictions) must be based on relevant standards
and on public trust to be effective: they need to be designed and
implemented in a transparent, evidence- and rights-based manner;
they must be de-politicised, co-ordinated nationally, regionally
and internationally, communicated clearly and applied fairly, as
outlined in Assembly Resolution
2114 (2016).
6. Although the first peak of the pandemic seems to have passed
in most European countries, the health crisis is not over – and
may not be for some time. The lessons from the suffering of the
past few months must be that, to avoid a disastrous outcome in terms
of lives lost and the burden of sickness, and equally disastrous knock-on
effects on the economy and human rights, we need to act fast to
contain outbreaks, using tried, tested and effective measures, implemented
in a rights-compliant way.
7. The Assembly thus recommends that member States, during outbreaks
of the coronavirus SARS-CoV-2 on their territory:
7.1. take rapid and sustained action
to reduce human contact through physical distancing, as far as possible
on a voluntary basis and if necessary through rights-compliant shutdowns/lockdowns,
for the time it takes until active community spread of SARS-CoV-2
is reduced to a level that is controllable through rigorous testing,
data protection-compliant contact tracing, quarantine and self-isolation, respecting
the principle of proportionality and taking into consideration the
impact such measures have on fundamental rights including social
and economic rights, as well as physical and mental health, and implementing
measures to offset any negative impact;
7.2. procure protective gear for health and other essential
personnel, boost and optimise the capacity of the health system
by mobilising inactive health professionals, and by increasing supplies
of the necessary equipment to diagnose and treat patients safely
and effectively – in particular diagnostic tests, oxygen and ventilators/respirators
– as well as augmenting the numbers of acute care beds available
in hospitals;
7.3. ensure that all public health measures respect human rights,
are gender sensitive, involve women in decision making in a meaningful
way and protect vulnerable groups of the population (in particular,
persons with disabilities, children and the elderly);
7.4. put in place conditions to isolate and care for symptomatic
cases not requiring immediate hospitalisation, on a voluntary basis,
with a view to preventing household/family infection clusters and having
the necessary medical supervision in place to allow rapid hospitalisation
when a patient’s condition deteriorates;
7.5. open borders and lift unnecessary travel restrictions
to allow for an unhindered emergency response across borders; within
the European Union at least, allow public health measures to be designed
centrally and implemented along regional rather than jurisdictional
(member State) lines, as needed, depending on where outbreaks are
situated.
8. The Assembly recommends that member States, at all times:
8.1. make available reliable information
on the comparative dynamic changes in the number of deaths due to
different pathologies in the last three years, and the number of
those infected with Covid-19 among them;
8.2. communicate information in a full and timely manner, which
is clear to all and accessible to persons with disabilities, and
ensure that any decisions made take into account evidence-based scientific
opinion and are transparent (including by publishing expert advice);
8.3. organise active and broad community testing of all persons
present on their territory regardless of status, which is not just
limited to those admitted to hospital or health or other essential
personnel, and roll out wide antibody testing of representative
samples of the population as soon as is feasible;
8.4. actively promote responsible research, development and
production of medicines, diagnostic kits, vaccines and personal
protective equipment, and regulate prices in a spirit of solidarity,
ensuring that any medicines, tests or vaccines thus developed are
accessible and affordable to all, in particular to vulnerable groups;
8.5. prioritise and systemise European and international solidarity,
co-ordination and co-operation; protective gear should not be hoarded
by States “just in case”, but distributed in areas where the need is
greatest across Europe and the rest of the world;
8.6. establish and keep up to date an open access, transborder
directory of available intensive care unit (ICU) beds, as well as
ventilated and staffed beds in ICUs, and make them available to
member States in need;
8.7. avoid executive overreach, disproportionate and unnecessarily
repressive measures infringing human rights or human dignity, as
well as all discrimination in the implementation of public health measures,
with special attention to discrimination against persons with disabilities
and the elderly, notably avoiding discriminatory triage systems;
8.8. reaffirm the fundamental role of parliaments in their
mandate to oversee government actions and ensure that they are able
to fully exercise this mandate, by providing them with both the
technical means and the required level of information;
8.9. ensure that their economic recovery and safeguarding plans
do not create the conditions for a future degradation of ecosystems
likely to generate other epidemics of a zoonotic nature, and thus condition
the aid put in place on the fulfilment of ambitious environmental
and social criteria in line with the United Nations Sustainable
Development Goals.
9. Furthermore, in the face of the current pandemic, the Assembly
calls on member States to intensify efforts to:
9.1. evaluate the state of their
health systems, pandemic preparedness and infection surveillance systems,
with a view to improving them as necessary, in order to guarantee
free access to high-quality public health care guided by the needs
of patients rather than profit, regardless of their gender, nationality,
religion or socio-economic status;
9.2. evaluate the effectiveness, as well as the collateral
damage (in particular to the full exercise of human rights, including
socio-economic rights), of the measures taken to confront the current
pandemic, in order to apply the lessons learned to future public
health emergencies.
10. Beyond the current pandemic, public health preparedness and
global health security must adopt the “One Health” approach, which
embraces the interactions between animals, humans and the environment which
contribute to and protect against disease. Efforts must be stepped
up nationally and internationally to find the next zoonotic disease
before it spreads to humans, to continue to strengthen the co-ordination
of animal and human systems for disease detection and response,
and to protect the ecosystems that underpin human, animal and environmental
health. This includes identifying and fighting climate change as
a driver of emerging health threats and improving policies regulating
animal agriculture and addressing human destruction of pristine
natural habitats.
11. International and European health security and pandemic preparedness
interventions must also be data driven and evidence based, and they
must incorporate human rights provisions. Diverse sources of publicly available
data need to be brought together to create an internationally unified
data infrastructure that can facilitate modelling for decision making.
These models need to be translated into triggers for action. In
cases where sensitive data are transferred, appropriate privacy
and security safeguards must be guaranteed.
12. The Assembly thus recommends that the European Union build
a regional system capable of assisting the responsible international
institutions in their endeavours to ensure effective preparedness
for and reaction to pandemics.
13. Furthermore, the Assembly recommends a reform of WHO in order
to allow it to better fulfil its function of achieving the highest
attainable standard of health for everyone, which:
13.1. makes WHO independent of voluntary
contributions to fulfil its essential functions;
13.2. gives WHO the necessary power to visit member States unannounced
in a public health crisis which could become a Public Health Emergency
of International Concern;
13.3. re-examines and strengthens the International Health Regulations
in order to reframe global governance of disease, make the treaty
more fit for purpose (including the governance of information such
as sample and genetic sequence sharing) and explore mechanisms for
compliance;
13.4. puts in place effective and independent, ideally parliamentary,
oversight of the organisation: at international level, through the
Inter-Parliamentary Union, and at regional level, through regional parliamentary
assemblies, such as the Parliamentary Assembly of the Council of
Europe for the WHO Europe region;
13.5. binds WHO to develop regionally adaptable containment
strategies to fight future health hazards, taking into account the
everyday realities of countries, regions and populations.
14. The Assembly proposes that member States step up their efforts
to make progress regarding the European Social Charter (ETS No.
35 and ETS No. 163) and the Council of Europe Convention on Human Rights
and Biomedicine (Oviedo Convention, ETS No. 164) that facilitate
the safeguarding of social, economic and other human rights, which
are the most vulnerable during responses to a pandemic.
15. Finally, the Assembly proposes to establish a permanent system
of inspection at the United Nations for current and future biological
events with serious consequences, possibly including a permanent,
designated facilitator in the Office of the United Nations Secretary-General.
The United Nations should also ensure international oversight and
accountability for pandemic preparedness through an independent
external entity.