S/C/66  
 
12 December  2023 
(23-8527) Page: 1/5 
Council for Trade in Services    
 
  
REPORT OF THE COUNCIL FOR TRADE IN SERVICES  
TO THE GENERAL COUNCIL  
ON THE WTO RESPONSE TO THE COVID -19 PANDEMIC  
AND PREPAREDNESS FOR FUTURE PANDEMICS  
1  INTRODUCTION  
1.1.  This report has been prepared by the Council for Trade in Services (CTS)  pursuant to 
paragraph  24 of the "Ministerial Declaration on the WTO Response to the COVID 19 Pandemic and 
Preparedness for Future Pandemics"1 adopted at the Twelfth Ministerial Conference  (MC12) .2  
1.2.  It compiles information on the work undertaken by the CT S on the WTO  response to pandemics  
and preparedness for future pandemics  since MC12 . 
2  STOCKTAKING IN THE SERVICES AREA  
2.1.  The CTS addressed the Ministerial mandate related to the WTO  response to the COVID -19 
pandemic and preparedness for future pandemics  at all its meetings following MC12.  
2.1  Written s ubmissions  
2.2.  At the March and June 2023 meetings, the Council addressed two com munications by India on 
the "Role of telemedicine services in response to the pandemic"3 and "Building a pool of health 
professionals to respond effectively to pandemics/natural disasters".4 Several delegations 
underscored the importance of the issues raised in the Indian submissions and expressed support 
for engaging in dedicated discussion s of those issues. Other delegations said that the informal 
experience -sharing session on health services already offered an avenue for engagement and 
cautioned against unnecessary duplications; they also questioned the relevance of the GATS and the 
WTO to  some of the issues raised in the Indian submissions.  
2.3.  Additionally, the Council addressed a communication from India on trade -related measures 
taken in response to the COVID -19 pandemic at its October meeting.5 
2.2  Informal experience -sharing  
2.4.  In the lead -up to the CTS meeting of October 2022, the first formal meeting following MC12, 
the Chairperson held bilateral consultations to gather Members' views on the implementation 
matters relevant to the CTS as per the MC12 Decisions and Declarations. At the meeting, he reported 
on the views he had heard from Members relevant to the WTO response to pandemics6, indicating 
 
1 WT/MIN(22)/31 . 
2 Paragraph 24 states: "Relevant WTO bodies [Footnote: " Relevant WTO bodies include […] the  Council 
for Trade in Services or its relevant subsidiary bodies  […]."] will, within their fields of competence, and on the 
basis of proposals by Members,  continue or initiate work as soon as possible, to analyse lessons that have been 
learned and challenges experienced during the COVID 19 pandemic. A stocktaking exercise will be taken of the 
work by WTO bodies under this declaration yearly at the General C ouncil until the end of 2024, based on the 
reports of those relevant bodies.".  
3 S/C/W/426 . 
4 S/C/W/427 . 
5 JOB/SERV/CTS/15 . 
6 The Chairperson's report was subsequently circulated in JOB/SERV/CTS/6  and Addendum 1 . S/C/66  
 
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  that delegations were open to discussing ideas that other Members might bring forward, as long as 
these were part of the WTO's core mandate, forward -looking and relevant to services trade.  
2.5.  At the December 2022 meeting, some Members shared information about national telehealth 
initiatives and the impact of COVID -19 on services exporters.  
2.6.  Following further consultations organised by the Chairperson7, at the March 2023 meeting the 
Council agreed to organize a series of informal experience -sharing sessions , modelled on a similar 
exercise conducted in the Committee on Market Access, addressing: 1) transport and logistics 
services; 2)  health services; 3)  tourism services; and 4) ICT and digitally delivered services.8 
Members agreed on the understanding that the sessions would have balanced representation, 
provide for the participation of external stakeholders and address the trade impact of COVID -19, 
both generally and specifically on LDCs, and the trade -facilitative measures introduced by Members 
to respond to the pandemic. The sessions would be organised during the services clusters of 
meetings.  
2.7.  The first CTS experience -sharing session , on the impact o f COVID -19 on trade in transport and 
logistics services , was held on 13 Jun e.9 The following Members contributed speakers to present 
their experiences: China  (Cain iao Group) ; Hong Kong, China  (Airport Authority of Hong  Kong, 
China) ; Mongolia ( Ministry of Foreign Affairs ); the Separate Customs Territory of Taiwan, Penghu, 
Kinmen and Matsu  (Taoyuan International Airport Corporation ); Bangladesh ( Ministry of 
Commerce ); India ( Ministry of Ports, Shipping and Waterways ); Mauritius  (Mauritius Port Authority) ; 
the European Union ( Directorate General for Mobility and Transport , European Commission ); South 
Africa  (E-commerce Forum South Africa and Africa) ; and the Dominican  Republic ( General 
Directorate of Customs ). The Secretariat also delivered an overview presentation on the impact of 
the COVID -19 pandemic in the transport and logistics sectors.   
2.8.  The following questions were proposed to guide Members' presentations: (i) what were the key 
transport and logistics challenges Members encountered during the COVI D-19 pandemic and what 
were their impacts?; (ii) what types of measures did Members take to mitigate the effects of 
transport and logistics disruptions and build resilience in this sector?; (iii) what were the 
considerations underpinning these measures and  what motivated their continuation or termination?; 
and (iv) what were the specific implications of the pandemic for LDCs in the sector?  
2.9.  The paragraphs below reproduce the concluding remarks by the Chairperson .  
Due to time constraints, the Chairperson of the Council for Trade in Services, Ms. 
Dimitrova, Permanent Representative of the Republic of Bulgaria, highlighted the main 
points of her concluding remarks, which are included hereafter in full for Members' 
reference. She noted that the presentations del ivered by government and private sector 
representatives showed that the COVID 19 pandemic had presented many common 
challenges and had constituted a "stress test" for transport and logistics networks. 
Among the obstacles caused by the health emergency, lim ited transportation capacity, 
shortages of facilities and drivers, severe cost fluctuations, as well as the imperative of 
protecting the health of the workforce had been highlighted. The pandemic had created 
uncertainty for suppliers, which had struggled t o sustain revenue, and which could not 
rely on work -from-home options for much of their workforce. The fragility of the delivery 
and logistics infrastructure in some regions, the remoteness of islands economies from 
international markets, as well as the co nstraints faced by certain land -locked economies 
had created further challenges. While constituting a source of sustained demand, the 
increased reliance on cross -border e -commerce had added further pressure to transport 
value chains.  
 
7 An account of the consultations is contained  in JOB/SERV/CTS/9 . 
8 JOB/SERV/CTS/10 . 
9 JOB/SERV/CTS/1 6/Rev. 1. S/C/66  
 
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  Despite the significa nt challenges, COVID -19 had also created new opportunities and 
accelerated trends that had begun to emerge before the pandemic. Above all, the 
pandemic had underscored the critical role of digital technologies, for instance to 
optimise parcel packing, ship ment tracking and tracing, streamlined procedures, as well 
as e-documentation and clearance. Advanced digital technologies such as automation 
and AI were mentioned as especially key to the future of the transport and logistics 
sectors. The pandemic had als o prompted the exploration of alternative options to 
increase the efficiency of transport and logistics operations, such as sea -air trans -
shipment and the creation of one -stop upstream logistic services.  
To address the complexities caused by the pandemic, Members had introduced various 
measures, including, for example, certain regulatory flexibilities (such as the temporary 
modification of airport slot allocation rules or the extension of validity of licences and 
certificates), financial support mechanisms,  the designation of transport workers as 
"essential workers" to facilitate their movement, and "green lanes" to ensure the 
continuous flow of essential goods. In addition, certain Members had introduced 
targeted packages to sustain the progressive recovery  of the economy as a whole. Some 
Members had also designed a set of guiding principles to step -up crisis preparedness 
and guide a rapid regulatory response in the event of future health crises.  
Interventions generally confirmed the importance of the trans parency and predictability 
of applicable regulatory frameworks. Moreover, it was noted that communication and 
coordination among transport authorities at the international level played a vital role. 
The information -sharing under the CTS could serve as a us eful platform to maintain an 
open dialogue.  
2.10.   At the October 2023 meeting, Members expressed appreciation for the first CTS experience -
sharing session.  
2.11.   The second session, on health services, was held on 4 October .10 Two Members, India 
(Permanent Mission to the WTO and Ministry of Health and Family Welfare) and the Russian 
Federation (Ministry of Health) , as well as  the World Health Organization  and the International 
Council of Nurses, intervened as speakers to present their experiences  and perspectives . The 
European Union and the Philippines contributed from the floor. The Secretariat also delivered an 
overview presentation on the impact of the COVID -19 pandemic on health -related services.  
2.12.   The following questions were proposed to guide Members' presentations : (i) What were the 
key challenges Members encountered during the COVID -19 pandemic with regard to trade in health -
related services and what were their impacts? Was there a change in how health -related services 
were traded (e.g., health -related travel abro ad, cross -border telehealth services)?; (ii) What types 
of measures affecting trade in health -related services did Members take to mitigate the effects of 
the pandemic?; (iii) What were the considerations underpinning these measures and what motivated 
their continuation or termination? Were there any takeaways?; (iv) What were the specific 
implications of the pandemic for Least Developed Countries (LDCs) in the sector?  
2.13.   The paragraphs  below  reproduce the concluding remarks by the Chairperson.  
The Chairperso n of the Council for Trade in Services, Mrs. Tsvetelina Dimitrova, 
Permanent Representative of the Republic of Bulgaria, offered some concluding 
remarks. She noted that trade in health -related services had been growing fast over 
the previous decade, at an average annual rate of 7% per year compared to about 4% 
for other services. The pandemic had caused dramatic effects on trade in health 
services, which relied mainly on the cross -border movement of individuals, i.e. modes 
2 and 4. At the same time, health -related services traded through mode 1 – as 
practitioner -to-practitioner services, but increasingly as practitioner -to-patient services 
– had been experiencing significant growth. Still, given that low and middle -income 
economies resorted mainly to modes 2  and 4 to export health services, health service 
suppliers from these countries had been especially affected by the pandemic.  
 
10 JOB/SERV/CTS/21 /Rev. 2. S/C/66  
 
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  To address the challenges caused by the pandemic, Members had introduced various 
regulatory flexibilities and adaptations in the health sector, broadly along four lines. 
First, they had eased the entry to practice, for instance, for students or retired health 
professionals. Second, they had increased the scope of practice. Third, Members had 
facilitated international mobility, both for emergency as well as routine situations. 
Finally, they had supported the supply of telemedicine services, mainly domestically but 
also internationally.  
The WHO had presented its digital health strategy, which had been set up with the goal 
of, inter ali a, advancing the implementation of relevant strategies and strengthening 
the governance of digital health at the global, regional and national levels. This included 
comprehensive guidelines to support telemedicine implementation. When it came to the 
international mobility of health workers, this was a phenomenon that had already been 
well at play before COVID -19. Between 2006 and 2016, the foreign health workforce in 
OECD countries had grown by 60%. International mobility had declined in 2020 due to 
COVID -related travel bans, but, in subsequent years, it had accelerated further, driven 
by the pandemic itself. This had increased concerns about brain drain in economies of 
origin. The WHO Global Code of Practice established principles and practices for th e 
ethical international recruitment of health workers and provided guidance on the 
adoption of relevant bilateral and international agreements. 55 economies, of which 37 
in the African region, were identified by the WHO as facing the most severe health 
workforce vulnerabilities; active recruitment from these economies was discouraged.  
The ICN's presentation showed that, at present, there were over 28 million nurses 
worldwide, with the vast majority working in high -income countries. A shortage of a 
further 13 million nurses was expected in the future, and the gap between demand and 
supply was still widening. It was noted that there was a need to invest in the nursing 
workforce for health systems' effectiveness, and this included investing in educatio n, 
looking at how international migration was happening and how it impacted the sending 
economy, in particular in vulnerable economies, and strengthening the WHO Global 
Code of Practice.  
Members who contributed as speakers had shared their experience on ho w COVID -19 
had affected health -related services and trade in this sector, how they had addressed 
the challenges posed by the pandemic and the actions they had introduced, as well as 
presenting their key takeaways. A couple of key themes emerged from these 
contributions. First, the importance of being prepared and "future -proofing" the risks 
from future pandemics. Second, the imperative of creating an enabling regulatory 
environment and "whole of government" approach – in this regard the importance of 
having  digital capabilities and infrastructure was also underlined. Finally, on a more 
positive note, it was noted that the pandemic had also served an enabler for the 
development of novel health solutions, including based on digital technologies.  
2.14.   The third sess ion, on tourism services, was organised on 6 December.11 Two Members, 
Hong Kong, China (Culture, Sports and Tourism Bureau ) and Mexico ( Secretary of Tourism ), as well 
as the UN World Tourism Organization (UNWTO) , the Organisation for Economic Co -operation and 
Development (OECD), the Enhanced Integrated Framework  (EIF), and the World Travel & Tourism 
Council (WTTC), intervened as speakers to present their experiences and perspectives. Canada, 
China, the European Union , Chinese Taipei and the United Kingdom contributed from the floor. The 
Secretariat also delivered an overview  presentation on the impact of the COVID -19 pandemic on 
tourism  services.  
2.15.   The following questions were proposed to guide Members' presentations: (i) What were the 
key challenges Members encountered during the COVID -19 pandemic with regard to trade in tourism 
services and what were their impacts? (ii) What types of measures affecting trade in tourism services 
did Members take to mitigate the effects of the pandemic? (iii) What were the con siderations 
underpinning these measures and what motivated their continuation or termination? Were there any 
takeaways? (iv) What were the specific implications of the pandemic for LDCs in the sector?  
 
11 Summary report to be issued.  S/C/66  
 
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  2.16.   The paragraphs  below  reproduce the concluding remarks by the Chairperson.  
The tourism sector is a pillar industry for many Members  and was devastated  by the 
pandemic. Tourism accounted for 10.4% of GDP in 2019 , and this share was halved by 
the onset of COVID -19. The number of tourist arrivals in 2020 was 74% lower compared 
to 2019; by way of comparison, during the economic crisis of 2009, tourist arrivals had 
fallen only by 4%. Domestic tourism increased, but only very partly compensated the 
plunge in international tourist arrivals.  Internal touris m receipts fell by US$2.6  trillion 
between 2019 and 2022.  While i n 2019, tourism services were the 3rd  top export sector,  
by 2021 they had fallen to 9th place.  
 
At the regional level, the Asia and Pacific  region  was particularly affected  by COVID -19, 
falling from 30% of world tourism receipts pre -pandemic to just 13% in 2022.  In terms 
of income groups, LDCs have been the most impacted , and are currently still at 30% 
below pre -COVID levels  in terms of  international  tourist arrivals . Other impacts of the 
pande mic-induced tourism crisis in LDCs included reduced air transport connectivity for 
the smaller, remote LDC economies and a negative effect  on the informal sector of the 
tourism value chain. It was indeed highlighted that the fall in international tourism had 
broad impacts  beyond the immediate tourism sector, affecting other sectors throughout 
the tourism ecosystem.   
 
The good news, however, is that the sector is on the road to a full recovery . The 
estimates show that  tourist receipts will reach 93%  of the p re-pandemic levels  in 2023 . 
Some regions, such as the Middle East and Europe, are doing particularly well. Looking 
ahead, although one question mark for the sector's recovery relates to economic growth, 
which is expected to decline in 2024, over the next t en years the sector is expected to 
grow from US$9.5 trillion in 2023 to US$15.5 trillion in 2033.  Some new trends  can also 
be observed, namely tourists staying longer and spending more during their visits, the 
sector digitally transforming and focusing on sustainability.  
 
Government measures introduced  to counter the impact of the pandemic were in  three 
main phases, as the pandemic evolved . First, m itigation  measures , to protect tourists, 
jobs and businesses . These were of two main kinds: (i)  targeted fiscal and monetary  
measures for businesses and their workforce, such as tax reliefs, government 
guarantees, job retention schemes  or temporary redeploy ment of tourism workers to 
other sectors ; (ii) following initial travel restrictions and border controls, several 
governments introduced targeted safety protocols , alongside measures to facilitate safe 
cross-border movements, such as vaccination  or COVID  certificates or quarantines. 
Second, measures to m anage the restart  of tourism activities, such a s lifting travel 
restrictions, restoring traveller confidence,  or addressing labour shortages. Third, 
measures to p repar e for the future , such as introducing new tourism strategies,  
supporting the acceleration of digital capacities and the digital transfor mation and 
upskilling , or diversifying tourism offer ings and markets . 
 
Other issues  that were mentioned include  the challenges of inconsistent  and 
unpredictable travel restrictions, lack of interoperable systems and fragmented health 
and safety standards ; the importance of evaluating the impact of measures taken ; the 
need to improve data and share information to ensure evidence -based decisions can be 
taken ; and t he relevance of collaboration , and, in that regard,  a number of  joint 
initiatives by various  International Organisations were mentioned.  
 
2.17.   At the December 2023 meeting, Members took note of the second and third CTS experience -
sharing sessions.  
2.18.   The fourth session, on ICT and digitally delivered services, is planned to be held during the 
first cluster of services meetings in March 2024.  
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