GENEVA (AP) — The head of the World Trade Organisation (WTO) predicted a “bumpy and rocky” road as it opened its highest-level meeting in 4-1/2 years on Sunday, with issues like pandemic preparedness, food insecurity and overfishing of the world’s seas on the agenda.

At a time when some question WTO’s relevance, Director-General Ngozi Okonjo-Iweala hopes the meeting involving more than 120 ministers from the group’s 164 member countries yields progress toward reducing inequality and ensuring fair and free trade.

Okonjo-Iweala acknowledged the Geneva-based trade body needs reform but said she was cautiously optimistic that a deal might be reached on at least one of the meeting’s main ambitions like fisheries or COVID vaccines.

“The road will be bumpy and rocky. There may be a few landmines on the way,” Okonjo-Iweala said. “We’ll have to navigate those landmines and see how we can successfully land one or two deliverables.”

In her opening address, she said a “trust deficit” had emerged over the years following the failure of negotiations known as the Doha Round more than a decade ago.

“The negativism is compounded by the negative advocacy of some think tanks and civil society groups here in Geneva and elsewhere who believe the WTO is not working for people,” she said. “This is, of course, not true, although we’ve not been able to clearly demonstrate it.”

She cited an array of crises facing the world such as the COVID-19 pandemic; environmental crises like droughts, floods and heat waves; and inflationary pressures that have been compounded by food shortages and higher fuel costs linked to Russia’s war in Ukraine. She noted higher prices are“hitting poor people the hardest.”

“With history looming over us, with that multilateral system seemingly fragile, this is the time to invest in it, not to retreat from it,” Okonjo-Iweala said. “This is the time to summon the much-needed political will to show that the WTO can be part of the solution to the multiple crises, the global commons that we face.”

The WTO chief insisted that trade has lifted 1 billion people out of poverty, but poorer countries – and poor people in richer ones – are often left behind.

Blockaded ports in Ukraine have impeded exports of up to 25 million tons of grain from the key European breadbasket.

Ministers at the meeting will consider whether to lift or ease export restrictions on food to help countries facing a shortage of wheat, fertiliser and other products because of the war in Ukraine. They also will decide whether to increase support for the United Nations’ (UN) World Food Program to help needy countries around the world.

“I strongly urge the WTO members with the capabilities to commit at MC12 to exempt their donations to the World Food Program from any export restrictions,” said Katherine Tai, the U.S. trade representative, referring to the 12th ministerial conference at the WTO.

Okonjo-Iweala hopes the member nations, which make decisions by consensus, also can strike an agreement about whether to temporarily waive WTO’s protections of intellectual property on COVID-19 vaccines.

The topic has generated months of contentious negotiations. The pharmaceutical industry wants to protect its innovations while advocacy groups say the pandemic’s devastation merits an exemption to the usual rules and developing countries say they need better access to vaccines.

Some experts and diplomats say two decades of WTO efforts to limit overfishing in the world’s seas appears to be as close as it ever has to reaching a deal.

The draft text on fisheries aims to limit government subsidies — such as for fuel — to fishing boats or workers who take part in “illegal, unreported and unreported” fishing, or national subsidies that contribute to “overcapacity or overfishing.” Some workers in developing countries could qualify for exemptions.

“This agreement is crucial to the 260 million people around the world whose livelihoods depend directly or indirectly on marine fisheries,” Okonjo-Iweala said. “It is also central to the sustainability of our oceans, where the latest studies show close to 50 per cent of stocks for which we have data are overfished.”

An umbrella group of nongovernmental groups, “Our World Is Not For Sale,” said over 50 NGOs were stripped of access that they had been previously granted to attend the opening day events.

WTO spokesman Daniel Pruzin said that because of “space limitations” at WTO and events inside, “we were unfortunately unable to grant accredited NGOs access, both civil society groups as well as business groups.” He said they would be granted access for the rest of the ministerial starting Monday.

The World Trade Organisation, created in 1995 as a successor to the General Agreement on Tariffs and Trade, has seen a slow unravelling — often because United States objections have largely hamstrung its dispute-resolution system.

The WTO hasn’t produced a major trade deal in years. The last one, reached nearly a decade ago, was an agreement that cut red tape on goods clearing borders and was billed as a boost to lower-income countries.