The countdown to a pandemic treaty Premium

The final leg of negotiations for the 30-page World Health Organization Pandemic Agreement is the most momentous time in global health since 1948

In March 2021, an extraordinary call for a pandemic treaty was issued by 25 heads of government and international agencies, marking a pivotal moment in global health governance. The ninth meeting of the Intergovernmental Negotiating Body (INB), the final leg of negotiations for the 30-page World Health Organization (WHO) Pandemic Agreement, commenced last week (March 18). This is the most momentous time in global health since 1948. As we approach the World Health Assembly in late May, where the final draft will be presented for approval, the fate of the Pandemic Agreement hangs in the balance, with the risk of collapse looming large amidst contentious debates.

The WHO Pandemic Agreement aims to address the systemic failures revealed by the COVID-19 crisis, with the goal of strengthening global defences and averting future pandemics from spiralling into catastrophic human crisis. The world’s first pandemic treaty aims to “strengthen pandemic prevention, preparedness and response” with “equity as the goal and outcome”. It addresses the searing inequity witnessed during the COVID-19 pandemic including a lack of preparedness in countries and the lack of coordination at international levels.

The draft negotiating text covers several issues, that includes pathogen surveillance, health-care workforce capacity, supply chain and logistics, and tech transfer to support the production of vaccines, diagnostic tests and treatments, and the waivers of intellectual property (IP) rights. It seeks to strengthen surveillance for pathogens with “pandemic potential”. The Agreement requires countries to also commit to better managing antimicrobial resistance, strengthening their health systems and sanitation, and making progress toward universal health coverage. Separate talks at WHO aim to amend the International Health Regulations, which compel countries to report health emergencies within their borders.

There is a significant emphasis throughout the text on equitable access to medical products. This theme shows up across provisions from language on principles, articles on preparedness, production, technology transfer, access and benefit sharing, supply and procurement.

The current negotiating texts have also proposed an establishment of the Conference of Parties (COP) to oversee the implementation of the Pandemic Agreement. The proposed establishment of a COP suggests that the Agreement could be a classic international treaty adopted under Article 19 of the WHO Constitution as opposed to the alternative Article 21 opt-out regulations.

At the ongoing negotiations, the developing countries have largely embraced the revised negotiating text (perhaps for the first time in two years of negotiations), while the developed countries uniformly criticised it, stating that the text now contains elements that are ‘redlines’ for them including on financing and matters related to IP. Countries including Australia, Canada, the European Union, the United Kingdom, and the United States went to the extent of referring to the text as a ‘step backwards’. Other than the few major substantive disagreements, there is also a general disagreement on the modalities for the conduct of these negotiations in this final stretch.

India, representing the South-East Asia region, has emphasised the importance of clarity on obligations vis-à-vis responsibilities, especially between developed and developing countries, to effectively operationalise equity within the Agreement.