Looming deadline puts pressure on slow pandemic treaty negotiations

Controversial topics, little time and closed doors – talks are moving slowly and significant disagreements are yet to be negotiated among the World Health Organisation (WHO) members on a Pandemic Accord.

Given the complex and delicate topics on the table, doubts persist as to whether the 194 WHO member states will be able to agree on a pandemic treaty with any significant impact. At the same time, their deadline for an agreement on 24 May 2024 at the World Health Assembly (WHA) is extremely tight.

“I think it’s going to be challenging for member states to meet the deadline. My perception from the last session [in July] is that the process is moving slowly,” Daniela Morich, manager and advisor at the Governing Pandemics Initiative hosted by the Global Health Centre at the Geneva Graduate Institute, told Euractiv.

Agreeing on a new WHO instrument could be an opportunity to ensure better prevention and preparedness for future pandemics as well as agree on how to improve global response and global access to medical countermeasures.

The talks are happening in the Intergovernmental Negotiating Body (INB), which WHO members decided to establish in 2021 to draft and negotiate a new WHO instrument.

Many of the ongoing informal talks and drafting sessions have happened behind closed doors until now. So far, countries have been meeting to try to understand each other’s positions, but text-based negotiations still have not begun and compromises on the most tricky topics will be difficult to reach.

“I think it will be disappointing if the international community couldn’t agree on something meaningful or be close to agreeing on something meaningful by May 2024,” said Morich.

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The WHO’s international pandemic treaty, scheduled to be presented …

One of many global health discussions

Until now, talks have been based on three different draft texts by the INB Bureau consisting of six countries elected to lead the process: South Africa, the Netherlands, Japan, Brazil, Thailand and Egypt. First the “conceptual zero draft” from November 2022, then the “zero draft” from February, and latest the “Bureau text” from June.

On 16 October, the Bureau will share a proposal for a negotiating text, which will be considered at the INB’s 7th meeting on 6-10 November and 4-6 December. According to Third World Network, members wanted to review the text before even accepting it as a negotiating text.

At the same time, governments are discussing new amendments to the 2005 WHO International Health Regulations (IHR), currently the only international law governing responses to cross-border health threats.

Having two different instruments, which overlap on some parts, being negotiated in Geneva by the same 194 countries simultaneously is a “unique” situation, said Morich.

These parallel processes reflect the general placement global health has on the agenda. On Wednesday (20 September), global leaders agreed on a political declaration to strengthen global health emergency architecture following a high-level event on pandemic prevention, preparedness and response at this week’s UN General Assembly in New York.

It also climbed higher up on the EU agenda, as the European Commission presented its communication on an EU Global Health Strategy in December 2022 updating a long-outdated communication from 2010.

Sandra Gallina, director general of the EU Commission’s DG SANTE, is the main negotiator for the Commission in the pandemic treaty negotiations. While the EU as a whole is not a member of the WHO, EU member states are. Therefore, the EU presence is to make sure any agreement is in line with EU legislation, policies and commitments under other multilateral agreements.

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Sharing and equity remain significant disagreements 

The big focus is evidence of the dire need for action to change the global health security framework. That being said, major disagreements on key parts persist.

One of these parts is pathogen and benefit sharing. Quick access to pathogens for researchers in the event of disease outbreaks, means medical countermeasures, such as vaccines, can start development as soon as possible.

However, talks about sharing pandemic-related products and the benefits from the use of these pathogens are some of the biggest challenges in the negotiations.

“Some developing countries are strongly advocating to attach benefit sharing to this system of pathogen sharing,” Morich explained.

Benefit sharing is mentioned several times in the Bureau text. One option proposed is that manufacturers of pandemic-related products developed from shared pathogens would have to give the WHO access to 20% of the production. Some of this would then be donated and some sold at “affordable prices” to developing countries.

Mohga Kamal-Yanni, senior global health policy advisor at the People’s Vaccine Alliance, told Euractiv, that this option has been a part of talks already.

“So basically 20% of the supply would go to 80% of the world population, and 80% of the supply would go to 20% of the population. That’s called equity. I mean, it’s just crazy,” she said, adding that any compromise should be in favour of developing countries.

In general, equity will be a tricky part of the negotiations. It already proved difficult during the negotiations among World Trade Organisation members for a TRIPS waiver related to intellectual property rights.

“I hope that developing countries really stick together and insist on changing the system that led to the inequality that happened during COVID-19,” Kamal-Yanni said.

Action on pandemic prevention, preparedness and response will also require major investments into improving the monitoring of diseases, new research, health promotion and many other elements. This is set to be one of the trickiest topics.

“At some point, member states will have to have a frank discussion about financing, because the needs are vast if you really want to protect the world from the next pandemic,” Morich said.

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Committing to change

Specific commitments on the difficult topics might also be hard to agree on, and at the moment there is no indication of what they could be.

Kamal-Yanni insists that commitment on things like technology transfer, funding and sharing pandemic-related products is what could make the pandemic treaty have a real-world impact.

“Otherwise there’s just no trust whatsoever in rich countries, and they will meet that in everything beyond pandemics even. Nobody will trust them,” she added.

Whichever commitments end up being included, it is often mentioned that the treaty will eventually be legally binding. Being an international agreement, this can be a difficult term to grasp.

“First of all, you decide what kind of obligation you want to be bound by, and then you decide how to enforce them,” Morich explained.

“Members have signalled that they don’t want to establish a sanctionatory system but rather one that is facilitative, non-punitive and non-adversarial in nature. It has been proven in other international law regimes that when you go after countries, you usually don’t obtain what you want. Most of the time, if countries don’t comply with international law obligations, it is because they don’t have the means more that they are unwilling to comply,” she concluded.

[Edited by Giedrė Peseckytė]

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