Countries fail to agree on treaty to prepare world for next pandemic

Countries around the world have failed to reach a consensus on the terms of a treaty that would unify the world in a strategy against the inevitable next pandemic, overcoming the nationalist spirit that emerged during Covid-19.

The deliberations, which were due to be a central theme at the week-long meeting of the World Health Assembly that began on Monday in Geneva, were aimed at correcting inequalities in access to vaccines and treatments between richer nations and the poorest that became evident during the Covid pandemic. .

Although much of the urgency around Covid has faded since treaty negotiations began two years ago, public health experts are still keenly aware of the pandemic potential of emerging pathogens, familiar threats like bird flu and mpox. , and once-defeated diseases such as smallpox.

“Those of us in public health recognize that another pandemic really could be around the corner,” said Loyce Pace, deputy secretary of the Department of Health and Human Services, who is overseeing the negotiations in her role as the United States’ liaison to the world. . Health Organization.

Negotiators hoped to adopt the treaty next week. But canceled meetings and contentious debates, sometimes over a single word, paralyzed the agreement in key sections, including equitable access to vaccines.

The negotiating body plans to ask for more time to continue discussions.

“I’m still optimistic,” said Dr. Jean Kaseya, director-general of the Africa Centers for Disease Control and Prevention. “I think the continent wants this agreement. I think the world wants this agreement.”

Once adopted, the treaty would establish legally binding policies for WHO member countries, including the United States, on pathogen surveillance, rapid data sharing on outbreaks, and local manufacturing and supply chains for vaccines and treatments, among others.

Contrary to the rhetoric of some politicians in the United States and Britain, it would not allow the WHO to dictate national policies on mask wearing or use armed troops to enforce lockdowns and vaccination mandates.

Next week’s deadline was self-imposed and some public health experts have said it was too ambitious (most treaties last many years) for such a complex task. But negotiators were struggling to ratify the treaty before elections in the United States and several European countries.

“Donald Trump is in the room,” said Lawrence Gostin, director of the WHO Center for Global Health Law, who helped draft and negotiate the treaty.

“If Trump is elected, he will probably torpedo the negotiations and even withdraw from the WHO,” Gostin said.

During his time as president, Trump severed ties with the WHO and has recently signaled that, if re-elected, he could close the White House pandemic preparedness office.

Among the biggest points of contention in the draft treaty is a section called Pathogen Access and Benefit Sharing, according to which countries should quickly share genetic sequences and samples of emerging pathogens. This information is crucial for the rapid development of diagnostic tests, vaccines and treatments.

Low-income nations, including those in Africa, want to be compensated for information with rapid and equitable access to the tests, vaccines and treatments developed. They have also asked that pharmaceutical manufacturers share information that allows local companies to manufacture the products at low cost.

“We don’t want Western countries to come and collect pathogens, take them, make drugs and vaccines without returning those benefits to us,” Dr. Kaseya said.

Member countries have agreed to only one other health treaty, the 2003 Framework Convention on Tobacco Control, which strengthened control of the tobacco industry and decreased smoking rates in participating countries. But the devastation of the Covid pandemic and the inequalities it reinforced shook them to embark on a second one.

Countries are also working to strengthen the WHO’s International Health Regulations, which were last revised in 2005 and set out detailed rules that countries must follow in the event of an outbreak that could cross borders.

In May 2021, an independent review of the global reaction to Covid-19 “found weak links at every point in the preparedness and response chain.”

The pandemic also deepened distrust between richer and poorer nations. By the end of 2021, more than 90 percent of people in some high-income countries had received two doses of the Covid vaccine, compared to less than 2 percent in low-income countries. Lack of access to vaccines is believed to have caused more than a million deaths in low-income countries.

The treaty would be a kind of recognition that an outbreak anywhere threatens everyone and that providing vaccines and other resources is a win-win. Coronavirus variants that emerged in countries with large unvaccinated populations spread rapidly around the world.

“Nearly half of the deaths in the United States were due to variants, so it is in everyone’s best interest to have a strong agreement,” said Peter Maybarduk, director of Public Citizen’s Access to Medicines program.

In December 2021, the WHO established a group of negotiators to develop a legally binding treaty that would allow all countries to prevent, detect and control epidemics, and allow for equitable allocation of vaccines and medicines.

More than two years after negotiations began, negotiators have agreed, at least in principle, on some sections of the draft.

But much of the goodwill generated during the pandemic has evaporated and national interests have returned to the forefront. Countries such as Switzerland and the United States have been reluctant to accept terms that could affect the pharmaceutical industry; Others, like Argentina, have fought strict regulations on meat exports.

“It’s clear that people have very short memories,” said Dr. Sharon Lewin, director of the Cumming Global Center for Pandemic Therapeutics in Melbourne.

“But it can happen again, and it can happen with a pathogen that is much more complicated to combat than Covid,” he warned.

A proposal for the Pathogen Access and Benefit Sharing section would require manufacturers to reserve 10 percent of vaccines to be donated and another 10 percent to be given to the WHO at cost for distribution to low-income countries.

But that idea turned out to be too complicated, said Roland Drice, one of the leaders of the negotiations. “Along the way we discovered that that was too ambitious in the expected time frame.”

Instead, a working group established by the World Health Assembly will be tasked with finalizing the details of that section by May 2026, Driece said.

The terms of the proposed agreement have generated some confusion. In Britain, Nigel Farage, the conservative broadcaster and populist politician, and some other conservative politicians have claimed that the WHO would force richer countries to give away 20 percent of their vaccines.

But that is an incorrect interpretation of the proposed agreement, Driece said. “It is not the countries that have to create these vaccines, it is the companies,” he said. Pharmaceutical companies would commit to the system in exchange for guaranteed access to the data and samples needed to manufacture their products.

Britain will not sign the treaty unless it is “firmly in the UK’s national interest and respects national sovereignty”, a spokesperson for the country’s health department told Reuters earlier this month.

In the United States, Republican senators have demanded that the Biden administration reject the treaty because it would “potentially weaken American sovereignty.”

Dr. Tedros Adhanom Ghebreyesus, director-general of the WHO, has roundly criticized what he called “the litany of lies and conspiracy theories,” noting that the organization does not have the authority to dictate national public health policies, nor does it seek that power.

The secrecy surrounding the negotiations has made it difficult to counter misinformation, said James Love, director of Knowledge Ecology International, one of the few nonprofits with a window into the negotiations.

Allowing more people to enter discussion rooms or view drafts as they evolve would help clarify complicated aspects of the treaty, Love said.

“Also, the public could relax a little if they read the agreement regularly,” he said.

Some proposals in the draft treaty would require massive investments, another sticking point in the negotiations.

To monitor emerging pathogens, wealthier nations support the One Health strategy, which recognizes the interconnections between people, animals, plants and their shared environment. They want low-income countries to regulate live animal markets and limit trade in animal products, dealing a huge economic blow to some nations.

Last month, the Biden administration released its own strategy for global health security, focusing on bilateral partnerships aimed at helping 50 countries bolster their pandemic response systems. The administration hopes to expand the list to 100 countries by the end of the year.

U.S. support would help countries, most of which are in Asia and Africa, strengthen their One Health systems and better manage outbreaks.

The US strategy is intended to be complementary to the global treaty and cannot serve as an alternative, public health experts said.

“In my opinion, this is the most important moment in global health since the founding of the WHO in 1948,” Gostin said. “It would be an unforgivable tragedy if we let this slip away after all the suffering of Covid.”

Leave a Comment