GENEVA (AN) — Negotiators are under pressure at their ninth round of talks on a proposed global pandemic treaty: the deadline for gaining its approval from the 194-nation World Health Assembly is two months away.
The latest round of talks opened on Monday as part of the Intergovernmental Negotiating Body created by the World Health Organization in Dec. 2021, after the COVID-19 pandemic had nearly reached the two-year mark.
“It’s time to deliver by us all, and that’s not going to be easy,” said Roland Driece, a Dutch health minister who co-chairs the INB along with Precious Matsoso, a former WHO official and ex-head of South Africa's health department. “You all told us it’s going to be difficult, this text, it’s not really what we like.”
Matsoso said negotiators took a "scientific approach" toward agreeing on the main principles and technical elements of the text over the past two years. "Surely, that can't change now when you're supposed to start the negotiations. And you can't chicken out now – you said it already," she emphasized. "You've already agreed."
The INB's latest revised draft of the negotiating text calls for stronger measures to prevent, prepare for and respond to pandemics, "guided by equity" and other principles such as transparency and accountability.
A legally binding pandemic treaty – giving WHO access to a fifth of the world's pandemic-related products for distribution based on public health risks and needs – is due to be voted on at the 77th World Health Assembly, the decision-making body of WHO, to be held May 27-June 1 in Geneva.
It would require nations to share viral specimens and genome sequences of pathogens that have pandemic potential with a global respository and database managed by WHO – allowing others to use that intellectual property to create vaccines, diagnostic tests and treatments.
Drug manufacturers also would have to pay into the system and, as part of legally binding contracts with WHO, provide "real-time contributions of relevant diagnostics, therapeutics or vaccines produced by the manufacturer, 10% free of charge and 10% at not-for-profit prices during public health emergencies of international concern or pandemics."
India, a leading producer of vaccines and exporter of generic drugs, kicked off the talks with a push on behalf of Southeast Asian nations to "operationalize equity." Divisions quickly appeared, however, as African nations voiced support for a treaty while Switzerland, the United Kingdom and United States, each home to major drug makers, expressed opposition.
"The status quo is unsustainable," South Africa's Ambassador Mxolisi Nkosi said of the widespread inequalities that favor public health systems in wealthier nations. "For South Africa, this is not a typical negotiation but a pact of international health and solidarity and cooperation."
Australia's Ambassador Amanda Gorley, speaking also for Canada, New Zealand, Norway, and the U.K., said the negotiating text contains "concerning elements that do not bring us closer but rather contribute to polarization and significant aspects that are neither practicable nor implementable." But, she added, the five nations remain "absolutely committed to this final push towards agreement."
Drug manufacturers said last week they do want a pandemic treaty and will accept binding commitments to delivering equitable access to essential medical countermeasures, but only if the system is workable.
"Achieving equitable access to medical countermeasures requires a comprehensive solution and should not be based on linking access to pathogen samples and sequence data to benefit-sharing obligations," said the International Federation of Pharmaceutical Manufacturers and Associations, a Geneva-based trade group with more than 90 members.
The companies said they would commit to allocating a percentage of real-time production of a needed therapeutic or vaccine – as donations to low-income countries or equity-based tiered pricing – once a pandemic is declared "on the basis of public health risks, needs and demand."
A study published last week underscores the need for better pandemic preparedness.
At the COVID-19 outbreak's peak, the death toll reached almost 16 million, causing the global mortality rate to rise 5.1% and temporarily reversing the 62.8% decrease from 1950 to 2019, according to The Lancet study. WHO says the number of reported deaths topped 7 million – hitting hardest in the United States, Brazil, India, Russia and Mexico – but estimates the true toll could be several times higher.
A 'mission-critical' agreement
A global vaccine-sharing initiative known as COVAX tried to address widespread inequities exposed by the pandemic, including rich nations hoarding vaccines, diagostics and treatments while poor nations often were left waiting for handouts.
Its efforts to deliver COVID-19 vaccines to low-income and developing countries fell short of its ambitious targets but still managed to deliver almost 2 billion doses of vaccines and safe injection devices and saved an estimated 2.7 million lives, according to WHO. That accounted for just under 15% of the total number of vaccine shots administered.
More than 70% of the world's 8 billion population received at least one dose of a COVID-19 vaccine, but only a third of those who got at least one dose were in lower-income countries.
Along with the pandemic treaty, governments are conducting parallel negotiations on amendments to WHO's International Health Regulations.
The set of legally binding rights and obligations, known as IHR, apply to disease outbreaks and other acute public health risks. The proposed amendments to them also deal with some challenges from the pandemic.
"I am very encouraged by the revised draft of the negotiating text, which shows your efforts to find common ground are progressing on many aspects of the agreement. But we all know there remain critical areas where you are yet to reach consensus," WHO chief Tedros Adhanom Ghebreyesus told the INB on Monday.
Tedros said "it's mission-critical for humanity" that the INB reach agreement. "If we miss this opportunity, we risk losing momentum," he said. "More importantly, we risk leaving the world exposed to the same shortcomings that hampered the global response to COVID-19: a lack of coordination, a lack of sharing information, and a lack of equity."
Last week, he warned that the pandemic treaty talks suffer from "a torrent of mis- and disinformation about the agreement," including false claims it’s a power grab by WHO and will undermine national sovereignty.
"More importantly," he said on Thursday at the Nizami Ganjavi International Center in Azerbaijan, "we risk leaving the world exposed to the same shortcomings that hampered the global response to COVID-19: a lack of coordination, a lack of sharing information, and a lack of equity."
This story has been updated with additional details.
