WHO chief opens assembly with push for 'historic' pandemic treaty

As the World Health Assembly gears up this week, global health experts say the year ahead could be make-or-break for pandemic preparedness.

Negotiations will be held in Geneva on a new pandemic accord and the legally binding international rules that nations must follow when responding to global health emergencies like the COVID-19 pandemic.

"This is a pivotal year of opportunity for political leaders to take decisions to prevent another deadly and costly pandemic like COVID-19 from happening again,” Eloise Todd, executive director and co-founder of the Pandemic Action Network, told Arete News.

“At this year's World Health Assembly, we need to see action on pandemic threats including progress on investments, accountability, and most importantly political leadership and collaboration at the highest levels," said Todd, based in Brussels, whose network launched in April 2020 as a partnership among more than 350 organizations.

As he opened the 10-day annual meeting for the World Health Organization’s governing body on Sunday, WHO Director-General Tedros Adhanom Ghebreyesus emphasized its 194 member nations can only face shared threats with a shared response. The hope is to finish drafting a pandemic accord for approval by next year’s health assembly in May 2024.

'It still kills'

The pandemic brought into sharp focus many of the world's glaring divides in health care and access to products such as vaccines, therapeutics and tests.

The U.N. health agency has been fighting widespread misinformation that a global pandemic treaty would take away the sovereign rights of nations. Instead, it is intended to encourage international coordination so future pandemics can be better managed with less lives lost and fewer social inequities.

WHO's Intergovernmental Negotiating Body, which includes its 194 member countries, began negotiations on a global accord in March, using a “zero draft” as the starting point.

The draft proposed letting WHO hand out a fifth of all the vaccines and other products the world needs and easing intellectual property restrictions to provide more equitable access to vaccines and therapies. That's opposed by the pharmaceutical industry and some nations where its biggest companies are based.

“We cannot simply carry on as we did before,” Tedros told world leaders and other high-level officials. “The pandemic accord that member states are now negotiating must be a historic agreement to make a paradigm shift in global health security, recognizing that our fates are interwoven.”

Though he declared that COVID-19 no longer is a global health emergency after killing at least 7 million people, the virus is “still with us, it still kills, it’s still changing, and it still demands our attention,” Tedros said.

First tobacco, now pandemics

U.N. Secretary-General António Guterres had a similar message for the assembly.

“It is vital to prepare for the health threats to come – from new pandemics to climate dangers – so that we prevent where we can, and respond fast and effectively where we cannot,” he said in a video message. “I hope the current negotiations on pandemic prevention, preparedness and response result in a strong multilateral approach that saves lives.”

Such an accord would be just the second legally binding health agreement in WHO’s 75-year history. The health assembly adopted an international anti-tobacco accord in 2003 that took effect two years later. Over 20 years it has curbed smoking by one-third globally.

More disputes are expected over other global health instruments, such as WHO’s International Health Regulations that provide legally binding rights and obligations towards disease outbreaks and other acute public health risks among 196 nations.

Last year’s health assembly adopted a new strategy for HIV, viral hepatitis and sexually transmitted infections that appeased socially conservative nations by omitting a standard glossary of sexual health terms for discussing treatment and care.

It also approved a U.S.-led process for reforming the legally binding international rules that nations must follow when responding to global health emergencies like the COVID-19 pandemic. They were last revised in 2005, two years before they took effect.

Broader public health concerns

This year’s key decisions and talks also will focus on the health of women, children and adolescents, along with the push for universal health coverage, better primary health care, reductions in non-communicable diseases and better ways of aiding migrants and refugees.

Tedros hopes to strengthen the world’s ability to handle “multiple threats” from diseases by improving lagging public health emergency preparedness and responses. And some nations are pushing a resolution to improve primary health care globally.

That’s ahead of a high-level meeting on universal health coverage planned for September on the sidelines of the United Nations General Assembly in New York.

In a report to the health assembly, Tedros called for people and communities to “raise their voices to insist on universal access to high-quality health services, products and information without financial hardship.”

But that will cost money, and the health assembly is also planning to debate how countries uphold their previous budget commitment to gradually increase their assessed contributions. The United States, United Kingdom and Bill and Melinda Gates Foundation have traditionally been WHO’s top backers, contributing far beyond the mandatory dues. During the Trump era, the U.S. fell behind Germany as the largest donor for one year.

Nations will be asked to decide if WHO can conduct investment rounds starting in the second half of 2024 to replenish its funds, similar to how organizations such as Gavi, the Vaccine Alliance and the Global Fund to Fight AIDS, Tuberculosis and Malaria raise money.