Accountability, equity: Experts suggest what WHO’s first-ever pandemic treaty should encapsulate

The first round of public hearings for the treaty is currently underway though it will be drafted only by 2024  

By Taran Deol
Published: Wednesday 13 April 2022

Experts in India and across the globe have made various suggestions as to what the first-ever pandemic treaty in the world should consist of, even as the World Health Organization (WHO) started the first round of public hearings for it April 12, 2022.

Suggestions range from accountability to more powers to developing countries to the insufficiency of the International Health Regulations (IHR) to deal with pandemics currently.

It was the World Health Assembly that had constituted an intergovernmental negotiating body in December 2021 to “strengthen pandemic prevention, preparedness and response” by drafting a global treaty.

The guiding question of the first round of public hearings being conducted now is: What substantive elements do you think should be included in a new international instrument on pandemic preparedness and response?

The pandemic has highlighted dangerous fissures in the global health system. The IHR — adopted in 2005 in the aftermath of the 2002-03 SARS outbreak — do provide a legal framework on how to proceed in such events.

However, the WHO director-general, Tedros Adhanom Ghebreyesus noted in his opening remarks April 12:

The pandemic has exposed shortcomings in the application and implementation of the IHR that I believe are best addressed with a convention, agreement or other international instrument.

He added: “We have treaties and other international instruments against tobacco, nuclear, chemical and biological weapons, climate change and many other threats to our shared security and well-being.”

The outcome of these public hearings and scores of meetings will only be submitted by 2024, during the 77th World Health Assembly. If the issue of inequity is addressed, developing countries stand to gain the most.

KM Gopakumar, legal advisor and senior researcher with the Third World Network, an independent non-profit international research and advocacy organisation working on development issues, was not particularly enthusiastic about the treaty.

He said:

Since IHR falls under Article 21 of the WHO’s Constitution, countries have to explicitly opt out if they wish to do so. The potential treaty will be formed under Article 19 under which countries have to explicitly opt in.

Gopakumar added: “To address issues of inequity, developed countries have to undertake some positive obligations, which means they must be party to the treaty. But if they are not, inequity will persist even with a treaty.”

The IHR, in its ambit, already covers all kinds of public health emergencies of international concern which includes a pandemic.

Gopakumar said incorporating equity within IHR was the way forward.

“The European Union is trying to come out as proactive in addressing pandemic issues by pushing for this treaty. But they are the main opponents in the TRIPS waiver,” he said.

Leena Menghaney, south Asia head for Médecins Sans Frontières (MSF) Access Campaign, talked of two key trends that she had noticed: How high-income countries capture all vaccine and drug supply while at the same time, they are also very reluctant to waive intellectual property rights.

“No treaty can move forward without addressing this. These are going to be politicised negotiations in any forum,” she said.

How does having a treaty change the equation between high-income countries and low- and middle-income countries vis a vis access to technology, tests, vaccines and therapeutics, Menghaney asked.

The concerns are not for developing countries alone.

The Panel for a Global Public Health Convention (GPHC) — an independent coalition of global leaders working towards preventing infectious disease outbreaks from becoming pandemics — has stressed on the need for accountability in a report released this month.

“While we appreciate the complexity of negotiating a Convention, we also urge haste. With current systems, we are little better prepared now to face a new pandemic threat than we were two years ago,” the report noted.

The report also called the IHR not strong enough, echoing Ghebreyesus. Dame Barbara Stocking, head of GPHC, was quoted as saying in a UK daily that the new body must be “arm’s length to WHO”.

The report also suggested incentivising alerting any public health threat, making public health measures an obligation and sharing information, sequences and samples “rapidly and systematically” so everyone can benefit from it, essential.

It pushed for three other non-negotiable principles: Solidarity, transparency, and equity.

The G20 Health and Development Partnership (HDP) had, in February 2021, suggested creating a body similar to the Office for Budget Responsibility (OBR) for pandemic preparedness and health system resilience which would report annually to the British Parliament.

“The OBR, created in 2010, is a fiscal watchdog which provides independent economic forecasts and analysis of the UK economy. A similar body for health would increase scrutiny of and confidence in Britain’s pandemic plans for future outbreaks,” Alan Donnelly, a coordinator at the HDP was quoted as saying.

The Geneva Global Health Hub released a report December 21, 2022, on the politics of a WHO pandemic treaty.

It stated in a rather sobering conclusion: “Whatever the route of the pandemic treaty, whatever the strategies for pandemic preparedness and response, it will not be possible for negotiators to sideline how deeply unjust the international order is and to avoid positioning themselves vis á vis this conjuncture, worsened by COVID-19.”

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