Countries around the world have failed to agree on the terms of a treaty that would unite the world on a strategy to deal with the next inevitable pandemic, overriding the nationalist sentiment that has emerged during Covid-19.
The deliberations are set to be at the center of a weeklong World Health Assembly meeting in Geneva on Monday aimed at redressing inequalities in vaccines and treatments that have become apparent between rich and poor countries during the coronavirus pandemic.
While the urgency surrounding the coronavirus has receded since treaty negotiations began two years ago, public health experts remain acutely aware of the risks of emerging pathogens, common threats like avian flu and measles, and once-eradicated diseases like smallpox. Popular potential.
“Those of us who work in public health recognize that another pandemic may indeed be coming,” said Loyce Pace, assistant secretary of the U.S. Department of Health and Human Services, who serves as the U.S. liaison to the world. person, responsible for overseeing negotiations.
Negotiators had hoped to adopt the treaty next week. But canceled meetings and heated debates — sometimes over just one word — have hampered key parts, including equitable access to vaccines.
The negotiating body plans to ask for more time to continue discussions.
“I remain optimistic,” said Dr. Jean Kasea, director of the Africa Centers for Disease Control and Prevention. “I think the African continent wants this deal. I think the whole world wants this deal.
If adopted, the treaty would establish legally binding policies for WHO member states, including the United States, on pathogen surveillance, rapid sharing of outbreak data, and local manufacturing and supply chains for vaccines and treatments.
Contrary to the rhetoric of some politicians in the US and UK, it would not enable the World Health Organization to decide national mask policies or use the armed forces to enforce lockdowns and vaccine authorizations.
Next week’s deadline is self-imposed, and some public health experts say it’s too ambitious for such a complex effort — most treaties take many years. But negotiators are scrambling to ratify the treaty ahead of elections in the United States and several European countries.
“Donald Trump was in the room,” said Lawrence Gostin, director of the World Health Organization’s Center for Global Health Law, which helped draft and negotiate the treaty.
“If Trump is elected, he may sabotage negotiations or even withdraw from the WHO,” Gostin said.
Trump, who severed ties with the World Health Organization during his presidency, also recently suggested he might close the White House Office of Pandemic Preparedness if re-elected.
One of the biggest points of contention in the draft treaty is a section called “Pathogen Access and Benefit Sharing,” under which countries would be required to quickly share genetic sequences and samples of emerging pathogens. This information is critical for the rapid development of diagnostic tests, vaccines and treatments.
Low-income countries, including those in Africa, want quick and equitable access to tests, vaccines and treatments that have been developed so they can be compensated for the information. They also asked drugmakers to share information that would enable local companies to produce products at low cost.
“We don’t want to see Western countries collecting pathogens, processing pathogens, manufacturing drugs, manufacturing vaccines, and not bringing us these benefits,” Dr. Kasea said.
Member states have only agreed to one other health treaty, the 2003 Framework Convention on Tobacco Control, which has tightened controls on the tobacco industry and reduced smoking rates in participating countries. But they were so alarmed by the devastation caused by the pandemic and its exacerbation of inequality that they began a second wave.
Countries are also working to strengthen the World Health Organization’s International Health Regulations, which were last revised in 2005 and set out detailed rules for countries to follow if an outbreak threatens to breach borders.
In May 2021, an independent review of the global response to Covid-19 “identified weaknesses at every link in the preparedness and response chain”.
The pandemic has also deepened mistrust between rich and poor countries. By the end of 2021, more than 90% of people in some high-income countries had received two doses of a COVID-19 vaccine, compared with less than 2% in low-income countries. The lack of a vaccine is thought to have killed more than a million people in low-income countries.
The treaty would go some way to acknowledging that an outbreak anywhere threatens the entire globe, and that providing vaccines and other resources is in everyone’s interest. Coronavirus variants emerging in largely unvaccinated countries are rapidly sweeping the world.
“Nearly half of all deaths in the United States are caused by variants, so a strong agreement is in everyone’s interest,” said Peter Maybarduk, director of Public Citizen’s Access to Medicines Initiative.
In December 2021, the World Health Organization established a negotiating team to develop a legally binding treaty that would enable every country to prevent, detect and control epidemics, and allow for the equitable distribution of vaccines and drugs.
Negotiations have been ongoing for more than two years, with negotiators agreeing at least in principle on some parts of the draft.
But much of the goodwill generated during the coronavirus pandemic has faded, and national interests are back in focus. Countries such as Switzerland and the United States have been reluctant to accept terms that could affect the pharmaceutical industry; others, such as Argentina, have opposed strict rules on meat exports.
“Obviously people have short memories,” said Dr. Sharon Levine, director of the Cumming Center for Global Pandemic Treatment in Melbourne.
“But it could happen again, and it could happen with a more troublesome pathogen than COVID-19,” she warned.
One proposal on the pathogen access and benefit-sharing component calls for manufacturers to set aside 10% of their vaccines for donation, with another 10% provided at cost to the World Health Organization for distribution to low-income countries.
But the idea proved too complex, said Roland Driece, one of the leaders of the negotiations. “What we discovered along the way was that this was too ambitious in terms of the time frame.”
Mr Dries said a working group set up by the World Health Assembly would be responsible for finalizing the details of that section by May 2026.
The terms of the proposed agreement have caused some confusion. In the UK, conservative broadcaster and populist politician Nigel Farage and some other conservative politicians have claimed that the World Health Organization will force rich countries to give up 20% of their vaccines.
But Driss said that was a misinterpretation of the proposed agreement. “It’s not countries that need to develop these vaccines, it’s companies,” he said. Pharmaceutical companies will commit to using the system in exchange for guarantees of access to the data and samples needed to make their products.
A spokesman for the British health department told Reuters earlier this month that Britain would not sign the treaty unless it was “firmly in the UK’s national interest and respectful of national sovereignty.”
In the United States, Republican senators asked the Biden administration to reject the treaty because it “could undermine U.S. sovereignty.”
WHO Director-General Dr. Tedros Adhanom Ghebreyesus harshly criticized what he called “a litany of lies and conspiracy theories” and noted that the organization does not have the power to determine national public health policy and does not seek such power.
James Love, director of Knowledge Ecology International, one of the few nonprofits with a window to negotiate, said the secrecy surrounding the negotiations makes it difficult to counter misinformation.
Mr Love said getting more people into the discussion room or watching the draft evolve would help clarify complex aspects of the treaty.
“Also, if the public did read the actual agreement on a regular basis, they might relax a little bit,” he said.
Some proposals in the draft treaty require significant investments, another sticking point in the negotiations.
To monitor emerging pathogens, rich countries support so-called “One Health” strategies that recognize the interconnectedness between people, animals, plants and their shared environment. They want low-income countries to regulate live animal markets and restrict trade in animal products – a huge economic blow for some countries.
Last month, the Biden administration released its own global health security strategy, which focuses on bilateral partnerships and aims to help 50 countries strengthen their epidemic response systems. The government hopes to expand the list to 100 countries by the end of this year.
U.S. support will help these countries, most of which are in Asia and Africa, strengthen their “One Health” systems and better manage the outbreak.
Public health experts say the U.S. strategy is intended to complement the global treaty, not as a replacement.
“I think this is the most important moment in global health since the founding of the World Health Organization in 1948,” Mr. Gostin said. “After the pain of COVID-19, it would be an unforgivable tragedy if we let this slide.”
