How will countries comply with the first step in Negotiating a Pandemic Treaty?

The 2024 World Health Assembly and the Prospect for a Global Pandemic Agreement: A Key Moment to Revisit the Work in Addis Ababa?

It has been years since the original deadline for a global pandemic treaty was missed, but there is growing hopes that an extension will allow them to reach a consensus.

The agreement and treaty extension were both announced on 1 June, the final day of the 2024 World Health Assembly, the WHO’s annual decision-making meeting in Geneva, Switzerland.

“There was a great weariness setting in Geneva,” says Lawrence Gostin, a specialist in health law and policy at Georgetown University in Washington DC, who closely followed the negotiations. The deadline was a good outcome. It showed that there still is a political will to try to get this accomplished and not walk away from the table”.

“One year is a good, reasonable time” to conclude the negotiations, says KM Gopakumar, a researcher with the Third World Network, a research and advocacy organization focused on development in low-income countries in Penang, Malaysia. The legitimacy of the process could be jeopardized if the discussions were hurried to meet the original deadline.

Another important measure still in dispute, according to Michelle Childs, policy advocacy director at the non-profit organization Drugs for Neglected Diseases Initiative in Geneva, is a potential requirement that vaccines and drugs developed with government funding are shared more equitably than they were during the COVID-19 pandemic. There is a provision in the text, but it contains a number of recently revised caveats that could affect its purpose and effect.

Several delegates speaking at the assembly said that the adoption of the amendments would re-energize the efforts to forge a pandemic treaty. “This, in our view will create a pivotal moment to accelerate the discussions in the pandemic agreement and complete our unfinished work,” said Mekdes Daba, Ethiopia’s minister of health, based in Addis Ababa, speaking on behalf of a large group of African member states.

But not all observers are optimistic about the treaty’s future. “They could eventually approve some sort of agreement,” says Nina Schwalbe, a public-health researcher and founder of the public-health think-tank Spark Street Advisors, in New York City. “But the question is whether it will represent a meaningful step change for equity or have any commitment to accountability.”

I’ve seen countries fail to honor their obligations after concludingambitious treaty negotiations. For example, with regard to free trade, some nations that have promised to avoid subsidies still offer tax breaks to domestic companies; others take advantage of exemptions by delaying renegotiations.

That’s a lot to ask. How can the country be made to comply? Unlike domestic laws, international treaties have no mechanism to enforce them. There is no penalty for violating these laws.

Other treaties have included incentives. For example, an independent committee could be established to monitor compliance, as is the case for nuclear or chemical weapons. A clause that isn’t in the current draft could be added as an amendment in the future.

Sharing information is a way of making sure that a nation does the right thing. Other treaties require member states to notify each other when enacting or amending domestic laws that are relevant to the treaty. The draft of the pandemic treaty includes a requirement for reporting and sharing information, with the frequency and content to be determined later. It’s not certain if this will be enough.

Yet, even by adding all these mechanisms, treaty compliance cannot be guaranteed. And, in my experience, most breaches happen for more mundane reasons.

Collaboration in government: the challenges of pandemic preparedness, justice and capacity building in low-infrared (LMIC) countries

Different ministries in the same government often struggle to collaborate. Pandemic preparedness might not be at the top of every ministry’s agenda. For example, the treasury might not want to spend money on capacity building in LMICs or on hiring extra health-care personnel in case of a future pandemic.

Similarly, ministries supporting businesses and industry might find it hard to persuade private firms to comply with the treaty, especially if it involves the loss of royalties. Ministries of justice might be reluctant to provide reviews to health ministers after domestic laws are changed.

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