GENEVA (AN) — It took until the final hours, when the deadline came to call in the translators, for negotiators to reach a deal on a draft pandemic treaty after more than three years of negotiations.
The World Health Assembly formally approved the landmark treaty on Tuesday, after some drama the evening before when Slovakia, with backing from Italy and Poland, tried to challenge its adoption. The treaty sailed through unopposed, 124-0, with 11 abstentions. The U.S. and 45 other member nations were absent.
"The agreement is a victory for public health, science and multilateral action. It will ensure we, collectively, can better protect the world from future pandemic threats," said WHO's director-general, Tedros Adhanom Ghebreyesus.
"It is also a recognition by the international community that our citizens, societies and economies must not be left vulnerable to again suffer losses like those endured during COVID-19," said Tedros, referring to the deaths of an estimated 15 million people and the global inequities over access to COVID-19 vaccines, treatments, and diagnostic tests.
The negotiations leading up to Tuesday's formal vote stretched from Dec. 2021, when the 194-nation assembly first authorized talks, through 13 formal rounds of meetings until the early morning hours of April 16. Some difficult questions were left to fully resolve later, but enough agreement was found for a draft proposal.
Those last four days and final hours were "really extraordinary," said Zeid Ra’ad Al Hussein, who supported the negotiations as the International Peace Institute's president and CEO and a member of The Elders, "and it gives a flicker of hope in an otherwise confused and confusing world."
Zeid, a former U.N. high commissioner for human rights and Jordanian diplomat, told reporters on Friday that scholars will want to study how negotiators reached "some clumsy solutions found at the end and some very elegant ones" to close the gap between rich and developing nations.
"The method of negotiation was highly unorthodox" with some "amazing" critical problem-solving, he said. "There's still this other component which will have to be negotiated. And for many that was seen as one of the critical components, the pathogen access and benefits sharing."
Nations such as Brazil, France, Germany and Mexico took the intiative; a last-minute push to resolve outstanding equity issues led to compromise among the Group of Seven wealthy democracies and developing nations.
Against the odds, the Intergovernmental Negotiating Body created by the assembly, as the World Health Organization's governing body, pushed for a treaty that would better prepare the world for future pandemics.
"The health of each of us is intimately connected to the health of the planet and the biosphere," Zeid said of the linkages between peace, security and pandemics. "Existential threats are a threat to all of us – pandemics or climate change. And so it's not just the existence or the need to remove the scourge of conflict from our midst, but to deal with these threats."
The Elders also pushed for a pandemic treaty and other policies that address systemic barriers to equitable access to vaccines, diagnostics, and therapeutics. Its members Ellen Johnson Sirleaf and Helen Clark headed an Independent Panel on Pandemic Preparedness and Response that emphasized the need for global collaboration and equitable access.
For WHO, the negotiations were a much-needed bright spot against the backdrop of budget-cutting largely induced by the Trump administration's withdrawal of U.S. funding and support for international organizations.
Getting to consensus – before the annex is done
WHO outlined the next steps under Article 19 of WHO's constitution to make the treaty legally binding. It would enter into force once 60 countries ratify it, which could take years.
First, though, negotiators must craft an annex to deal with issues such as pathogen access and benefit sharing, including a definition of pathogens with pandemic potential.
Pharmaceutical companies stand to gain access to scientific data, such as pathogen samples and genomic sequences, in exchange for more fairly sharing drugs, vaccines and diagnostics during a pandemic.
Another point of contention was ensuring WHO has "real-time access" to 20% of global production of safe and effective pandemic-related products, including vaccines, oxygen, protective gear, diagnostics and therapeutics.
Nations that host drug makers would provide 10% for free, but the other 10% to be offered at "affordable prices" became an aspirational target.
"They really managed to get everyone on board with that framing," said Ricardo Miguel Matute Rojas, an IPI consultant on global health and Chilean diplomatic analyst, who was on hand when the deal was clinched.
International treaties usually take decades to reach a consensus, said Rojas, so "it's also a bit of a brilliant maneuver that they got to the consensus – because the pandemic agreement is completed, but there is an agreement to have an annex. And the consensus was that the pandemic agreement is not going to enter into force until the annex is finished."
The annex also would strengthen the amendments that the World Health Assembly made last year to the International Health Regulations, which took effect in 2007 and are legally binding on 196 countries. The assembly added a new category for when a "pandemic emergency" exists and committed to greater access to medical products and financing.
The annex could enhance early warning and surveillance through the timely sharing of information and biological materials of pathogens with pandemic potential. This would lead to quicker identification of emerging threats, a crucial aspect of the IHR's goal of early detection.
While the IHR focuses on events that may constitute a Public Health Emergency of International Concern, the annex could facilitate the sharing of a wider range of pathogens, including those with the potential to cause future pandemics, before they reach the PHEIC threshold.
"This would be a strengthening of the modifications to the International Health Regulations," Zeid said. "There is something happening here with this pandemic treaty which is really quite amazing to watch. And that is that in exchange for data, there will be some benefit paid."
"There are some constituencies basically arguing, 'We know you're monetizing it, but maybe there needs to be some sort of return for the (data) gathering and the scraping, so it's not all this information out in the ether and then some can monetize it," he added. "And that's really quite revolutionary, and extraordinary, and it's starting with this treaty. So you might see this as the thin edge of really quite an amazing development."
This story has been updated with additional details.
