Advocates say the UN pandemic meeting was a dud. What's next?

In a packed room at the United Nations headquarters in New York, Helen Clark, the former New Zealand prime minister and co-chair of the Independent Panel for Pandemic Preparedness and Response, dropped a big “what-if” scenario before several heads of state and government ministers. “Imagine if one of us here, now, were infected with a new, dangerous virus. More of us would become infected this week. We would fly back home to our families and communities, potentially sparking another crisis. Would our countries be ready to manage that outbreak? Would the world?” she asked. “That is a political choice. You have the power to make it,” she said. The question came several minutes after UNGA President Dennis Francis approved on Wednesday the political declaration for the high-level meeting on pandemic prevention, preparedness, and response with no objections. The event was meant to galvanize high-level political support to strengthen global health security after the COVID-19 pandemic highlighted many gaps in the world’s ability to respond effectively to global health threats. WHO Director-General Tedros Adhanom Ghebreyesus called it a “historic day for public health.” But others were clearly disappointed. Advocates relentlessly followed the intergovernmental process for the declaration for months and hoped countries would commit to bold actions to ensure the world is better positioned for future pandemics. But in the weeks leading up to the meeting, many health leaders voiced concerns that the opportunity to do so was being lost, with the draft text lacking specifics such as the creation of a heads of state level body that would ensure preparing for and addressing pandemics remain at the top of the political agenda. They expected more from the declaration and the meeting — and were disappointed. “Less than 15 Heads of State spoke. Wonder what that signals. Apathy? Disappointment? We will need to read the tea leaves,” Nina Schwalbe, CEO at Spark Street Advisors, tweeted. “If pathogens can cross borders, then so too must solutions, innovations, technologies, and treatments. … Good intentions are nice, but binding commitments are better.” --— Bahamas Prime Minister Philip Edward Davis It was apparent from the meeting that much of the focus is on the ongoing process in Geneva to draw up a pandemic accord, which many heads of state and government ministers are eyeing to address the issues that emerged during the COVID-19 global emergency, such as unequal access to lifesaving medical tools and the lack of vaccine manufacturing capacity in low- and middle-income countries. It will be incumbent upon countries to ensure the accord delivers. “While this high-level meeting and the adoption of the political declaration will help to galvanize political will, we believe that the issue of pandemic preparedness, prevention, and response can be best addressed through a legally binding treaty as mandated by the World Health Assembly,” Pakistan caretaker Prime Minister Anwaar-ul-Haq Kakar said. Sharing tech a clear priority Over 100 countries took the floor during the high-level meeting, including 13 heads of state. Many evoked memories of vaccine nationalism during COVID-19 and strongly called for technology sharing to be in a future pandemic accord. “We must draw on our collective lessons to scale up good practices and avoid past mistakes,” said Bangladesh Prime Minister Sheikh Hasina, who flagged five priorities for the year, including ensuring equitable access to lifesaving products such as vaccines through access to technologies and know-how. Hasina said developing an international cooperation framework for access and benefit sharing — a critical part of current discussions on a pandemic accord — should also be a priority. Several low- and middle-income countries want a binding agreement that would allow them to get something in return, such as access to medicines and vaccines, in exchange for pathogen samples, which can be used to develop an effective vaccine or treatment. Bahamas Prime Minister Philip Edward Davis also highlighted the transfer of technology and know-how as indicated in Article 11 of the current Intergovernmental Negotiating Body text of the pandemic accord as among the most significant, including for small island developing states. “If pathogens can cross borders, then so too must solutions, innovations, technologies, and treatments,” he said while underlining the need for binding commitments. “Good intentions are nice, but binding commitments are better,” he added. Zimbabwe President Emmerson Dambudzo Mnangagwa said the sharing of technology including the transfer of intellectual property rights to help expand the capacity of lower-income countries for vaccine production ensures they have access to vaccines outside of donations. Unclear path ahead After the high-level meeting, countries, global health leaders, and civil society organizations are now focused on the process in Geneva to negotiate and establish a pandemic accord. “This is the world’s next opportunity. Please do not miss it,” Clark said. There are however serious concerns on the current pace of the process, raising doubts whether the deadline of May 2024 will be met. At a side event hosted by the Pandemic Action Network ahead of the meeting, Zeid Ra'ad Al Hussein, a member of The Elders and former U.N. high commissioner for human rights, said by the end of the year — which is the two-year anniversary since WHO member states established the Intergovernmental Negotiating Body — if there remains confusion and “no clear way forward” on the process, then calls should be made to bring the negotiations to New York. “Two years in, someone has to say … enough of this. We need to shift it back to New York,” he said. “At the moment, we need the negotiations to succeed in Geneva. If they don't, we need a backup plan,” he added.