Devex CheckUp: Pandemic negotiations resume — but jargon's getting in the way

After a brief hiatus, member states are back to try to negotiate the details of the pandemic agreement. They resume the talks as another global health emergency — mpox — rages.

“We hope the predicament we are facing right now because of mpox would guide us in our going forward in the negotiation, particularly in dispelling the differences amongst us,” the delegate from Bangladesh said at the start of the discussions.

But instead, on their very first day back, they were bogged down by legal jargon.

The first issue centered on whether the accord should be adopted as an agreement or convention, regulation, or recommendation by the World Health Assembly — a basic question they still have not answered after two years of negotiations. Many countries have stated their preference for a legally binding agreement, but cannot agree on whether that should happen under Article 19 or Article 21 — as the U.S. delegation prefers — of the World Health Organization constitution.

This is no small decision. There are significant differences between how the two are adopted, come into effect, and their scope. My colleague Jenny Lei Ravelo has spelled all of that out here.

But things got much more complicated when member states tried to deal with annexes, protocols, and amendments — additional legal jargon that even lawyers among them found confusing.

The terms are relevant in the context of member states potentially adopting additional legal instruments that are related to pathogen access and benefit sharing, and to “One Health.” WHO has created a somewhat helpful guide explaining the differences between these terms.

But even Björn Kümmel, who works at Germany’s Health Ministry and is a lawyer by profession, said the terms are “completely confusing to me.” He cautioned that the discussion should first focus on the substance — what they want to achieve — before the form. And there’s plenty to discuss there, as well.

Among the things negotiators still need to figure out is how membership to the agreement will apply and whether there will be any additional instruments, when they will come into effect, and how they will be governed and financed. It seems, after two years, they still have a long way to go.

Related: Will the pandemic treaty get more time, or will it go down the toilet?

From the archives: Majority of WHO member states want legally binding pandemic instrument

+ Devex is officially on Telegram and WhatsApp! Join our channels to receive updates on the latest globaldev news directly to your mobile device.

A new game plan?

Should those negotiators be looking to soccer for some guidance?

Another one of the sticking points in the negotiations has been the question of how to appropriately compensate researchers — such as the scientists in Botswana and South Africa who discovered the omicron variant of COVID-19. Instead of getting, say, equal access to useful research being done in other countries, the scientists saw their countries actually punished for their discovery with travel restrictions under the current system.

The nonprofit Paris Peace Forum thinks the global health community should be a little bit more like FIFA. The global soccer governing body has set up compensatory mechanisms in a bid to achieve the fairness currently missing in the scientific community.

One mechanism guarantees that clubs are reimbursed for costs they took on in developing a player. The club receives a payment when the player is signed and each time they are subsequently transferred up until they turn 23 years old. The second mechanism ensures that when a player moves between clubs within different FIFA jurisdictions, part of the transfer fee is allocated to the teams who were involved in their training and education between the ages of 12 and 23.

Of course, this system couldn’t be directly copied to the process of information sharing that takes place within the scientific community. But it does have obvious extensions, beginning with thinking about models that give fair credit to originators of information and about how to fairly compensate them for their work.

Read: Soccer and science — can global health learn from FIFA's benefit sharing? (Pro)

+ Not yet a Devex Pro member? Start your 15-day free trial today to access all our expert analyses, insider insights, funding data, exclusive events, and more. Check out all the exclusive content available to you.

Partnering up

For the first time ever, the Africa Centres for Disease Control and Prevention and the WHO Regional Office for Africa are working from the same playbook on a major continental health emergency.

The two agencies unveiled a six-month partnership to respond to the continent’s mpox emergency last week. They are aiming to mobilize $600 million for the joint effort.

The announcement follows attempts to work together more cooperatively and a recognition that some of their past work has been duplicative and inefficient.

To meet the current outbreak, with more than 26,500 suspected cases on the continent so far this year, the two agencies will be operating from one continental coordinating team, response plan, budget, and monitoring and evaluation framework. All of this is based on estimates of at least 92,000 cases and a need to vaccinate at least 10 million people in Africa over the next six months.

It's a co-led effort, built around 10 pillars that are divided up between the two agencies. The idea is to leverage their specific strengths to bring the outbreak to an end as quickly as possible.

Read: Africa CDC and WHO launch a joint continental response plan for mpox

Keeping track

Drug companies make a lot of promises when it comes to making their medicines accessible to people in low- and middle-income countries. But what are they actually doing to ensure they’re making good on those pledges?

The Access to Medicine Foundation decided to find out.

They released this week the first report looking at what approaches 20 of the major drug companies have in place to determine how many patients are actually accessing their products.

The good news is that 19 of the 20 companies had at least some system in place. (AbbVie was the outlier.) The methods they are using are a mixed bag, though. In some cases, the companies are only tracking access across specific locations and, in other instances, they’re only following some of their products.

One of the biggest problems, though, is that many are using sales volume as the only measurement. But this ignores products that arrive through donations or are manufactured under voluntary licenses, for instance.

The foundation is pushing the companies to adopt approaches that are more comprehensive. The idea underlying all of this is that if the companies do a better job of measuring how many people are accessing their medicines, it might encourage them to do a better job of reaching those populations who aren’t being served.

Read: Are drug companies making good on their access promises?

What we’re reading

In a public health victory, the number of children in the United States using e-cigarettes again dropped last year and is now down 20% from the record high in 2019. [Stat]

As we prepare for a discussion of antimicrobial resistance at the U.N. General Assembly, here’s a report on the patients already experiencing the consequences of the mounting crisis. [The Bureau of Investigative Journalism]

Polio vaccinations have now started in northern Gaza with a goal of inoculating 150,000 children in the area following detection of the virus in Gaza’s wastewater in July. [The New York Times]

Jenny Lei Ravelo contributed to this edition of Devex CheckUp.