Experts warn about deferring hard parts of pandemic treaty for later

There’s only five weeks left for member states to agree on a pandemic treaty. Some are hopeful that the upcoming negotiations starting at the end of the month will produce more concrete and meaningful results, but it’s likely that some of the more complex issues will be deferred for further negotiations, which comes with its own risks. “With what is left, I'm hopeful because I see the cup as half full, and I'm an optimist. I do think that we will get there,” Precious Matsoso, co-chair of the Intergovernmental Negotiating Body established to help draft and negotiate a pandemic agreement, said during an event at the Geneva Graduate Institute on Wednesday. The INB has another two-week marathon session starting April 29 where member states are expected to finalize the text for the agreement, as well as a resolution for the agreement to be introduced to the World Health Assembly in May. Ahead of that session, the group released a new draft text and a proposed resolution for the WHA that includes setting up various intergovernmental working groups to figure out how One Health and the WHO Pathogen Access and Benefit-Sharing System, or PABS, will work. Both are seen as really tricky issues to agree on. It also wants member states to form a working group to prepare for the first session of the Conference of the Parties where countries can make more decisions about the agreement. Meaning more negotiations will follow after May. “The major risk now is that we are still scarcely better prepared to manage new pandemic threats than we were four years ago.” --— Helen Clark, co-chair, Independent Panel for Pandemic Preparedness and Response Several observers and experts said the current proposal is perhaps the only realistic step seen by the INB toward an agreement in May as it’s unlikely that some of the most contentious issues would be resolved within this time frame. The INB’s resumed session later this month runs for two weeks, but it is divided between finalizing the pandemic text and the resolution. However, deferring some of the decisions comes with significant risks. The political attention and momentum in dealing with pandemics is waning. Many countries, particularly those with smaller delegations, struggled to participate in the negotiations for the pandemic agreement and the amendments to the International Health Regulations and will likely face similar challenges in future processes. Some worry that deferred decisions may lead to nothing at all, as was the case with the TRIPS waiver for COVID-19 tests and treatments. “How many developing countries have the energy and the resources to effectively participate in all these [proposed processes]?” said K.M. Gopakumar, legal adviser and senior researcher with the Third World Network, an independent nonprofit international network that advocates for the needs of people from the global south. Helen Clark, co-chair of the Independent Panel for Pandemic Preparedness and Response, questioned where the funding will come from for both the proposed processes and for WHO’s implementation of approved processes, such as the Global Supply Chain and Logistics Network. “And of course the major risk now is that we are still scarcely better prepared to manage new pandemic threats than we were four years ago,” Clark wrote to Devex. “The world is facing a dangerous type of mpox in the [Democratic Republic of Congo], H5N1 in cattle herds in the US, record levels of dengue, multi-country surges of cholera, and large outbreaks of measles all at once. We’ve lost time. A new pathogen could appear anytime, anywhere. And we’re just not ready for it,” she added. To be determined Member states still have a lot to discuss and negotiate when they meet again for the marathon session starting April 29. The resolution proposes using Article 19 of the WHO constitution to adopt an agreement, but it's uncertain if member states will agree. Article 19 allows the WHA to make agreements on any WHO-related issue, but it needs to be ratified. In the United States, this means approval from the Senate, which might be hard due to opposition, especially from some Republicans who have pushed back against a treaty and introduced a bill that would see any resulting agreement from the negotiations in Geneva to require a supermajority vote in the Congress. Some experts said the latest draft text of the agreement is worse than the last one. “It also will be forcing developing countries to take obligations, which serves the interests of the developed countries.” --— K.M. Gopakumar, legal adviser and senior researcher, Third World Network “Extremely disappointing draft,” one insider, who wanted to remain anonymous because they are not authorized to speak on the matter, told Devex. They said the text needs to bring back the definition of health and care workforce as per the International Labour Organization, and a fund for surge financing on day zero of a pandemic. The “Pandemic Fund will not last forever and we will need a fund for Day Zero financing, not just capacities,” the insider said. Low- and middle-income countries want the establishment of a fund to help them implement obligations arising from the pandemic agreement as well as amendments to the International Health Regulations. But high-income countries have pushed back against it, saying it’s a redline for them. The Pandemic Fund said the creation of another fund will only duplicate the work it’s already doing. A concrete financing commitment is among the “minimum expectations” for the Africa group, according to Ambassador Tsegab Kebebew Daka, permanent representative of Ethiopia to the U.N. office and other international organizations in Geneva. Other expectations include “a conducive ecosystem for enhancing distributed local manufacturing,” a PABS that’s based on “equal footing,” strengthened health systems with a focus on the care and health workforce, and a governance arrangement that ensures “sustained political commitment by all parties,” he said. At the very least “It’s important that an agreement results from this long process - though I would like to see an agreed text with real commitments to transformational change,” Clark said. “It’s disappointing - and bewildering frankly - that a negotiating text was only made available before the last INB meeting - that was simply too late,” she added. Dr. Michael Ryan, executive director of the WHO health emergencies program and who was recently appointed as deputy director-general, asked member states to set a foundational agreement in May, arguing that many of the fixes needed in preventing, preparing and responding to pandemics will require a long time to implement. These won’t be resolved in six weeks. “A house built on sand will never be stable. [But] no one is suggesting that this full, complete mechanism house can be built in the next six weeks,” he said. “We're asking our member states to create the starting line, systematic improvement in how we do business. And it's going to take years and it may take decades. God knows I've been at this … for 30 years,” he said. Gopakumar however is concerned that low- and middle-income country member states will be “under tremendous pressure to accept” and give up their issues. “The text does not reflect their needs and their demands. They will be asked to take something which is not serving any of their interests. But it also will be forcing developing countries to take obligations, which serves the interests of the developed countries,” he added. He said low- and middle-income countries should convey very clearly what they want and take a good look at the text. One key test is to see if there’s a pandemic happening tomorrow, if they can invoke any provisions in the text to access medicines, technologies, and finance, he said. Suerie Moon, co-director of the Global Health Center at the Graduate Institute, said there are some provisions in the text that “would be meat and not just bones” if negotiators can find consensus on them. However, time is running out to reach a meaningful agreement. “I think the window of opportunity will close at the end of WHA, and until then, there's still a chance of a meaningful agreement. But a lot rides on the next negotiating session, which can't work the same way as the last one with every country putting their full wishlist back on the table,” she wrote in response to Devex.