Negotiating body co-chair skeptical about pandemic treaty timeline

Countries around the world have set a deadline of next May to produce a final draft of a global treaty on pandemic prevention, preparedness, and response — a major step in efforts to strengthen the global architecture around health security. During the World Health Assembly held in Geneva in May there were calls for countries to meet this deadline because another pandemic could be just around the corner. “I urge you to deliver the pandemic accord on time as a generational commitment. The next pandemic will not wait for us, and we must be ready,” Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, said. But it's not an easy feat ensuring the world’s countries are on the same page and willing to compromise in a meaningful way — raising questions around whether that deadline is realistic. Roland Driece, a co-chair of the Intergovernmental Negotiating Body Bureau on the pandemic accord, said that while it would be ideal for countries to meet the deadline, he is concerned the timeline isn’t realistic given the complexities involved in getting the world’s countries to agree on an international treaty. “I'm not pretty confident,” he said. Driece said other efforts to bolster the global health infrastructure that’s consuming the attention of countries — mainly amendments to the International Health Regulations — could also slow down the process. Countries also have different priorities on what they want in the treaty and aren’t in agreement on all the issues — and it will take time to find a consensus. Efforts must be put into ensuring all countries are able to participate in the process of crafting the treaty, which can also be time-consuming. Some groups are also calling for a simulation exercise to test out the agreement before countries sign on, which is another step added to the timeline. Some of the areas under discussion include equitable access to medical countermeasures; the swift sharing of pathogenic information; improved logistics for deploying medical countermeasures; more coordinated research and development; and funds to finance it all, according to Driece. A jam-packed year WHO member countries decided in late 2021 to create an intergovernmental negotiating body to facilitate the discussions and a bureau representing all six regions of WHO was established. Countries began negotiations in March, and the latest 42-page draft was leaked during the 76th WHA in May. The aim is to have the final draft of the accord ready for the next WHA in May 2024, but Driece said this means the draft must be completed in advance for translation into multiple languages. This leaves about 9 months before a final draft is due, which is “not a lot [of time] when you talk about international agreements,” he said. The global health space has few binding international agreements, Driece said. There is the WHO Framework Convention on Tobacco Control and the IHR. It’s expected the pandemic treaty will have both binding and nonbinding elements. And because these agreements are rare, it's expected countries will approach this accord cautiously. “Countries want to understand what it is that they'll be signing up to, and if it’s going to solve their problems,” Driece said. Driece said that next year’s deadline was not an easy target on its own, but to “complicate things even more” countries decided to simultaneously improve the IHR, which has over 300 proposed amendments. And in September, the U.N. General Assembly will host its first high-level meeting on pandemic prevention, preparedness, and response, which also includes a political declaration that aims to garner political support from heads of states around bolstering the global health infrastructure. These are both separate processes to the negotiations around the pandemic treaty, but it’s hoped these efforts are complementary and don't undermine each other. But Driece expressed concerns about “overlapping discussions” between the IHR amendments and the pandemic accord. “Delineation is much needed so we can progress with the needed work in both processes,” he told an audience at this year’s WHA. And there is also the challenge, within countries, of getting everyone in agreement on what they are signing up for. Omar Hilale, Morocco's ambassador and permanent representative to the U.N., said during WHA that some country delegations support certain principles at the assembly, but then don’t support these same principles in UNGA. He said he hopes these inconsistencies can be reduced within countries so that members of country delegations can be on the same page. Some have also expressed concerns about the transparency of the process and that the accord has been “watered down and stripped of the key stipulations needed to prevent another global health disaster.” It will ultimately be up to WHO’s 194 member countries to meet the deadline. “I hope we will just finish in time, but we have to see,” Driece said. Meaningful compromise The negotiations bureau asked countries and civil society groups to articulate their most pressing issues, Driece said. Most of the issues are on the table — but there are different approaches to how these issues could be tackled, he said. Countries have different priorities. For some, such as the bloc of African nations, a key focus is legal obligations to ensure equitable access to medical countermeasures. This group of countries was not pleased that equity was “presented in a weakened or reduced format” in the most recent draft of the treaty. Some countries want the accord to include text that allows them to benefit from sharing pathogen genomic data in exchange for access to medical products, such as treatments. But not every country is in agreement on this. Other countries have more of a focus on surveillance and data. A top priority for the United States, for example, is strengthened biosurveillance and data systems for early warnings of biological threats. Countries also have expressed concerns about losing sovereignty. During a WHA event, a representative for Russia said that this is a top concern for his country. He said reaching the goals of the accord will not be easy due to “a lot of contradictions” in the text that “cannot be resolved without real compromises.” He asked whether the world would consider it a success if the May 2024 deadline is reached but not all countries have signed on to the treaty and IHR amendments, and countries are not able to implement what is outlined in the new agreements. He said Russia is proposing that a framework convention be adopted that allows for all the areas that can’t yet be agreed upon by countries by next May to be fine-tuned later. But despite these concerns around sovereignty, the treaty “does not overrule any nation’s ability to pass individual pandemic-related policies,” according to the Associated Press. Driece said that while it's true that countries might need to make some sacrifices when they decide to sign up for the pandemic treaty, they would do this in the collective spirit of creating a better-protected world. “Now it's up to member states to say: ‘OK, can we find common ground on this or not?’” Driece said. “The beauty would be that we just find something for everybody and they say: ‘We will give you more equity if you invest more in your own prevention systems, for example. And that's the combination we will try to look to establish,” he added. Inclusiveness and a stress test Ensuring these negotiations are inclusive of all countries — no matter size or income level — is also a complicated task that can be time-consuming. Driece said the bureau has heard concern from smaller countries that they feel unable to participate in the process. “If that means that we will not finish next year, that's also something of a problem — so we have to find out how we're going to deal with that,” Driece said. And a stress test to see how the terms of this agreement play out in reality might also be added to the list of tasks at hand this year. During a WHA session on pandemic preparedness, Joy Phumaphi, co-chair of the Global Preparedness Monitoring Board, urged countries and stakeholders to “carry out a simulation exercise based on the draft accord and draft IHR amendments later this year, before they are finalized and adopted.” “It can provide assurance of their effectiveness, help us all as a global community to identify any remaining gaps, and resolve any outstanding areas of disagreement,” she said. Driece said the concept of a stress test is wise to ensure “everything we've written down is really going to do the trick.” “But I'm not sure what it will look like — we cannot fake a pandemic. We'll have to see how it works out,” he said.