Opinion: Protecting pandemic preparedness efforts in a US election year

Governments are scrambling to finalize negotiations on the pandemic treaty, ahead of next week’s World Health Assembly. And all eyes are on one country in particular: the United States. As the Biden-Harris administration enters the final round of negotiations, weighs the pros and cons of pursuing different strategies, and prepares for the upcoming general election in November, it should consider three key policy options to secure global pandemic preparedness and response, or PPR, efforts. Reinforce global health security Protecting the United States from the next global health threat has been a shared concern among U.S. lawmakers and officials. The inclusion of the bipartisan Global Health Security and International Pandemic Prevention, Preparedness, and Response Act in the fiscal year 2023 National Defense Authorization Act, which was signed into law in December 2022, clearly signaled this; the measure sought to enhance U.S. efforts to promote international PPR, recognizing the vital national interests that it serves. However, while the goal of these endeavors — safeguarding the health of Americans and people around the world — is shared by many, elements of the PPR agenda relating to multilateral cooperation, have faced political headwinds. Given this, and the likelihood that further negotiation will be required post-election on issues such as diversified production, technology transfer, pathogen access and benefit sharing, and financing, the Biden-Harris administration should emphasize the need for the World Health Organization to stick to its role as a normative, technical, standard-setting body, rather than become the secretariat of the agreement or the entity responsible for coordinating all the financing of PPR efforts. This is essential for the global governance of PPR and could help temper the concerns of critics and facilitate future negotiations. Push for a negotiated agreement during the World Health Assembly Nevertheless, the Biden-Harris administration should seize this opportunity for meaningful action even if it means compromising on some of the more contentious issues of the treaty to ensure an agreement is reached at the WHA this year. The administration should help break the realities of the crisis-neglect cycle that has plagued global efforts to shore up PPR in the past — and embrace practicality. This includes, for example, attaching conditions to public funding for the development of medical countermeasures, such as requiring grantees to openly share study results or retaining certain intellectual property rights to be used only in special circumstances, such as pandemics. It could also include agreeing to financially support and champion a new, dedicated “surge” financing instrument that would complement existing financing mechanisms. This instrument — also known as Day Zero Financing — would create a pool of funding, readily accessible at the onset of the next pandemic to use for medical countermeasures and “at-risk” investments, ensuring a timely, equitable, and coordinated global response. To date, the Biden-Harris administration has shown willingness to pair strong commitments to share information, pathogen samples, and genetic sequence data with contractual commitments, including dedicated percentages of production for equitable distribution during pandemics and a system based on voluntary technology transfers. However, this has been met with disappointment by lower-income countries seeking stronger measures to ensure equity, including mandatory transfer of technology and know-how, intellectual property waivers, and additional financing. Champion the Pandemic Fund The United States was a leader in the creation of the Pandemic Fund, which seeks to mobilize support and incentivize low- and middle-income-country investment in PPR. In the fourth quarter of this year, the Pandemic Fund is expected to hold a pledging moment, during which it hopes to secure donor commitments of at least $2 billion over two years. Demand for the fund’s first round of grants far outstripped available resources. The Biden-Harris administration FY 2025 budget request included $250 million for a contribution to the fund. With tight toplines and competing demands, securing further resources could prove challenging. But the administration should double down on its efforts to leverage its diplomatic capacity to rally additional support from other donors. The Pandemic Fund is the largest and most important mechanism to help low- and middle-income countries strengthen their pandemic preparedness readiness, is demand-driven, and is structured to leverage additional funding from multilateral development banks and global health initiatives, yielding roughly $6 for each dollar invested. A strong, well-funded Pandemic Fund could address some of the concerns posed by lower-income countries regarding the financing and implementation of the pandemic agreement, once signed. A pandemic treaty presents a once-in-a-generation opportunity to better protect the world against pandemic risks. After two years of negotiation, it remains unclear whether governments will commit to signing an ambitious, yet feasible agreement at the 2024 WHA. But amid emerging health threats and looming political uncertainty, now is the time to act — and the United States should help lead the way.