Will the World Health Assembly adopt a pandemic treaty?

A pandemic treaty can take months to years to draft and negotiate, and it’s unlikely one would be adopted at next week’s 74th World Health Assembly. But some experts are hoping member states would endorse a resolution for the formation of an intergovernmental task force to draft and negotiate a treaty.

“With all the pain and the deep suffering that every part of the globe has experienced, if we don't do something bold now, when will we ever do something bold?” asked Georgetown University professor and global health law expert Lawrence Gostin.

But if the World Health Assembly doesn’t end up forming this group, it should at least adopt a resolution supporting a treaty that could be taken up at the U.N. General Assembly in September, where there’s higher political engagement, he said.

“The only option that should be off the table is neglect and failure, and just to literally do nothing on the pandemic treaty, and wait and see what happens in September. I think that would be a global failure,” he said.

During a recent briefing hosted by the U.N. Foundation, Steven Solomon, World Health Organization’s principal legal officer, described the question over a treaty being adopted at the Assembly as the “real crystal ball question,” but added that “as far as we know there's no draft of the treaty.”

There has been huge interest in a treaty, which received considerable attention in March 2021 when the European Council, WHO, and over 20 government leaders proposed an international treaty on pandemic preparedness and response that would tackle challenges exposed by the COVID-19 pandemic.

WHO Director-General Tedros Adhanom Ghebreyesus said the treaty could tackle challenges in the sharing of data, pathogens, technologies, and products such as vaccines. It could also boost transparency on production and supply chains, and strengthen the International Health Regulations.

There is no shortage of recommendations in the development of a treaty and what it should entail. But there has been skepticism whether a treaty would help the world better respond to the next crisis. Some member states are also reportedly hesitant to negotiate a treaty now as the world continues to grapple with COVID-19. Only a few governments were involved in the proposal for a treaty in March, and countries such as the United States and China were absent.

But some experts said the window of opportunity for leaders to strengthen pandemic preparedness and response, enshrined in a treaty, is in 2021  — while there is a pandemic, not after.

“Waiting until the pandemic is over will be too late, especially as the next pandemic is likely to emerge within the next decade,” said Carolyn Reynolds, co-founder of the Pandemic Action Network.

“As the United States and other powerful nations emerge from the acute crisis, political attention and support will shift toward other priorities, and we will be in danger of repeating the cycle of panic and neglect yet again,” she added.

A treaty with teeth

A pandemic treaty would help forge global political consensus, shift from voluntary to more mandated system of data sharing and reporting, allow for earlier outbreak response, and “drive a more robust and institutionalized process for monitoring, implementation, and accountability,” said Reynolds.

But there is recognition, too, among experts Devex spoke to that a treaty alone won’t be sufficient, such as in tackling issues of transparency and accountability. For it to be effective, it needs to be ratified by every government, and include tools that monitor and support compliance to a treaty, such as in the form of periodic reviews and on-site investigations.

“A treaty on its own at the level of ministers of health without any independent monitoring or investigation mechanisms is of little value,” said Nina Schwalbe, CEO at Spark Street Advisors and co-author of a policy brief that proposes ways to strengthen the implementation of a treaty. “IHR was already legally binding and still failed,” she added.

Periodic reviews and on-site investigations could help in assessing countries’ preparedness plans and their ability to respond to health threats. But to be effective, these mechanisms should include incentives or a sanction for noncompliance, according to the brief. In the case of noncompliance to periodic reporting for example, consequences “could include investigation visits, “naming and shaming,” or legal consequences.”

Measures that may cede a government’s sovereignty could be challenging. It’s the same question around calls to strengthen WHO by giving it powers to enforce the IHR, which include provisions for countries to immediately report to WHO of any unusual or unexplained health events.

The IHR, in its current form, doesn’t include penalties for countries that do not comply with its provisions. A treaty however is different to the IHR in that countries can decide to be part of a treaty or not, experts said.

But Susanna Lehtimaki, senior advisor at Spark Street Advisors and a co-author of the policy brief, argued that emphasis should be on incentives, such as WHO providing technical support to countries, and not sanctions. She said there are not a lot of available sanctions in the existing mechanisms they reviewed for peer reviews and on-site investigations.

“There are challenges related to all kinds of treaties. Even if we talk about the nuclear weapons treaty, governments can always say, ‘no thank you, we do not comply’ or ‘we just don't sign the additional protocols that are related to it,’” she said.

While recognizing countries’ claim to sovereignty, Gostin said “every country having sovereignty resulted in the world being devastated by a novel [corona]virus. And now is the time to try global cooperation.”