From Equity to Conspiracies, People Say What They Want From a Pandemic Treaty 
A wide range of organisations and individuals took part in the second round of public hearings on future pandemic preparedness.

From bedrooms in China to boardrooms in Geneva, people offered their views on how to protect the world against future pandemics during the second round of public hearings called by the World Health Organization (WHO).

The public hearings are part of the WHO intergovernmental negotiating board (INB) process to develop a pandemic “convention, agreement or other international instrument” to “strengthen pandemic prevention, preparedness and response”, as agreed on at a special World Health Assembly in November 2021 

The call for comments elicited over 250 video submissions, some of which were aired on Thursday via the WHO’s website with the rest due to be released on Friday.

Equitable access to medicines and protective equipment, more support for health workers and an end to pandemic profiteering had wide support for inclusion in a future pandemic accord.

Meanwhile, a flotilla of conspiracy theorists also submitted the comments, condemning COVID-19 vaccines (“gene genocide”, according to one), WHO “global domination”, masks and social distancing. People from Australia, Poland and Switzerland seemed particularly agitated about these issues, as well as any notion that there could be global decision-making about how to address pandemics.

Intellectual property rights

But back to the serious commentary, all delivered in 90-second bites (and often by unnamed presenters). Equity of access to vaccines and medicines was a common theme across most presentations, a principle that member states have also agreed on at the INB.

Oxfam, supported by the People’s Vaccine Alliance, advocated for increased public investment in research and development (R&D) conditional on “sharing of intellectual property (IP) rights and know-how as well as technology transfer, especially with producers in developing countries”.

“This must be delivered by a WHO-led IP and technology pooling mechanisms and mandate governments to find regional manufacturing capacity in the Global South, which secures supplies for developing countries,” said Oxfam.

However, the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) said that the fast development of COVID-19 vaccines had been the result of many years of investment in mRNA and viral vector technologies.

“We need to make sure that the IP-based innovation ecosystem is not undermined,” IFPMA director general Thomas Cueni said.

Strong primary health systems

Rosemary Mburu, representing the community and civil society representatives at the ACT Accelerator, called for significant investment in primary health care and national health systems. 

“We need to put trained, skilled, equipped health workforce protection, recruitment and remuneration at the centre of future pandemic response,” said Mburu. “Without this, detection of new pandemics will be slower and those in the frontline responsible for testing treatments and immunisation will not be able to perform their duties.”

Bill Rodriguez of FIND, the global alliance for diagnostics, stressed that “pandemic preparedness and routine primary health care (PHC) are inseparable”. 

“Pandemic surveillance requires investment in routine PHC based testing programmes. 

If we are not testing for common conditions, we will not detect an emerging pandemic until it’s too late,” said Rodriguez, who also stressed that low and middle-income countries needed the capacity to develop their own diagnostics as pandemics disrupted global supply chains and travel.

The Pandemic Action Network wants the accord to ensure that every country has the capacity to “detect, prevent and respond to outbreaks at their source and fulfil their obligations under the International Health Regulations”. 

Legally binding

Third World Network stressed that equity in international public health response is not possible unless there are “legally binding commitments on WHO and member states to operationalize equity” and that member states should be under an international legal obligation to realise equity. 

“We firmly believe in the need for an article 19 convention which sets out what is required of countries in preparedness, response to outbreaks and management of pandemics,” said Dame Barbara Stocking from the Panel for Global Public Health Convention.

“Countries need to be held to account. There is now strong evidence that treaties without compliance measures are ineffective. We believe the best way to do this is by having an independent assessment body within the treaty structure for at arm’s length of the WHO.” 

The panel also wants to “incentivize countries to be accountable” where, for example, “non-delivery could have implications for a country’s financial stability” in terms of article four of the IMF

Sharing of pathogens

A number of submissions stressed the need to share information about the pathogens driving pandemics to fast-track global response.

For the IFPMA, this sharing should form part of a “social contract”.

“The world needs to show more solidarity because pandemics do not respect borders,” said Cueni. 

“The industry has committed to reserve vaccines and treatments for priority populations in lower-income countries, but this will only work if countries commit to a social contract. That means immediate sharing of pathogens and their genetic sequence data, unrestricted trade and open borders, and it also means financial support so that those most in need can have equitable access to vaccines, treatments, and tests.”


“Meaningfully engage civil society and communities in every aspect and structure that is set up to better protect against future pandemics,” said Mburu.

“Civil society needs to be on the governance structures of pandemic response architecture. We need to be part of the decision-making and co-creation at every stage and have a say in financing and resource mobilisation decisions. Nothing for us without us.”

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