Keep the momentum to negotiate a pandemic instrument, urged Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO) at the start of the third meeting of the intergovernmental negotiating body (INB) on Monday.

“The conceptual zero-draft that your bureau has developed is a true reflection of the aspirations for a different paradigm for strengthening pandemic prevention, preparedness, response and recovery,” said Tedros. “As we move to a new phase of this process, I urge you to maintain momentum.” 

Almost exactly a year ago, a special meeting of the World Health Assembly resolved to negotiate a treaty to outline the future global pandemic prevention, preparedness and response. 

Members of the INB were appointed in February and developed the draft in record time,  presenting it to member states in late November.

Support for draft – but with more detail

At Monday’s meeting, most member states expressed support for the draft as the basis for a ‘zero draft’ to launch official negotiations on the first of the three-day meeting, but many thought the draft was too general.

“I’m very happy with the common voice in this room that the document we provided you with is a good basis for the next steps,” said INB co-chair Roland Driece. “Nobody said it was not and most of you think that, with improvements or alterations, it could serve in an improved way as a zero draft for negotiations next year.”

But, Driece added, most member states “wanted to have more elaborated text” that also had more legal terminology and definitions.

“Furthermore, many of you said this conceptual zero draft has a lot of good starting points, but we need to focus on the real priorities, focus on the issues that have the most impact and most of you said that is because May 2024 is coming rather soon,” added Driece.

The body has until the WHO’s 77th World Health Assembly in May 2024, a mere 17 months, in which to develop and present an agreement.

In that regard, Tedros announced that he has asked Dr Jaouard Mahjour to continue to co-ordinate the INB’s secretariat. Mahjour’s contract as WHO’s Assistant Director-General for emergency preparedness and international health regulations ended on the last day of November.

“I have asked Dr Mahjour to continue as head of the secretarial team for the INB and the [International Health Regulations] amendment process. The team established to support your work has made me proud, with their delivery and efficiency. Time is short, and there is much work to do,” added Tedros.

The Group of Friends of the Pandemic Treaty, a group of 43 countries from different regions of the world, called for the treaty to be “an ambitious legally binding agreement which has a real-world impact in terms of pandemic prevention, preparedness, response and recovery”.

The US, UK and the European Union stressed that the treaty could not address everything, but needed to prioritise key concerns.

Meanwhile, the African region said that some of their concerns had been left out, such as the need to reflect that government investment in medical R&D was part of the “global good” – and presumably, this knowledge should be freely available.

It also wanted the agreed principle of equity to be “operationalised” and included throughout the document.

Dovetailing with IHR reform

Most states wanted the process of reforming the IHR and the development of the treaty to dovetail, with China articulating that the IHR reform and development of the treaty needed to be “fully coordinated, consistent and complementary in terms of content”.

Stressing that the treaty needed to be formulated with respect for the sovereignty of member states, China also called for “the stigmatization of countries that report cases which helped to motivate countries to share information and pathogen timely way” to be included in the principal part of the document.

This was echoed by South Africa, which pointed out how it had been stigmatised and punished with travel bans after it had identified and shared the omicron variant of COVID-19 with the international community.

Treaty, agreement or convention?

In response to member states’ queries about the different legal forms of a pandemic instrument, WHO principal legal officer Steven Solomon said that both an agreement and a convention “are both treaties within the meaning of international law”. 

In addition, said Solomon, a convention and a “framework convention” were “not mutually exclusive” and it is “possible to have a hybrid approach as well as one or the other”.