NEW YORK – Despite the weaknesses of the political declaration on Pandemic Prevention, Preparedness, and Response (PPPR) expected to be adopted by the United Nations (UN) High-Level Meeting (HLM) on Wednesday, some world leaders believe that the UN is a more appropriate forum to thrash out the global pandemic response than the World Health Organization (WHO).

Juan Manuel Santos, former President of Colombia and a member of The Elders, believes that the UN may be the better forum as “pandemic preparedness encompasses far more than health”.

Santos told a UN side meeting on Tuesday hosted by the Pandemic Action Network (PAN) that if the pandemic accord negotiations are still “mired in confusion” by the time the WHO Intergovernmental Negotiating Body (INB) meets for the seventh time later this year,  “someone has to say, enough, we need to shift it back to New York.”

Mary Robinson, former Irish President and Chair of The Elders, supported Santos’s view that pandemic negotiations should be at the UN. 

“We do need to strengthen the WHO, but we need to realise pandemics affect the whole economy. It has an incredibly devastating impact that drives countries into debt,” said Robinson.

“The world is dismally prepared for the next pandemic, which is definitely coming,” warned Joy Phumaphi, chair of the Global Preparedness Monitoring Board, adding that her body’s report on global readiness would be released in six week’s time.

Next steps?

Alejandro Solano Ortiz, Costa Rica’s Vice Minister for Multilateral Affairs, said that while he was optimistic that the declaration would be passed, “what are the next steps?

“This is a non-binding declaration. It’s just a political declaration, and we need concrete steps in this process to complement the Geneva [WHO] process.”

WHO member states are currently involved in two pandemic negotiations: strengthening the International Health Regulations (IHR), the only legally binding global rules governing health emergencies, and negotiating a pandemic accord to address gaps that emerged during COVID-19, particularly equitable access to vaccines and medicines.

Winnie Byanyima, Executive Director of UNAIDS, said that any future pandemic response needed to be based on technology-sharing to enable more equitable access to medical products.

Byanyima also said that many countries were unable to invest properly in health and pandemic preparedness as they were servicing debts that were bigger than their health budgets.

But Dr Magda Robalo, president of The Institute for Global Health and Development, said that “there is no way we are going to prevent, prepare and respond to pandemics if we don’t address the critical issue of the healthcare workforce.”

However, she too stressed that countries with massive debt repayments were unable to invest in their health systems and health workforce.

Global Threats Council

Meanwhile, Helen Clark, former Prime Minister of New Zealand and former co-chair of The Independent Panel on PPPR, repeated the panel’s call for the establishment of a “high-level Global Threats Council” as a UN standing committee. 

It would be tasked with “really keeping everyone on their toes about the need for preparedness, and also support the mobilisation of finance to support […] the capacity of low and middle-income countries,” she said.

The Independent Panel had uncovered 16 previous reports about how unprepared the world was to address pandemics, as well as a previous call for a Global Threats Council to be set up following the Ebola outbreak.

“We have to break the cycle of panic and neglect. As we’ve seen with the COVID pandemic, which really isn’t over, we’ve been through the panic phase, and we’re well into the neglect phase. To break that, you need sustained political attention on the importance of preparedness and response because otherwise we will be doomed to repeat the painful lessons of history,” said Clark, reminding the audience that excess mortality during the COVID-19 pandemic was in excess of 24 million people.

Climate and health

Robinson also called for closer collaboration between the climate and health sectors, and for health to follow the lead of the climate sector, which is “trying to have the broadest climate justice movement possible”.

In the face of a massive fossil fuel lobby, climate activists are “trying to gather all the forces” and “the health space needs to widen the circle as much as possible. Health is everybody’s business [and we need] the same kind of connected movements.”

Most of the speakers at the PAN event expressed frustration that the declaration did not commit member states to any action. 

Zeid Ra’ad Al Hussein, former UN High Commissioner for Human Rights and also a member of The Elders, said that weaknesses in the UN system itself needed to be addressed.

“Some parts are highly developed and mature, where the mechanisms are layered and there’s a measure of surrender of sovereignty, which is acceptable. Then parts of the UN system are highly underdeveloped, almost primitive, and it’s staggeringly slow getting anything done. Health is one such sector. The other is climate,” said Hussein.

“In human rights, you have an interesting array of different incentives and disincentives to get governments to do things. That doesn’t exist where you have only a voluntary system and that is where we are with health.”