Not enough progress was made at the 11th round of the World Health Organization (WHO) pandemic agreement negotiations, conceded Dr Tedros Adhanom Ghebreyesus, the global body’s Director-General on Friday.

“I know you have made progress, but I also know that from what you have been saying, it’s not as good as what we wanted,” Tedros told delegates at the Intergovernmental Negotiation Body (INB) at the end of the two-week-long talks.

According to the latest draft of the pandemic agreement, the most controversial part of the agreement – developing a pathogen access and benefit-sharing (PABS) system (Article 12) – will now be addressed via a separate “instrument”.

The provisions governing the PABS system – described as a “multilateral system for safe, transparent, and accountable, access and benefit sharing for pathogens with pandemic potential” – will be developed by the Conference of the Parties (COP). This COP will be set up after the World Health Assembly has adopted the pandemic agreement.

The COP has also been given responsibility for defining “pathogens with pandemic potential and PABS Materials and Sequence Information, modalities, legal nature, terms and conditions, and operational dimensions” for PABS. 

All these details will be contained in a PABS instrument – and no deadline for its finalisation has been set. The COP itself has to be set up within a year of the adoption of the pandemic agreement, so it could be years before any PABS system comes into being.

Some observers have described the current document as “pandemic agreement lite” as it defers many key decisions. Delegates appear to have accepted this deferment, as text dealing with it is “greened” in the draft agreement, indicating its acceptance.

Tedros told the INB that he believed it was still possible for the pandemic agreement to be adopted by the end of the year at a special session of the World Health Assembly (WHA) in December.

However, the next round of negotiations set for 4-15 November, will determine whether this is realistic. Procedurally, 12 November is the latest date by which a December special WHA can be called.

However, the INB Bureau will hold informal meetings with member states during the course of October to try to reach consensus on key articles.

Will Africa trade deferring PABS details for speed?

African member states are anxious for the speedy adoption of the agreement, which currently includes support for “local manufacturing” and technology transfer to help member states to prepare for, and mitigate against, another pandemic.

While the Africa Group has pushed hardest for a PABS system in which countries are rewarded for sharing pathogen information, it may be prepared to accept deferring the PABS system details in exchange for early adoption of a pandemic agreement.

The spectre of the US elections this November and the possibility of a Donald Trump victory is also causing jitters amongst some member states. Trump previously froze the US contribution to the WHO, which severely affected its operations.

On 11 September, the US Congress passed the No WHO Pandemic Preparedness Treaty Without Senate Approval Act, which was introduced by Republicans who claim that the pandemic agreement will undermine US national sovereignty. 

This is despite all iterations of the pandemic agreement affirming member states’ national sovereignty in pandemics.

At the close of the INB meeting on Friday, the representative from Argentina – which now has a far-right government – asserted that the pandemic agreement should ensure no “interference with national regulations and legislation”. 

“My country firmly believes that we need to implement an International instrument to tackle pandemics but this must be designed respecting the sovereignty of all states. Without exception, we must maintain the capacity to legislate and apply our own laws within our jurisdictions as we see fit, with regard to the health of our citizens,” said Argentina, which has resisted joining regional positions on the pandemic agreement with other Latin American countries.

Tedros has previously described the notion that the agreement threatens nations’ sovereignty as “misinformation”, but it hasn’t stopped right-wing groups and parties globally from portraying the agreement as a “globalist power-grab”.

Their campaigning is part of growing nationalist populist rhetoric against international bodies and human-rights-oriented agreements.

This has also been evident in negotiations over the UN’s Summit of the Future starting on Sunday. The UN is due to adopt a Pact for the Future, but this has been watered down by conservative countries – particularly regarding the right to health, gender equity and human rights.

Happier stakeholders

One aspect of INB11 that is different and, by most accounts better, has been the daily consultations with officials stakeholders at the start of each day.

These stakeholders include patient advocates, the pharmaceutical industry, NGOs and academics, who have long complained at being shut out of the talks.

“We’ve seen [stakeholders] engage in the corridors, but this time, it was different, because they also participated in the meeting,” said INB co-chair Precious Matsoso.

“They were able to provide their advice as best as possible, and I must say that there’s a lot of goodwill and there’s a lot of commitment.”

Nina Jamal, Head of Pandemics at the global animal welfare organisation FOUR PAWS, thanked the INB Bureau “for transparency towards relevant stakeholders, increased openness and constructive proposals by member states, promoting successful negotiations”.

Michelle Childs, Policy Advocacy Director for the Drugs for Neglected Diseases initiative (DNDi), said that her organisation welcomed the sharing of the draft texts and daily briefings.

“These help to improve the ability of stakeholders to follow and input and counter misinformation about what is actually being discussed. We encourage further steps to enhance transparency, including making stakeholder interventions publicly available,” added Childs.

‘Messy middle’

The Pandemic Action Network said “progress efforts [were] bumping into the messy middle”, adding that while engagement with stakeholders was better, they want more transparency and access to the actual negotiations.

Matsoso said progress had been made on “research and development, regulatory systems strengthening, One Health, pandemic prevention and technology , supply chain networks and a new system for increased access to pathogens of pandemic potential and sharing of benefits, such as vaccines, diagnostics and treatments”.

“Following nearly three years of negotiations, countries are now focused on the remaining and most critical elements of the draft agreement to protect the world from future pandemics,” Ms Matsoso said.

Matsoso added that “we are going to find a solution in our life time.”