The draft pandemic accord needs more emphasis on preventing pandemics at their source – where animal pathogens “spill over” to people – according to a number of organisations participating in a consultation on the document’s “zero draft” on Wednesday.

Negotiations between World Health Organization (WHO) member states on the draft are due to begin at the fourth meeting of the Intergovernmental Negotiating Body (INB), scheduled to take place from 27 February to 3 March.

However, Wednesday’s meeting gave WHO’s civil society stakeholders an opportunity to comment on the draft ahead of that meeting.

Only member states will take part in the actual treaty negotiations, which are likely to start behind closed doors on the second day of the month-end meeting (called INB 4), INB co-chair Roland Driece told the meeting.

INB 4 and the following INB5 meeting from 3 to 6 April would be approached as “one big meeting”, he added.

While the start of the meeting would be open to all stakeholders, “as soon as member states tell us that they accept the zero draft as the zero draft, we will move into negotiation mode, and that means that only member states can be present,” said Driece. “So that’s why it’s so important that you tell us and member states now what you feel and think about this zero draft.”

He added that he thought that the INB Bureau had done “a pretty decent job [of synthesizing stakeholders’ inputs]” but “this is an important moment for you all to share whether or not you share my optimism about that and tell us what you think is important”.

Prevent ‘zoonotic spillover’ – environmental and animal health groups

An unprecedented number of organisations spoke about how the draft needs to pay more attention to pandemic prevention at the source; this means addressing the social, environmental and food safety factors that lead to the spillover of pathogens from wild animal populations into human communities. These drivers range from deforestation which has prompted animal populations like bats, which harbor a range of deadly pathogens from SARS-COV to Marburg, to move closer to human habitats; to wild animal trafficking and trade, both legal and illicit; as well as industrial production, sale and slaugher of wild animal species.  

The Wildlife Conservation Society recommended that the accord commit governments to “identifying and prioritising actions to prevent pathogen spillover in the first place” by prioritising tougher regulations on “markets and trade chains and wildlife domestic and international trade”. 

“We have extensive experience and expertise with habitat degredation, deforestation, forest degradation, wildlife trade and wildlife markets,” said the WCS representative. “And this isn’t about illegal trade, its about any live trade, particularly for food but also for other purposes, birds and mammals.  We look forward to working with member states and the INB to ensure that first and foremost there are commitments by governments to avoid the spillover in the first place. And we do know how to do that, from a biodiversity perspective and in terms of markets.”

The World Wildlife Fund (WWF) appealed for the “list of drivers of pathogen emergence risks to be expanded to include not just deforestation, but ecosystem loss, fragmentation and degradation”. 

“Deforestation alone omits many of the potentially important pandemic frontiers and ignores the role of fragmentation and degradation in increasing proximity between humans and wildlife,” said the WWF.

Meanwhile, the World Organisation of Animal Health (WOAH) called for the inclusion of the full definition of “One Health” in the treaty.  Its delegate also questioned why preparedness and response were stressed whereas “preventive actions targeting activities and places that increase the risk of zoonotic spillover” were not.

Pointing to a lack of expertise to address zoonotic spillover, the Action for Animal Health Coalition said that member states needed to invest in increasing the animal health workforce.

Equity obligations

Meanwhile, Oxfam, also representing the People’s Vaccine Alliance, said that “the accord’s language must oblige governments to take specific actions to ensure equity; otherwise it would be very difficult to implement this”.

The current zero draft also assumes that “critical public health interventions are based on the willingness of pharmaceutical companies to engage in voluntary mechanisms” but “these have proved to be largely insufficient during the current and previous pandemics,” said Piotr Kolczynski, of Oxfam and PVA.  

For this reason, it added, “the accord must require governments to invest in research and development and manufacturing capacities and to condition public funding on the sharing of technologies, knowledge and intellectual property with developers and manufacturers in the South”. 

In reference to the accord’s proposal that 20% of pandemic-related goods be allocated to the WHO for distribution, Oxfam stated that “equitable allocation of medical countermeasures cannot be achieved by reserving a 20% of production for 80% of the world’s population”. 

Medecins sans Frontieres (MSF), meanwhile, asked for a legal definition of “pandemic”, and “explicit reference to governments complying with international humanitarian law obligations in the context of pandemic preparedness, prevention and response”.

It also demanded stronger language in relation to commitments to protect “humanitarian populations of concerns” and healthcare workers during pandemics.

Private sector is a ‘critical partner’

“The private sector should be seen as a critical partner in preparedness, response and recovery, and should have a seat at the table,” stated Grega Kumer, Deputy Director of Government Relations at the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA).

However, it warned that some of the accord’s proposals “would jeopardise our capacity to efficiently prepare for the next pandemic.” Key concerns it cited included proposals for a waiver on intellectual property rights (IP) for health products during a pandemic, as well as proposals that would “be “transactionally linking access to pathogens and sharing of benefits”. 

It also urged the INB to “avoid unnecessary overlaps and duplications including other multilateral organisations mandate and expertise such as WTO and WIPO”. 

While there were over 200 participants online, a handful of member states were also on hand to listen in person at WHO’s Geneva Headquarters to the inputs as they prepare for INB4, when the real negotiations begin for the accord that is due to be presented by May 2024 to the World Health Assembly.

Image Credits: Peter Griffin/Public Domain Pictures.