BERLIN  – Negotiations to produce a pandemic agreement still face a number of challenges, but some of the key negotiators in the International Negotiating Body (INB) told the World Health Summit that they are cautiously optimistic. 

As protestors gathered outside the summit venue, the JW Mariott Hotel in Berlin, to express their distrust of the pandemic agreement negotiations, panel participants addressed a session about “finding consensus” on the pandemic agreement.

Francisco Perez-Canado, the European Commission’s Advisor to the Director-General on the External Dimension of Health, underscored the erosion of trust among international partners as a result of the COVID-19 pandemic. 

“The first victim, in political terms, was trust. This erosion of trust has created a sense of urgency to establish a more reliable and legally binding framework for future responses to health emergencies,” said Perez-Canado, explaining that the accord was necessary to rebuild trust. 

“We need this pandemic agreement because this is how we can rebuild trust in the need for pandemic preparedness and response, and this trust is based on far-reaching obligations for low- and middle-income countries to be empowered towards equity for them to extend their R&D and manufacturing capacity through either voluntary or compulsory tech transfer,” Perez-Canado said. “We must remember that this Pandemic Accord is not about charity but about solidarity.”

Equity at the forefront

Steven Solomon, WHO’s Principal Legal Officer, who has been intimately involved in the INB processes, believes that the May 2024 deadline is doable provided the negotiations continue to be as intense as he and other facilitators witness them to be.

“If member states have the political will to agree on this treaty faster, then it is doable by May 2024,” Solomon said. “There are four key areas to focus on towards operationalizing equity.” 

First, a meaningful sharing of pathogens data and tools: finding combined obligatory sharing of pathogens data and sharing of benefits such as tools should be on an equal footing between the global north and the global south. 

“Finding mechanisms to exchange genetic sequence data of pathogens and in return pandemic response products such as vaccines, diagnostics, and treatments should be obligatory,” Solomon said. 

Second, a crucial aspect of the proposed agreement is the building of sustainable and geographically distributed production capacity for vaccines and other pandemic products. 

“It’s widely acknowledged amongst the negotiating parties that countries need to work together to enhance their capacity to produce essential medical supplies,” Solomon said. “This includes addressing issues related to intellectual property rights and ensuring that production is not solely based on purchasing power but also on public health needs.”

Third, national health capacities need to be strengthened, and this involves improving health systems, health and infectious disease surveillance, enhancing risk assessment capabilities, securing supply chains, and bolstering regulatory mechanisms towards real-time supply – as needed – of pandemic response products without any delay, which can happen only when regulatory mechanisms strengthen the global supply chains. 

“All of these should aim to operationalize equity by ensuring that all countries have the capacity and access to respond effectively to health emergencies,” Solomon said. “Access to diagnostics, treatment options, and vaccines are like justice – it means when delayed, it is actually denied.”

Fourth, governance, financing, and political will: effective governance is essential for the success of any international agreement. It should be inclusive, transparent, and promote accountability. Additionally, financing mechanisms must be sustainable, and there must be a strong political will to ensure that the agreement’s provisions are implemented and enforced. 

“Therefore, the need to address the risk of political amnesia and potential shifts away from multilateralism is also acknowledged by the negotiating bodies,” Solomon said.

Progress and challenges 

The negotiations to create this binding instrument for pandemic preparedness have had their share of challenges. Initially, there were ideological differences among negotiating parties, according to the panellists. However, informal sessions and mediated discussions have helped bridge these gaps, where participants in the negotiation process have started to recognise the urgency of creating legally binding obligations, according to the panellists.

“Work on negotiations in the informal discussions has actually pushed the negotiation discussions further,” said Perez-Canado.

Maria Juliana Tenorio Quintero, a representative of the Colombian Permanent Mission in Geneva and one of the facilitators of the negotiations, added that participants have shifted from general statements to focusing on concrete provisions that will ensure equity. 

“The negotiations have reached a stage where they can have meaningful discussions about legally binding obligations,” she said. 

Member states’ negotiations on Article 9 of the Zero Draft, which focuses on fair, equitable and timely access and benefit-sharing, are basically “done”, she added.

However, when questioned about the optimism about the negotiations, the panel flagged some of the remaining difficulties. 

These include intellectual property waivers, voluntary or compulsory tech-transfer between countries that discover pandemic response products, how to include the OneHealth approach, incentivisation of technology co-creation and strengthening joint venture initiatives.

The panellists conceded that the deadline is just around the corner and that unless these issues are agreed on, the divide between the global north and south could widen. 

“Thanks to the work of the facilitators of negotiations, there’s a greater understanding between the negotiating parties of the need for the components of all the articles the Zero Draft highlights,” Solomon told Health Policy Watch. “However, fulfilling the mandate for a strengthened International Health Regulations, operationalized by the pandemic treaty, is only achievable with political will.”

One of the panellists, who asked not to be named, told Health Policy Watch: “Should the political will and momentum we see is real and kept up, we can – and we have to – deliver the agreement by May 2024. 

“But the reality of the agreement is not up to the negotiators, rather their bosses that deliver the agreement. Articles of the Zero Draft that are the heart of the negotiations, are Articles 9, 11, 12, 13, OneHealth, and negotiators are still finding it difficult to come to terms with some of the terms under most of these Articles.”

Asked whether there is a Plan B if the negotiations are deadlocked by the self-imposed deadline, Solomon said, it is up to the negotiating member states. 

However, Perez-Canado said, “Until the pandemic agreement is enforced, we do not have Plan B because this is too important to fail at this juncture.”