Pandemic Treaty Offers Opportunity to Repair Fault Lines in COVID-19 Response – and Address Equity
A nurse takes the temperature of a child suspected of COVID-19 symptoms in a Lebanese public health centre.

An international pandemic treaty based on equity could be the antidote to current weaknesses and imbalances in the global response to COVID-19, according to a group of influential authors in a Lancet paper published on Tuesday.

A number of the authors are associated with The Independent Panel for Pandemic Preparedness and Response chaired by Helen Clark and Ellen Sirleaf Johnson, which was set up to assess the World Health Organization’s (WHO) response to COVID-19.

Based on a timeline developed by the panel that lays out the global COVID-19 response, the authors conclude that the International Health Regulations (IHR) are too weak, and the required country actions are too slow, to protect the world against pandemics.

Revised after the 2005 Severe Acute Respiratory Syndrome (SARS) outbreak, the IHR focus on balancing disease notification and health risks with international trade and travel considerations. They specify when and how Member States should notify WHO of a local disease outbreak, and what actions WHO and States should take after that notification. 

The IHR are currently the only legally binding international instrument governing countries’ obligations to report and respond to pathogens that could result in cross-border disease outbreaks and potential public health emergencies.  

In their review, the authors identified a number of significant IHR weaknesses, including: constraints on WHO reporting publicly about national events with pandemic potential; the need for greater specificity on the information that countries need to share with WHO; and a streamlined process to facilitate WHO verification of events within 24 hours of the first signals of an outbreak being received.

Special World Health Assembly

The article comes a few weeks before global leaders meet at a World Health Assembly special session (29 November – 1 December) to consider adopting an “instrument or treaty” to address pandemic preparedness and response. 

“It’s clear: if a new, fast-spreading pathogen were to emerge next month, the current IHR regime would not protect people and trade as intended,” said Dr Sudhvir Singh, lead author on the paper and an advisor to the Independent Panel.

“We suggest change to the IHR and a new treaty or another instrument that would result in more information shared faster, WHO able to investigate rapidly, all countries moving immediately to assess risk;  and tools, like tests and vaccines, available to all who need them.”

Georgetown University’s Dr Alexandra Phelan added that “COVID-19 has shown that the existing obligations under the IHR are insufficient for our interdependent and digital world.” 

 “Our analysis demonstrates that collectively, countries urgently need to update our international system to respond to the potential rapid spread of a high impact respiratory pathogen,” said Phelan.

“We have concrete suggestions for ways in which the IHR may be revised or amended, as well as the approach and issues that must be covered in any new legal framework, like a pandemic treaty.”  

Four reasons for a pandemic treaty

The authors advance four reasons why a pandemic treaty “presents the opportunity to enact comprehensive reform in pandemic preparedness and response”. 

“First, a pandemic treaty centred on the principle of equity would be an important signal of international commitment to guard against the entrenchment of global division and injustice.”

A pandemic treaty offers an opportunity to “develop and instil norms of equity, justice, and global public goods of pandemic preparedness and response”, they argue.

“Second, a pandemic treaty could provide high-level complementarity to the IHR and any potential post-pandemic reforms and proactive multidisciplinary approaches to zoonotic risk,” they argue.

Their third argument is that a treaty establishes greater accountability, outbreak support, and global access to vital public health information. 

Finally, a pandemic treaty could provide the opportunity to develop “a solid evidence base for non-pharmaceutical interventions” that might prevent the next outbreak from becoming a pandemic.

“The upcoming Special Session of the World Health Assembly is a critical opportunity for Member States to move ahead with strengthening the IHR and to agree on a process for negotiating a pandemic treaty. We must not lose this opportunity to protect global public health and future generations,”  said Phelan.

At a recent event hosted by G2H2, civil society organisations expressed fear that a pandemic treaty was a distraction from the TRIPS waiver.

But Björn Kümmel, deputy head of the global health unit in the German Federal Ministry of Health, disputed that there is any direct political link between the treaty and the TRIPS waiver.

Kümmel added that amending the IHR also would take time to negotiate.  And a key question here is: “would they be a game-changer for the next pandemic to come? Certainly not,” he added, noting that there is “no compliance mechanism that currently is foreseen in the IHR.”

Image Credits: UNICEF .

Combat the infodemic in health information and support health policy reporting from the global South. Our growing network of journalists in Africa, Asia, Geneva and New York connect the dots between regional realities and the big global debates, with evidence-based, open access news and analysis. To make a personal or organisational contribution click here on PayPal.