An effective pandemic agreement will need to include “accountability mechanisms” to ensure that countries implement the terms – and these will need to be independently monitored, according to new research published in BMJ.

“Accountability mechanisms are used through a variety of methods across global treaties and governance mechanisms to varying degrees of effectiveness,” argue the researchers, based on their evaluation of other global treaties and interviews with experts. 

“The pandemic agreement should have accountability mechanisms built into it from the start to increase the likelihood of countries complying with the obligations they sign up for.”

📜 Negotiations began this week in Geneva on a new #PandemicAccord.

🌐In our new analysis for @GlobalHealthBMJ, we review the governance of international treaties.

🗝 We found that enforcement mechanisms are key to compliance.

🧵 pic.twitter.com/jgp3za7Q6h

— Nina Schwalbe (@nschwalbe) November 8, 2023

‘Soft incentives’ for compliance

While finding consensus is the current imperative for the INB, there is a risk that countries will simply fail to implement the terms of a pandemic agreement.  During the COVID-19 pandemic, for example, many countries did not comply with the  International Health Regulations (IHR), despite the fact that they are legally binding.

To enhance compliance with a pandemic agreement, the researchers – mostly from Spark Street Advisors – argue for the provision of “soft incentives” such as “technical and material resources” to help countries.

“Reputational incentives” could also assist with compliance, they add, arguing against “the harms of sanctions and benefits-based incentives”.

But compliance with the terms of the agreement should not simply rely on countries’ self-reporting, as is the case with many international agreements.

“The pandemic agreement should establish, as part of its institutional arrangements, an independent monitoring committee, tasked with producing regular assessments of state parties’ compliance with the pandemic agreement and the timeliness, completeness and accuracy of self-reporting,” they argue.

This monitoring committee “should be politically, financially, technically and operationally independent of the WHO and donors”, and able to” triangulate” information from a diverse range of sources including civil society about countries’ compliance.

It would report to a high-level political body to promote compliance with the pandemic agreement.

‘Find common ground between public health and profit’

Meanwhile, Dr Tedros Adhanom Ghebreyessus, the Director-General of the World Health Organization (WHO), appealed to member states negotiating a pandemic agreement to find “common ground”  between equitable access and innovation; protecting public health and making a fair profit; global health security and national or regional interests. 

Addressing a closed session of the seventh meeting of the intergovernmental negotiating body (INB) in Geneva on Wednesday, Tedros warned that “a pandemic agreement that fails to ensure collective security and equity in all its forms, fails”. 

Referring to “numerous meetings” in the almost two years since a special session of the World Health Assembly decided to establish the INB, Tedros said “I believe strongly that this [negotiating] text may help you come closer together on the path towards consensus.

“No one is pretending your work is easy. I know it is not. It is not surprising that, with 194 member states, reaching consensus is not straightforward. But that does not mean it is unachievable,” said Tedros, whose INB speech was released by WHO.

Sovereignty ‘nonsense’

Tedros also appealed to member states to counter the “torrent of fake news, lies, conspiracy theories and mis- and disinformation”. 

“There are those who say – whether they believe it themselves or not – that the accord will cede sovereignty to WHO; that it will give the WHO Secretariat power to impose lockdowns or vaccine mandates on countries, and other nonsense. 

“You know and we know that the agreement will give WHO no such powers.  We need your support to put this nonsense to rest.  We need your support to counter these lies, by speaking up at home and telling your citizens that this agreement will not, and cannot, cede sovereignty to WHO. Period.”

The seventh INB meeting started on Monday, will break on Friday, and then resume on 4-6 December.