UN Draft Pandemic Declaration Offers ‘Little Hope’ for Strengthening Global Preparedness
Pandemic Preparedness 01/09/2023 •
United Nations Headquarters in New York.

A draft political declaration on pandemics, due to be adopted by the United Nations General Assembly later this month, offers “little hope” that the UN process will make a difference in global pandemic preparedness, global health experts said on Friday.

The document, made public on Thursday, is long on words but short on commitments. The only specific action the text commits to is to convene another high-level meeting on pandemics in 2026 – and even this is problematic.

“The three-year timeline is far, far too long,” one expert told Health Policy Watch. “A new pandemic threat could arise at any time.”

The draft declaration does not include any numbers or financing targets for global and domestic health spending to prevent and prepare for pandemics.

Earlier proposals for the UN to create an independent monitoring body to assess member state compliance with the pandemic treaty have been scrapped, and no enforcement or independent review mechanisms remain in the draft. 

The draft requests that countries commit to removing trade barriers and strengthening medical supply chains, “especially during pandemics and other health emergencies”, and to support “technology transfer hubs and intellectual property sharing mechanisms”.

“The document is mired in platitudes,” Nina Schwalbe, a public health expert and professor at the Columbia School of Public Health, wrote in the Financial Times on Friday. “The political declaration for this [UN] meeting suggests that pandemic amnesia has already set in,” 

General Assembly kicks the pandemic preparedness back to WHO

The lack of concrete commitments in the draft political declaration on pandemics may reflect a feeling within the United Nations General Assembly that the real action on pandemic preparedness lies in the hands of the World Health Organization (WHO).

The draft commits member states to providing “adequate and predictable funding” for the WHO, which struggled to keep up with the demands of the COVID-19 pandemic on its shoestring budget. It also stresses the importance of funding for the WHO Contingency Fund for Emergencies, which would allow the UN health body to respond quickly to future pandemics.

“The ball is kicked squarely back to WHO and the joint treaty and international health regulation negotiations to actually figure out how to make anything happen,” Suerie Moon, a global health expert and professor at the Graduate Institute in Geneva, told Health Policy Watch.

The draft is due to be adopted by the UN General Assembly on September 21. Global health officials are calling on member states to step up to the plate and make real commitments to pandemic preparedness.

“The UN General Assembly High-Level Meeting’s Political Declaration offers a one-time and historic opportunity to commit to lasting and transformative change to pandemic preparedness and response,” Ellen Johnson Sirleaf and Helen Clark, co-chairs of the Independent Panel for Pandemic Preparedness and former heads of state of Libera and New Zealand, respectively, wrote in an open letter to UN delegates last month. “We call on leaders and decision-makers to make this moment count.” 

In its current state, the draft declaration offers “little hope” of making a difference in the next pandemic, said Schwalbe. “History is on track to repeat itself – in the form of more pandemics which could have been avoided.”

The draft text addresses key issues, but no numbers to be found

United Nations Headquarters, New York

The vague language and lack of real commitments in the UN’s draft pandemic declaration are emblematic of the reasons for public frustration with the organization.

“The document contains almost no concrete commitments to anything transformative, is weak, and has low ambition,” another expert told Health Policy Watch. “If this is indeed the outcome, it represents a missed opportunity to make high-level commitments to better protect the world against pandemic threats.”

The draft calls for countries to spend a “sufficient” amount on domestic health spending and asks governments to “maximise efficiency” in distributing this indeterminate amount of funds. On global health spending, it calls for “solidarity” through “enhanced official development assistance and financial and technical support” for developing countries, especially in Africa and for Small Island Developing States.

The technology transfer and intellectual property rules in international public health emergencies are addressed in similarly general terms in the draft declaration. Despite the lack of new commitments by the General Assembly declaration, steps to improve technology transfer have been made since the pandemic. 

The WHO mRNA vaccine hub in Cape Town, South Africa, began operating at full capacity last year, following its announcement in 2021. The facility, which celebrated its official launch in April, aims to support mRNA technology transfer and provide equitable access to vaccines and other medicines in low- and middle-income countries.

Pharmaceutical giants, such as Moderna and Pfizer, have declined to provide the technical knowledge necessary to replicate the COVID-19 vaccines to the WHO mRNA hub. However, both Pfizer and Moderna have set up new vaccine production hubs of their own in Africa in partnership with local governments and the private sector. 

Despite its failure to commit to any specific actions, the draft text does hit most of the key points that must be addressed to prepare for the next pandemic.

“The draft is very short on concrete commitments, long on aspiration,” said Moon. “It does flag what are clearly the high political priorities of many countries in the pandemic treaty and IHR negotiations: Medicines access, publicly funded R&D, IP, local production, tech transfer, and pathogen access and benefit sharing, get a lot of air time, as does One Health and financing.”

“There’s some good language on some of these issues that could perhaps, eventually, make it into one of the binding agreements,” Moon added.

Calls for “solidarity” recall failures of COVID-19 response

Vials of Pfizer´s COVID-19 vaccine. COVID vaccines mostly reached in or around the regions they were produced, a WHO report finds.

Calls for solidarity proved to not be worth much at the height of the pandemic. In June 2020, the WHO and 30 low-income countries priced out of the vaccine supply race issued a “Solidarity Call to Action” that accompanied the launch of the UN health body’s COVID-19 Technology Access Pool (C-TAP) initiative.

The hope for C-TAP was that it would become a ‘one-stop shop’ where patent holders of COVID-19 vaccines, treatments and technologies could license their products for worldwide use. The initiative called on key pharmaceutical stakeholders to “advance the pooling of knowledge, intellectual property and data that will benefit all of humanity”.

Just two institutions – the Spanish National Research Council (CSIC) and the National Institutes of Health (NIH) – responded to the call, entering into licensing agreements for diagnostic tests.

Pfizer, BioNTech and Moderna rebuffed C-TAP when their vaccines hit the market, while rich governments with the ability to afford their vaccines elected to prioritize securing domestic supplies over global solidarity.

Earlier this week, Taiwanese vaccine manufacturer Medigen Biologics Corp. became the first private pharmaceutical company to share its vaccine technology with C-TAP.

Waiting on WHO?

Tedros addressing the opening of the 73rd WHO Africa regional meeting on Monday.

The Pandemic Accord process, launched by WHO in 2021, is scheduled to conclude in May 2024 at the World Health Assembly, the top decision-making forum of the UN health body.

Negotiations at the WHO, however, have also proven difficult. WHO Director-General Dr Tedros Adhanom Ghebreyesus warned on Monday that the slow pace of negotiations has put the pandemic accord at risk of missing the May 2024 deadline.  

“This is a unique opportunity that we must not miss to put in place a comprehensive accord that addresses all of the lessons learnt during the pandemic with a particular emphasis on equity,” Tedros said at the WHO Africa regional meeting. “As the COVID-19 pandemic laid bare, there are serious gaps in compliance and implementation which must be addressed.” 

Tedros has chafed at the power of pharmaceutical companies over the final outcome of negotiations. At a heated press briefing in July, Tedros called out “groups with vested interests” for spreading “lies” about the pandemic treaty that are “endangering the health and safety of future generations”. 

Despite the expansion of vaccine manufacturing worldwide – which now totals over 90 manufacturers – fewer than ten companies control the vast majority of global vaccine supplies, the WHO found in its vaccine market report released in May. 

“The new global architecture cannot be designed, built or managed by those with the most power, money and influence,” Tedros said on Monday. 

Whether the companies and governments with the power, money and influence to make that determination will choose to play ball remains an open question. 

Image Credits: UN, United States Mission Geneva, UN Photo/Manuel Elias, Photo by Mat Napo on Unsplash.

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