“It’s now or never,” World Health Organization (WHO) Director General Dr Tedros Adhanom Ghebreyussus told the start of the 13th round of talks on a pandemic agreement on Monday morning.

Five days of talks are scheduled this week with another five days scheduled in April. Thereafter, the plan is for an agreement to be presented at the World Health Assembly in May.

Those close to the process said that the “stock take” this Friday will be an important gauge of whether the talks will succeed.

Negotiators’ failure to reach agreement may mean the end of the road for the global endeavour to pandemic-proof the world. Energy and interest in the talks have waned considerably over the four-plus years of talks.

“I’m confident that you will choose ‘now’, because you know what is at stake. You remember the hard-won lessons of COVID-19, which left an estimated 20 million of our brothers and sisters dead,” said Tedros.

“We know that the next pandemic is a matter of when, not if. There are reminders all around us – Ebola, Marburg, measles, mpox, influenza and the threat of the next Disease X,” he added.

“No country can protect itself by itself. Bilateral agreements will only get you so far. Prevention is the responsibility of all countries. Preparedness is the responsibility of all countries, and response is the responsibility of all countries.” 

The US, although still technically part of the WHO until next January, informed the WHO last Friday (14th) that it would not take part in the Intergovernmental Negotiating Body (INB) overseeing the talks.

Trump’s executive order withdrawing the US from WHO explicitly states that “while the withdrawal is in process, the US will cease negotiations on the WHO Pandemic Agreement and the amendments to the International Health Regulations [IHR], and actions taken to effectuate such agreement and amendments will have no binding force on the United States.” 

“Like the [US] decision to withdraw from WHO, we regret this decision and we hope the US will reconsider,” Tedros told the INB.

Moving away from grandstanding?

INB co-chair Precious Matsoso told the meeting that the Bureau, which co-ordinates the talks, had taken heed of countries’ request to “propose text for all the outstanding work”.

“We did just that, and we’re hoping that, with what we’ve presented before you, to be able to move as fast as possible because we’ve got only 10 [negotiating] days left before we present the pandemic agreement to the World Health Assembly,” said Matsoso.

The latest draft of the pandemic agreement reflects that pathogen access and benefits sharing (PABS) and One Health remain sticking points. 

Matsoso also urged member states at the opening to confine their comments to the text at hand rather than making general comments – and for the first time, the open session was not dominated by repetitive grandstanding. 

With only Iran using the opening to make a general point, member states’ restraint is a positive indication that countries may finally be moving away from rigidly held positions.

Equity and solidarity

Stakeholders, who are not allowed into the negotiations, used their time slots during the open session to appeal for the deal to be struck, for equity to remain a cornerstone and to advocate for technology transfer to prepare for pandemics.

“Do not walk away from this vital mission,” urged the Pandemic Action Network’s Rafael Garcia Aceves.

“Bank and build on the promising consensus agreed thus far. Continue to advance a pandemic agreement that can lay the essential groundwork for equitable collective preparedness and response in 2025, which can be made stronger and more detail added in future through protocols.”

Ellen ‘t Hoen of Medicines Law and Policy said that “more than ever, the world needs a signal that multilateralism works, that solidarity is at the core of the pandemic agreement and that no country will be left alone to deal with pandemics, either current or future ones”.

“That is not the predominant spirit in Geneva – or the world for that matter – at the moment, but you can bring it back.”

Spark Street senior researcher Elliot Hannon warned that “the world has changed immeasurably” since the last negotiating session in December before US President Donald Trump took over.

“The global multilateral system is under siege, threatening the very institutions developed to promote and protect health around the world,” said Hannon.

“The pandemic agreement is a concrete action against this great dismantling. Its completion would not only make the world safer but affirm the commitment to equity, integrity and solidarity,” said Hannon, adding that trying to perfect every aspect of the agreement was an unaffordable luxury.

The South Centre stated that, “without legal commitments to enhance sharing of technology and know how, and surge financing, it will not be possible to ensure timely global production of and equitable access to effective vaccines during pandemics, as during COVID-19.

The South Centre said that a “democratic vote” was the way forward to settle “divergencies” rather than “continuously” watering down the text down “to find consensus”, deferring  decisions “to uncertain future negotiations or decisions by the Conference of the Parties”.

Knowledge Ecology International’s Jamie Love pointed out that the agreement’s definition of “technology transfer” was weaker than that permitted by US and European law, while, Oxfam’s Mogha Kamal-Yanni called for the agreement to contain “legal obligations” to share technology and remove intellectual property barriers.

This round of talks ends on Friday evening.