Countries fail to reach agreement on treaty to prepare world for next pandemic

Countries around the world have failed to reach consensus on the terms of a treaty that would unite the world in a strategy against the inevitable next pandemic, overcoming the nationalist ethos that emerged during Covid-19.

The deliberations, which were expected to form a central point of the weekly meeting of the World Health Assembly starting Monday in Geneva, aimed to correct inequalities in access to vaccines and treatments between richer and poorer nations that have become evident during the Covid pandemic. .

While much of the urgency around Covid has disappeared since treaty negotiations began two years ago, public health experts are still keenly aware of the pandemic potential of emerging pathogens, familiar threats such as avian influenza and disease, and once eradicated diseases such as smallpox.

“Those of us in public health recognize that another pandemic may indeed be around the corner,” said Loyce Pace, assistant secretary at the Department of Health and Human Services, who is overseeing the negotiations in her role as connection of the United States to the world. Healthcare Organization.

Negotiators hoped to adopt the treaty next week. But canceled meetings and conflicting debates – sometimes over a single word – have stalled agreement on key aspects, including equitable access to vaccines.

The negotiating body plans to ask for more time to continue discussions.

“I am still optimistic,” said Dr. Jean Kaseya, director general of the Africa Centers for Disease Control and Prevention. “I think the continent wants this agreement. I think the world wants this agreement.”

Once adopted, the treaty would set legally binding policies for WHO member countries, including the United States, on pathogen surveillance, rapid data sharing on outbreaks, and local production and supply chains of vaccines and treatments, among others.

Contrary to the rhetoric of some politicians in the United States and Britain, this would not allow the WHO to dictate national policies on masking, or to use armed troops to enforce lockdowns and vaccination requirements.

Next week's deadline was self-imposed, and some public health experts said it was too ambitious — most treaties take many years — for such a complex undertaking. But negotiators were rushing to ratify the treaty ahead of elections in the United States and several European countries.

“Donald Trump is in the room,” said Lawrence Gostin, director of the WHO Center on Global Health Law, who helped draft and negotiate the treaty.

“If Trump gets elected, he will probably torpedo the negotiations and even withdraw from the WHO,” Gostin said.

During his time as president, Trump severed ties with the WHO and recently signaled that, if re-elected, he could close the White House's pandemic preparedness office.

Among the biggest points of contention in the draft treaty is a section called Pathogen Access and Benefit Sharing, under which countries would be required to rapidly share genetic sequences and samples of emerging pathogens. This information is critical for the rapid development of diagnostic tests, vaccines and treatments.

Low-income nations, including those in Africa, want to be rewarded for information with rapid and equitable access to developed tests, vaccines and treatments. They also asked pharmaceutical manufacturers to share information that would enable local companies to produce the products at low cost.

“We don't want to see Western countries coming and harvesting pathogens, working with pathogens, producing medicines, producing vaccines, without returning these benefits to us,” Dr. Kaseya said.

Member countries have only ever agreed on one other health treaty, the 2003 Framework Convention on Tobacco Control, which strengthened control of the tobacco industry and reduced smoking rates in participating countries. But they have been shaken by the devastation of the Covid pandemic and the inequalities it has entrenched to embark on a second.

Countries are also working to strengthen the WHO's International Health Regulations, which were last revised in 2005 and set out detailed rules that countries must follow in the event of an epidemic that could cross borders.

In May 2021, an independent review of the global response to Covid-19 “found weak links at every point in the preparedness and response chain”.

The pandemic has also deepened mistrust between richer and poorer nations. By the end of 2021, more than 90% of people in some high-income countries had received two doses of Covid vaccines, compared to less than 2% in low-income countries. Lack of access to vaccines is believed to have caused more than a million deaths in low-income countries.

The treaty would be a kind of recognition that an epidemic anywhere threatens the entire globe and that providing vaccines and other resources is a win-win for everyone. Coronavirus variants that emerged in countries with large unvaccinated populations have rapidly spread across the world.

“Nearly half of deaths in the United States are due to variants, so it is in everyone's interest to reach a strong agreement,” said Peter Maybarduk, who directs the Public Citizens' Access to Medicines Program.

In December 2021, the WHO established a negotiating team to develop a legally binding treaty that would allow each country to prevent, detect and control epidemics and enable equitable allocation of vaccines and medicines.

More than two years after the negotiations began, negotiators have found agreement, at least in principle, on some sections of the draft.

But much of the goodwill generated during Covid has evaporated and national interests have returned to the fore. Countries such as Switzerland and the United States have been reluctant to accept terms that could affect the pharmaceutical industry; others, like Argentina, have fought against strict regulations on meat exports.

“It's clear that people have very short memories,” said Dr Sharon Lewin, director of the Cumming Global Center for Pandemic Therapeutics in Melbourne.

“But it can happen again, and it can happen with a pathogen that is much more complicated to deal with than Covid,” he warned.

A proposal for the pathogen access and benefit sharing section would require manufacturers to set aside 10% of vaccines to donate and another 10% to provide at cost to the WHO for distribution to low-lying nations. income.

But the idea proved too complicated, said Roland Driece, one of the leaders of the negotiations. “We discovered along the way that it was too ambitious in terms of time.”

Instead, a working group established by the World Health Assembly will be tasked with finalizing the details of that section by May 2026, Driece said.

The terms of the proposed agreement have generated some confusion. In Britain, Nigel Farage, a conservative TV host and populist politician, and some other conservative politicians have said the WHO would force richer countries to give away 20% of their vaccines.

But that's a misreading of the proposed agreement, Driece said. “It's not the countries that have to invent those vaccines, it's the companies,” she said. Pharmaceutical companies would commit to joining the system in exchange for guaranteed access to the data and samples needed to make their products.

Britain will not sign the treaty unless “it is firmly in the UK's national interest and respects national sovereignty,” a spokesperson for the country's health department told Reuters earlier this month.

In the United States, Republican senators have called on the Biden administration to reject the treaty because it would “potentially weaken the sovereignty of the United States.”

Dr Tedros Adhanom Ghebreyesus, director general of the WHO, sharply criticized what he called “the litany of lies and conspiracy theories”, stressing that the organization does not have the authority to dictate national public health policies, nor seek such power.

The secrecy surrounding the negotiations has made it difficult to counter misinformation, said James Love, director of Knowledge Ecology International, one of the few nonprofits with a window into the negotiations.

Having more people allowed to participate in discussion rooms or see drafts as they evolve would help clarify complicated aspects of the treaty, Love said.

“Also, the public might relax a little if they read the actual agreement regularly,” he said.

Some proposals in the draft treaty would require massive investments, another sticking point in the negotiations.

To monitor emerging pathogens, wealthier nations support the so-called One Health strategy, which recognizes the interconnections between people, animals, plants and their shared environment. They want low-income countries to regulate live animal markets and limit trade in animal products — a major economic blow to some nations.

Last month, the Biden administration released its Global Health Security Strategy, focusing on bilateral partnerships aimed at helping 50 countries strengthen their pandemic response systems. The administration hopes to expand the list to 100 countries by the end of the year.

American support would help countries, most of which are in Asia and Africa, strengthen their One Health systems and better manage epidemics.

The US strategy is intended to be complementary to the global treaty and cannot serve as an alternative, public health experts said.

“In my view, this is the most important moment in global health since the WHO was founded in 1948,” Gostin said. “It would simply be an unforgivable tragedy if we let this slip away after all the suffering of Covid.”

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