Countries around the world are arguing over the terms of a treaty that would unite the world to confront the inevitable next pandemic and transcend the nationalist spirit that emerged during the coronavirus pandemic.
These discussions will form part of a week-long World Health Assembly The summit, which begins on Monday in Geneva, aims to correct inequalities in access to vaccines and treatments between rich and poor countries that have become starkly apparent during the coronavirus pandemic.
While the sense of urgency about the coronavirus pandemic has faded since treaty negotiations began two years ago, public health experts remain acutely aware of emerging pathogens, common threats such as avian influenza and swine fever, and Once conquered Diseases such as smallpox.
“We in public health recognize that another pandemic could really be on the horizon,” said Loyce Pace, assistant secretary of the U.S. Department of Health and Human Services, who oversaw the negotiations as the U.S. liaison to the World Health Organization.
Negotiators had hoped to adopt the treaty next week. But canceled meetings and fierce arguments, sometimes over a single word, have stalled agreement on key parts, including equitable access to vaccines.
People familiar with the negotiations said that given the tight timeline, representatives from various countries are likely to finalize the overall principles and work out the specific details after meeting next week.
“I remain optimistic. I think the continent wants to make this deal. I think the world wants to make this deal,” said Dr. Jean Kaseya, director of the Africa Centres for Disease Control and Prevention.
Once adopted, the treaty would establish legally binding policies for WHO member states, including the United States, covering pathogen surveillance, rapid sharing of outbreak data and local production and supply chains for vaccines and treatments.
Next week’s deadline was set by the European Union itself and some public health experts say it is too ambitious for such a complex task – most treaties take many years to complete. But negotiators are working to ratify the treaty before elections in the United States and several European countries.
“Donald Trump was in the room,” said Lawrence Gostin, director of the WHO’s Center for Global Health Law, which helped draft and negotiate the treaty.
He added: “If you postpone the negotiations and he gets elected, then he will undermine the whole process and there will be no treaty.”
During his presidency, Trump Cut ties with WHOwho recently said that if re-elected he would May be closed White House Office of Epidemic Preparedness.
One of the biggest points of contention in the draft treaty is the section on “Access to Pathogens and Benefit Sharing,” which would require countries to quickly share genetic sequences and samples of emerging pathogens. Such information is critical for the rapid development of diagnostic tests, vaccines and treatments.
Low-income countries, including those in Africa, want compensation for information and quick, equitable access to developed tests, vaccines and treatments. They also want drugmakers to share information so local companies can produce the products at low cost.
“We don’t want to see Western countries come and collect pathogens, take them away, make medicines, make vaccines and then not give those benefits back to us,” Dr. Cassia said.
Member states have agreed to only one other health treaty, the 2003 Framework Convention on Tobacco Controlwhich strengthened controls on the tobacco industry and reduced smoking rates in participating countries. But they were alarmed by the devastation caused by the coronavirus pandemic and the inequality it has exacerbated, so they decided to start a second round of negotiations.
Countries are also working to strengthen the WHO’s International Health Regulations, which were last revised in 2005 and set out detailed rules for countries to follow when an epidemic threatens to cross borders.
May 2021 Independent Review In the global response to the COVID-19 pandemic, “weak links have been identified at every link in the preparedness and response chain.”
The pandemic has also deepened distrust between rich and poor countries. By the end of 2021, More than 90% While 70% of people in some high-income countries have received two doses of a COVID-19 vaccine, the figure is less than 2% in low-income countries, where a lack of vaccination is believed to have contributed to more than a million deaths.
The treaty is a recognition, in part, that an outbreak anywhere threatens the entire planet and that providing vaccines and other resources is good for everyone. Coronavirus variants that emerged in countries with large unvaccinated populations have quickly swept the world.
“Nearly half of all deaths in the United States are caused by virus mutations, so it’s in everyone’s interest to have a strong agreement,” said Peter Mebadouk, director of the Citizens Access to Medicines Project.
In December 2021, the World Health Organization was established A group of negotiators Develop a legally binding treaty that enables every country to prevent, detect and control epidemics and to equitably distribute vaccines and medicines.
After more than two years of negotiations, negotiators have agreed, at least in principle, on some parts of the draft.
But much of the goodwill generated during the pandemic has evaporated, and national interests have once again become paramount. Countries such as Switzerland and the United States have been reluctant to accept terms that could affect the pharmaceutical industry; others, such as Argentina, have opposed strict controls on meat exports.
“It’s clear that people have very short memories,” said Dr. Sharon Levine, director of the Cumming Centre for the Treatment of Global Pandemics in Melbourne.
“But it could happen again, and it could happen with a pathogen that is more difficult to deal with than COVID-19,” she warned.
One proposal under the “Pathogen Access and Benefit Sharing” section would require manufacturers to set aside 10% of vaccines for donation and provide another 10% to WHO at cost for distribution to low-income countries.
But Roland Dries, one of the leaders of the negotiations, said the idea had proved too complex. “We discovered along the way that the time frame was too ambitious.”
Mr Dries said a working group set up by the World Health Assembly would be tasked with working out the details of that section by May 2026.
The terms of the proposed deal have caused some confusion. In the UK, conservative broadcaster and populist politician Nigel Farage and some other conservative politicians have claimed that the WHO will force richer countries to provide 20% of vaccines for free.
But Dries said that was a wrong reading of the proposed agreement. “The responsibility for producing vaccines does not lie with countries, it lies with companies,” he said. Pharmaceutical companies would commit to joining the system in exchange for guarantees of the data and samples they need to produce their products.
A Department of Health spokesman said the UK would not sign the treaty unless “it is in the UK national interest and respects national sovereignty”. told Reuters Earlier this month.
In the United States, Republican senators have called on the Biden administration to reject the treaty because it would “It could undermine U.S. sovereignty.”
WHO Director-General Dr. Tedros Adhanom Ghebreyesus harshly criticized what he called a “cascade of lies and conspiracy theories,” noting that the organization did not have the power to dictate national public health policy and did not seek that power.
The secrecy of the negotiations makes it difficult to counter misinformation, said James Love, director of Knowledge Ecology International, one of the few nonprofits with access to the talks.
Mr. Love said allowing more people into discussion rooms or viewing the draft as it evolves would help clarify complex aspects of the treaty.
“Also, if the public actually read the actual agreement on a regular basis, they could relax a little bit,” he said.
Some proposals in the draft treaty require significant investments, another sticking point in the negotiations.
To monitor emerging pathogens, wealthy nations support so-called “One Health” strategies that recognize the interconnectedness of humans, animals, plants and their shared environment. They want low-income countries to regulate live animal markets and restrict trade in animal products — a huge economic blow to some countries.
Last month, the Biden administration released its own Global Health Security StrategyFocus Bilateral partnership The goal is to help 50 countries strengthen their epidemic response systems. The US government hopes to expand the list to 100 countries by the end of this year.
U.S. support will help these countries, primarily in Asia and Africa, strengthen their One Health systems and better manage the pandemic.
Public health experts say the U.S. strategy is intended to complement global treaties, not replace them.
“I believe this is the most important moment in global health since the founding of WHO in 1948,” Mr Gostin said. “It would be an unforgivable tragedy if, after all the suffering we have experienced with COVID-19, we let this moment slip away.”
