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After more than two years of discussion and negotiations, the representatives for 194 nations failed
to finalize a draft of the Pandemic Agreement, an international accord meant to fix the weaknesses
and global inequities in pandemic preparedness that COVID-19 revealed.
The chairs of the World Health Organization's Intergovernmental Negotiation Body (WHO INB), which
convened the deliberations, conceded on May 24 that negotiators would be unable to deliver a draft
accord in time for the seventy-seventh World Health Assembly (WHA), which begins on May 27 and
would have been responsible for approving the treaty.
"Every one of you tried to make this work," Precious Matsoso, INB co-chair, said at the final session.
"Everyone was given a huge opportunity to make a difference in people's lives. That's something that
none of us can take for granted."
After missing its initial deadline to finalize the pandemic agreement on May 10, the WHO INB carried
negotiations into this week in a race against the clock.
Those who followed the process have been largely underwhelmed by the negotiated drafts of the accord
relative to its initial ambitions, and the divisive nature of the talks leave questions about what legally
binding terms for international cooperation on pandemic preparedness are achievable in the
future.
Several domestic political battles had already emerged well before a decision could be made.
In countries including the United States and the United Kingdom (UK), far-right antipathy for international
legal agreements and their purported threat to national sovereignty have rendered ratification of the
agreement politically divisive. In the United States, all 49 Senate Republicans signed a letter to
President Joe Biden demanding that his administration "withdraw support" for the pandemic
agreement and IHR amendment at the World Health Assembly given that they "constitute intolerable
infringements upon U.S. sovereignty"—"shredding intellectual property rights" and "free speech." They
warned that they would consider the two international agreements to be "a treaty requiring the
concurrence of two-thirds of the Senate under Article II Section 2 of the Constitution."
Misinformation on social media about the agreement has also bred increasing public resistance
against it.
The Accord's Inception
The road formally began in December 2021 when the WHA held its second-ever special session to initiate
the process for a "WHO convention, agreement, or other international instrument on pandemic
prevention, preparedness and response," establishing the INB as its formal negotiating body. After the
catastrophic loss of life and absence of international coordination seen during the COVID-19 pandemic,
the agreement's aims, according to WHO Director-General Tedros Adhanom Ghebreyesus, would be to
ensure more equitable access to medical countermeasures, safeguard health systems through improved
sharing of information about emerging pathogens, and enhance cooperation between member states on
confronting health crises.
If ever adopted by the WHA, the pandemic agreement would become only the third legally binding health
accord that WHO member states have successfully negotiated, joining the International Health
Regulations (IHR), first adopted in 1969, and the Framework Convention on Tobacco Control, adopted in
2005.
The IHR, which defines "countries' rights and obligations in handling public health events and
emergencies that have the potential to cross borders," including the mandate to report such events, was
largely observed to be both insufficient and ignored during the COVID-19 response. Complementing their
call for a new pandemic instrument, WHO member states also launched a parallel negotiating process in
2022 to amend the IHR to strengthen its implementation and compliance. That negotiation has reportedly
made more progress but whether the WHA will approve IHR revisions next week or wait to do in tandem
with the pandemic accord is still uncertain.
"Let's take the Assembly as an opportunity to reenergize, to be inspired, and to have even more
commitment and prepare us to address the problems to get us where we need to be," Adhanom
Ghebreyesus told Friday's INB session. "Inshallah, we will conquer this."
Watered Down by Negotiations
Although the WHA's decision to establish the INB was based on broad recognition that countries were not
adequately or equitably prepared for COVID-19, two and a half years of unrelenting divisions
between member states over the policy's details produced an agreement criticized by many as
largely watered down from its initial intent.
Long-standing disputes between high- and middle- to low-income countries over issues of intellectual
property protection and resource-sharing persisted throughout the nine INB negotiating sessions and
saw little compromise. The sessions were underpinned by a lack of trust on both ends from
unsuccessful past international negotiations to the historical trauma of COVID-19 vaccine distribution and
legacies of colonialism.
COVID-19 was a catastrophe and, throughout history, humanity’s responses to catastrophes have been a
nearly unbroken series of abject failures. And now, as avian influenza spreads through dairy cattle
herds in multiple states, many healthcare leaders say they would not be ready if it spreads widely
among humans.
Meanwhile, the Centers for Disease Control is being hamstrung by state agriculture departments
and dairy farmers, as it struggles to track the virus. Politico describes this gap as “emblematic of the
trust gap between key agriculture players in both red and blue states and federal health officials.”
This version of the avian flu virus, H5N1, probably won’t spread among humans, but it might. But some
day, perhaps soon, some virulent virus will hit us as hard as the coronavirus did, or even harder.
And we won’t be prepared. The whole government, federal, state and local, remains at a high-risk
to botch the next crisis.
It’s hard to understand how we got here. In the four years since the start of the pandemic, there has never
been a proper accounting of what actually happened and why.
How could we have gotten here?
That our COVID-19 response was a failure seems a foregone conclusion. Excess deaths, for instance,
were up to 83% worse in the US than in Western Europe through the end of 2021. Contrary to
conventional wisdom, though, the causes of our failure were not political.
Although it’s true that containment failed, the differences between the choices made by most Republican
and Democratic governors have been greatly exaggerated. It is also true that federal crisis management
collapsed and that this occurred during the Trump administration, but systemic problems existed long
before 2020 and continue to exist today.
Where does the world currently stand in terms of achieving pandemic preparedness?
Yanzhong Huang: There have been important strides. There’s the pandemic preparedness treaty
currently in the works, the building of a pandemic intelligence hub in Berlin, a new pandemic fund at the
World Bank, and the 100 Days Mission to come up with a vaccine within 100 days of discovering a novel
pathogen.
But at the same time, international society seems to have become even less cooperative than
before the COVID-19 pandemic, in preparing for the next one.
Why is that?
Yanzhong Huang: With the acute phase of COVID-19 over, psychologically people just want to end this
traumatic chapter.
And in the meantime, we have all the other things that need to be prioritized: The crisis in Ukraine,
inflation, recession, climate issues, and now, of course, the conflict the Middle East. All of this
makes talking about preparing for next pandemic so unpopular—even though we are desperately
not ready for the next pandemic. We could repeat the same experience we had with COVID-19.
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