“We have to be prepared for the next pandemic because we know it is going to happen.” The phrase, from one of the negotiators of the agreement on prevention, preparedness and response to pandemics, is repeated by many experts in the corridors of the Palace of Nations in Geneva, where this week the World Health Organization (WHO) celebrates its 77th assembly. This year’s call was not just another one. All eyes were on the negotiation of this agreement, which, if reached, would have made this assembly “one of the most significant in history.” “Because it will be a treaty that will save lives,” Tedros Adhanom Ghebreyesus, director of the WHO, said last week during a meeting with journalists. However, the deadline that the 194 member states of the WHO gave themselves in December 2021 to agree on an international instrument that avoids the errors committed during covid-19 ended last Friday without reaching a consolidated text that the assembly could vote on this week. .
Not everything is lost. The results, “which were very close to a successful conclusion,” according to a source close to the negotiation, were submitted to debate this Tuesday in the WHO general assembly, which must now decide the steps to follow. The majority of negotiators defend the need for the body that the States created to negotiate the pandemic agreement to continue its work and close a definitive text before the end of this year, although some Health Ministers advocate a longer period, even up to two years. “The 2024 margin is in case Donald Trump returns [como presidente de Estados Unidos, en 2025]” slips a source close to the negotiations, who believes that if the former president returns to power he could torpedo the agreement.
“We must finish this process to save humanity… It sounds very bombastic, but it is what we have come to do,” said Roland Driece, director of International Affairs of the Netherlands Ministry of Health and co-director of the Organ, last Friday. of Intergovernmental Negotiation, the WHO working group that has debated the future agreement. “We have not gotten where we wanted to be, but our mandate is going to end. No one could say that we did not pitch in,” he added with some melancholy after announcing that despite the intense work and efforts of two and a half years, there was still no consensus.
“I think it is still possible,” says one of the negotiators who attended the Palace of Nations in Geneva very early this Tuesday to “exhaust until the last minute.” Most agree that the world “has forgotten very quickly” what happened during the covid pandemic, as pointed out by Precious Matsoso, former director general of the National Department of Health of South Africa and also co-chair of the WHO body that has negotiated the agreement. She perfectly remembers how in the first negotiation sessions it was necessary to wear a mask, or do them by video call. “Maybe we should do a session with masks to remember it again,” she adds.
These are the keys to an agreement that all the experts consulted consider “crucial” to avoid future pandemics and face those that come. “Because they are going to come,” one of the negotiators warns again:
What is the objective of the agreement?
The objective is to guarantee “prevention, preparation and response” to pandemics worldwide. “It focuses on strengthening the coordination of the international response with equitable access to personal protective equipment, vaccines, therapeutic treatments and diagnostics,” explained the agency’s director general, Tedros Adhanom Ghebreyesus.
What exactly is being negotiated?
The framework and instruments to respond globally to a future pandemic and how to allow equitable access to all resources. The agreement aims to establish clear tasks and procedures to act in an emergency. “For example, negotiators hope that a consensus will be reached around the definition of the concept of pandemic emergency to make it easier and simpler for the director general [de la OMS] warn the world in times of potential pandemic,” explains a senior official from the organization.
But tangible elements are also included such as the transfer of technology and knowledge in case of emergency or the creation of “a multidisciplinary global supply of health emergency personnel” so that they can be deployed and provide support in States that request it.
Why is the agreement being negotiated?
“The reason for the treaty on pandemics was the impact of the Covid-19 pandemic,” explained this Monday the director of the WHO, who assured that “the world is still not prepared” for the arrival of a future pandemic. According to official figures, more than seven million people have died as a result of the coronavirus. However, “we know that these are underestimates, and up to 20 million people probably lost their lives,” Dr. Tedros added. According to the WHO’s annual statistics report, released last week, Covid-19 “eliminated a decade of progress in the global level of life expectancy.”
But in addition to the great loss of human life, the impact of Covid affected many more areas: the disruptions suffered by households and societies due to the destruction of employment and the repercussions on the development of countries caused by the pandemic also underlie at the origin of this pact.
Who negotiates it?
At the December 2021 extraordinary meeting of the Health Assembly – WHO’s highest decision-making body, comprising all of its 194 sovereign member countries – world leaders agreed to establish an Intergovernmental Negotiating Body representing all the regions and in which an international agreement or instrument was agreed to collectively fight future pandemics.
What is the deadline to negotiate it?
The member countries of the WHO gave themselves until the general assembly held this year, between May 27 and June 1, to reach the agreement. The general assembly must now decide whether or not to extend the time.
What state are the negotiations in?
The Intergovernmental Negotiating Body ended the deliberations last Friday without reaching a final agreement. “The vast majority of the articles have been agreed, although there are some remaining areas that need to be discussed,” explains Michael Ryan, executive director of the WHO Health Emergencies Programme. According to Ryan, there are “key areas” in which member states remain far apart. “They come down to areas around access and benefit sharing [de las tecnologías, vacunas o tratamientos], the volume of vaccine reserves, some issues related to prevention and health, and others related to financing,” explains the senior WHO official, who assures that he always saw the “will” to reach an agreement. “But the devil is in the details,” he despairs.
A draft of the agreement to which EL PAÍS has had access marks in neon green what was agreed and in yellow, the points on which there is convergence but no consensus. The sentences without underlining are those in which “convergence has not been achieved” and there is also text in square brackets for aspects with “divergent points of view”.
Green predominates in the document, but no agreement has been reached on phrases such as the shared concern “for the inequalities at the national and international level that hindered timely and equitable access to health products” related to the disease caused by the coronavirus. And there are even different points of view on the need to “adopt measures to eliminate discrimination against women in the field of health care” or on the definition of “a pathogen with pandemic potential” or “people in vulnerable situations.” .
What does “equitable access” mean?
Equity is, precisely, one of the guiding principles of the agreement in order to guarantee universal access to all the tools necessary to prevent pandemics and care for the sick, such as vaccines, protective equipment, technology, medicines or diagnostic systems.
“Technological advancement does not by itself lead to equitable access,” criticizes Michel Kazatchkine, former director of the French National AIDS Research Agency, who recommends “transformative changes in the international pandemic preparedness and response ecosystem with respect to research and development, clinical trials, manufacturing and supply of vaccines, diagnostics and therapeutic products. From his point of view, it is necessary to focus on “medical measures against pandemics as resources managed collectively for the benefit of public health.” It is what he calls “global commons,” and he believes that what has been agreed so far in the agreement does not guarantee it.
Other sources consulted share the same point of view, although they insist that “the agreement is a first step.” “It’s the floor, not the ceiling,” says Eloise Todd, executive director of the Pandemic Action Network.
Does the agreement establish specific financing?
No. According to Todd, “a combination of financing mechanisms” will be needed to ensure equitable access to vaccines, treatments or protective equipment. “There have been many promises from different countries, such as the European Union, which promised millions, but it is very difficult to know where that money is, because some of the announcements go back several years, and it is not clear whether governments will keep their promises. “, criticism.
Will the States give up sovereignty if they sign the agreement?
The two draft resolutions that the general assembly debated this Tuesday recognize that the Intergovernmental Negotiating Body “agreed that the instrument should be legally binding and contain both legally binding and non-binding elements.” However, according to Michael Reich, a Harvard public health expert, one of the tools to ensure compliance are “sanctions for non-compliance,” which, for the moment, is not included in the document.
Is there a similar treaty?
Only one, the Framework Agreement for Tobacco Control, signed in 2003. “It is true that the tobacco problem continues, but it has helped to greatly reduce consumption,” acknowledges a negotiator of the agreement on pandemics. Tedros Adhanom Ghebreyesus, in his speech on Monday, gave a nod to this pact to highlight the importance of international treaties: “Tobacco use is declining in 150 countries and there are now 19 million fewer smokers than two years ago.”
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