Geneva — As countries recently gathered in Geneva for the fourth round of negotiations on the WHO proposed pandemic treaty or accord, close examination of the current text by civil society experts has revealed significant gaps.
Critical concerns about the underlying vision of the draft text have been highlighted in a public statement led and endorsed by civil society organizations globally. The statement has been shared with the Intergovernmental Negotiating Body (INB4) that is mandated with the pandemic treaty negotiation.
These concerns still stand true. And it is urgent that the INB begins to tackle them before the next round of negotiations are upon us.
First and foremost, our analysis focuses on the fact that several parts of the text rely on voluntary arrangements, and that the binding regime of the text appears discouragingly vague and weak. One such instance relates to the principle of “common but differentiated responsibilities in pandemic prevention, preparedness and response,” which the draft borrows from the climate instruments.
This notion is extremely important to avoid pandemics, and it cannot be made voluntary, if the world is serious about the goal of reaching systemic capacity to respond to future health crises.
The draft text’s failure to provide safeguards or an accountability framework regarding the role of the corporate sector is another major source of concern. The WHO negotiation places the new UN’s ‘whole of society’ approach – which has been pushed in other negotiating fora – at its core through multistakeholderism, against the backdrop of striking and unfettered geopolitical power asymmetries. The involvement of the private sector in the COVID-19 response has been extremely problematic.
Countries desperately needing a concerted effort to tackle the pandemic were held ransom to the whims of power and profits of both the philanthropic and pharmaceutical industry.
The proposed treaty or accord mustn’t make the same mistakes, and all attempts to bring the corporate sector into the negotiation of any pandemic prevention, preparedness, or response must be strictly regulated at best, and prevented whenever there is a risk of public interest health policies being hijacked for profit.
It is clear that the financing approach outlined in the draft text blatantly ignores that the global financial system has historically prevented low- and middle-income countries from investing in public health.
Tax dodging by corporations, lack of fiscal and policy space for domestic resource mobilization, and crippling national debts are major barriers that prevent many countries from strengthening their public health services and institutions.
In low-income countries, debt has increased from 58% to 65% between 2019 and 2021. Thirty nations in sub-Saharan Africa have seen a debt-to-GDP ratio exceeding 50% just in 2021.
While the current draft misses taking into account the challenges of the global financial architecture, there is a blind spot with no substantive acknowledgement that public health crises are often engendered or exacerbated by a systematic destruction of the planet, at the intersection of the climate and environmental crises, food insecurity, and the mounting inequality crisis enshrined in gender and racial discrimination.
So far, the draft text hardly does justice to the urgency of preventing pathogen spillover at the animal-human interface. A narrow focus on the biomedical approach to dealing with future pandemics, without considering these intrinsic systemic factors, is bound to remain largely insufficient in dealing with any future pandemics.
Governments and various relevant socio-political actors engaged in the WHO diplomatic initiative on the pandemic treaty or accord have different and diverging interests and the Intergovernmental Negotiating Body (INB), which has done impressive work to keep pace with the agreed negotiations’ roadmap, has to reckon with these diverse political demands and conflicting pressures.
However, it is clear that to carry out the original intent of the new pandemic treaty or accord, unambiguous wording is needed that conveys a binding character of the agreement. This also means that the multistakeholder model under which the entire process of the treaty is being managed has to be re-examined and re-imagined instead of its current ‘whole of society’ form.
In future, none of the promises made by member states in the WHO pandemic treaty or accord will result in the desired change needed if the robust and reliable compliance mechanisms that enable governments to be held accountable are absent.
These demands are not unique to this treaty, but have similarly been made by civil society in ongoing negotiations in the UN on climate change and in the UN treaty on business and human rights. These were also incorporated into the tobacco control binding policy that the WHO established nearly 20 years ago.
At the same time, public health, public governance, public systems, and public funding must be at the center of the pandemic planning, prevention, and response. It is important to finally recognise that the global financial architecture must be overhauled, especially for low income and developing countries to have sovereign control over their fiscal and policy space, and to resource their public health needs through progressive taxation policies.
It is imperative to understand that the private sector cannot fulfill the current funding gaps and needs no leveraging by international development and financial institutions. Healthcare privatization is not the way to go to face the health challenges of the present and the future.
Lastly, all efforts must be made to make sure that the text creates a deliberate interconnection between the right to health and the right to a healthy environment, now explicitly adopted as a human right by the United Nations, as well as the rights of nature to exist and thrive.
It is about time that this global public health discourse reckons with the reality of populations and the environments from the ground, rather than from the ivory towers of corporate investors and vested policy-making.
Ashka Naik is the Director of Research and Policy at Corporate Accountability, and directs its food program, which focuses on structural determinants of food systems, nutrition, and public health
Nicoletta Dentico leads the Global Health Justice program at Society for International Development and co-chairs the Geneva Global Health Hub (G2H2)
IPS UN Bureau