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How countries are wasting their best chance to prevent the next pandemic – POLITICO

This is a legally binding agreement that could prevent the next pandemic.

Originally proposed by European Council President Charles Michel in the worst days of the COVID-19 pandemic, the aim is to create a new set of rules to guide countries in preparing for and responding to the pandemic.

But with countries fiercely divided on key issues and just 12 months left to agree, it looks increasingly likely that the text will end up like a wet squib.

As the who’s who of global health descends on Geneva in the coming days for the World Health Assembly – the annual meeting of the decision-making body of the World Health Organization – the fate of the treaty will be the main topic discussion around glasses of champagne during chic receptions.

The draft text was ambitious, covering everything from access to vaccines to strengthening health systems so they can respond to health crises.

But with countries grappling with intellectual property rights and rules for sharing medical products developed during a pandemic, compromise with any substance seems increasingly difficult to achieve.

“If the bands can give up a bit and try to compromise, I think in the middle there might be something left for us…we might have something useful for the future,” said said a Geneva-based diplomat, who requested anonymity. talk about confidential negotiations. However, they added that the “fallback position could be a treatise with a little content – ​​just a little”.

And then there is the overriding question: how to make sure that countries actually respect what has been agreed. “A treaty without a compliance mechanism is just a piece of paper,” warned Nina Schwalbe, founder of public health think tank Spark Street Advisers and former senior official at UNICEF and Gavi, the Alliance of the vaccine.

POLITICO walks you through the main sticking points:

Face-to-face with Big Pharma

The draft text contains two highly controversial proposals. One calls on countries to take action to support time-limited waivers of intellectual property rights so that companies other than patent holders can manufacture vaccines or treatments – an issue countries have never had really managed to solve during the COVID-19 pandemic. The second is to ensure that countries that share information about dangerous pathogens can access any resulting treatments and vaccines developed using that data.

Developing countries see them as essential to ensuring fairness in the next pandemic. But the two are fiercely opposed by Big Pharma, which has the backing of some wealthy Western nations.

On intellectual property rights, the US took a big red pen to the draft text, deleting mention of intellectual property rights waivers. He also wants to weaken provisions that would force drug companies to allow other manufacturers to make their products.

US wants to weaken provisions that would force pharmaceutical companies to allow other manufacturers to produce their products | Thibaud Moritz/AFP via Getty Images

For the debate over whether sharing information about new pathogens should be tied to some sort of benefit – potentially monetary – the line is less clear. The Global South, which is pushing to include the benefits nexus, has the greatest demand, said a second Geneva-based diplomat who also requested anonymity to speak about confidential negotiations. But a definite no from the North could cause them to lose timely access to these pathogens, which could delay the development of vaccines or pathogen-specific treatments and cost lives.

Too many cooks, too little time

When WHO members agreed in December 2021 to negotiate a pandemic treaty by May 2024, the deadline seemed far off. But a lot of time was wasted early in the process on procedural issues, the top diplomat said. The delay was likely “strategic at some point for some groups as well,” they said, without specifying who they were referring to.

There is no denying that the text tries to cover a lot of ground, much of which is highly controversial. Given this, the May 2024 deadline is “extremely challenging”, the second diplomat said. What may be needed is some kind of rationalization. “It’s not about reducing ambition, but maybe reducing the level of detail,” they said.

Ambassador Nora Kronig, head of the international affairs division of the Swiss Federal Office of Public Health, told POLITICO that there were still uncertainties about the scope and content of the treaty. “There’s still a lot of work ahead of us to make it tangible, realistic and achievable,” she said.

“Just a piece of paper”

Perhaps the biggest question is how the treaty will actually be enforced.

“There hasn’t been a lot of discussion about it because it touches on the difficult issue of sovereignty and having an international organization or other countries, [having] a look at what you do, [and] on how you prepare,” the second diplomat said.

In a draft text, countries such as China, Russia, Iran, Namibia and Egypt express strong reservations about monitoring mechanisms such as a peer review process, where countries would regular reviews of everyone’s pandemic preparedness. Meanwhile, the EU, Canada and Switzerland have tabled proposals for stronger language on tracking a country’s preparedness for a health crisis.

Some countries fear a shaming and shaming process, but it doesn’t matter how well prepared one country is if another isn’t, the first diplomat said. “I think we should be accountable to each other, and we should be transparent, and we should do our best to allocate resources and also to make the changes necessary to improve ourselves, and also to help others improve. ‘improve,’ they said.

Some observers want to go even further. Schwalbe would like to see a committee of independent people report on the treaty. “Whatever is in it, we have to hold states accountable to what they have agreed to,” she said.

Ultimately, the outcome will be “the fruit of international negotiations”, the second diplomat said. “Of course it will be the [lowest] common denominator.”

But their view is that if it binds countries on something new, it’s worth something. “We could see everything these countries agree on [as] progress, even if watered down and incremental or iterative,” they said.

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