- The World Health Organization (WHO) last week published a draft of the first legally binding treaty.
- It is intended to ensure that vaccines, drugs and diagnostics are shared more equitably around the world during the next pandemic.
- Researchers say that the document is an ambitious effort to address searing inequities that occurred during the pandemic.
“It has more heart and brain than I expected,” says Kelley Lee, scientific co-director at the Pacific Institute on Pathogens, Pandemics and Society in Burnaby, Canada. “But it still has insufficient teeth and an insufficient spine to ensure that we’ll definitely have a better response next time.”
Huge Potential
The treaty has the potential to “make a tremendous difference for the next pandemic”, says Suerie Moon, a researcher who studies global health policy at the Geneva Graduate Institute in Switzerland. “This is a once-in-a-generation chance to fix some of the big weaknesses that we saw during COVID-19.” These failures included the huge gulf in access to vaccines. Compared with high-income countries, where some 73% of people have received at least one dose of a COVID-19 vaccine, only 31% of people in low-income countries have had one or more doses.
WHO member states will now begin debating the terms of the document — known as the zero draft — at a series of meetings, the first of which will begin later this month. Researchers expect the negotiations to be contentious, and some of the language is likely to be watered down before the agreement is adopted in 2024.
Bold Proposal
A key focus of the zero draft is equity. Articles in the treaty include establishing a global network for the supply and distribution of ingredients used to produce drugs; strengthening research and the development of vaccines and therapeutics; and sharing that knowledge with the world. The draft calls on parties to support temporary waivers on intellectual property (IP) rights to allow for the rapid manufacture of vaccines, medical equipment, masks, diagnostics and drugs when a pandemic hits.
The draft also seeks to “strike a grand bargain” in sharing data, says Moon. Rich states want countries to rapidly share data on pathogens and genomes, and low-income states want affordable access to the products created with the aid of that biological information, says Moon. The draft requires signatories to supply pathogens to a laboratory in the WHO’s network within hours of a new pathogen with pandemic potential being identified, and to upload genomic sequences to public repositories. In return, states will supply the WHO with 20% of the vaccines, diagnostics and drugs they produce — half as donations, and half at an affordable cost.
Weak Rules
But researchers are concerned that even if countries do sign up, the treaty in its current form is too weak to stop signatories from ignoring the rules when the next pandemic strikes. The document is intended to be legally binding, but in some key instances, the text avoids strong language, such as ‘shall’ and ‘must’, instead using fuzzier terms such as ‘encourage’ and ‘promote’, say researchers. “It’s still quite heavily reliant on voluntary compliance,” says Lee.
Negotiations around how to ensure compliance have been pushed back, to be addressed after the treaty comes into force, which is problematic, says Layth Hanbali, a health-policy analyst at Spark Street Advisors who is based in Ramallah, in the occupied Palestinian territories. “None of the promises that states will make in the treaty document itself will have any meaning, any effect, unless there is a robust mechanism in place for holding states accountable.”
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Source: Nature
