It has taken two years to develop a pandemic treaty to avoid the mistakes of COVID. Why can’t countries agree?

After more than two years of working to prevent some of the problems seen during the COVID-19 pandemic, countries have given themselves another year to finalize the final details of a pandemic treaty.

In the weeks leading up to a missed May deadline, diplomats working on the negotiations told Euronews Health they sometimes argued over a paragraph of text for three or four hours with late nights and intense discussions to meet a deadline. too ambitious schedule.

While several negotiators said they were optimistic about the prospect of reaching an agreement, they also expressed concern that some of the challenges were related to long-standing geopolitical differences that are not easy to resolve.

Why create a pandemic treaty?

“The biggest drama that unfolded during COVID-19 was the complete breakdown of solidarity between countries,” said Ellen ‘t Hoen, director of the organization Medicines Law and Policy.

“That disappeared as soon as vaccines came out. That vaccines were developed so quickly was fantastic. “It was the result of massive government funding, but the governments that put up the money also said we want to be first in line,” he added.

“The vaccine was not shared equitably.”

The objective of a treaty on pandemics is, in part, to avoid this failure, with an agreement within the framework of the World Health Organization (WHO).

But countries do not agree on how to do this, and the main obstacles relate to access to intellectual property, technology and knowledge, as well as the sharing of therapies and vaccines.

“On the one hand, everyone agrees that it is very important to expand manufacturing capacity in various regions of the world. But then the next step is to say that that also means that we will share the technology that we have that we have hidden from you until now. That step is the sticking point that becomes very difficult,” ‘t Hoen said.

Two diplomats compared a possible agreement to the UN climate change COP meetings or the Paris Climate Agreement, with the idea of ​​a treaty that could provide new international cooperation on pandemics.

It will change things, according to a diplomat from an EU country who spoke on condition of anonymity, but it won’t be a perfect deal to solve all future pandemics.

Instead, the diplomat saw it more as a legal basis that encourages cooperation.

‘Underlying differences’

Experts and diplomats agreed that the heart of the agreement is a new instrument called the pathogen access and benefit-sharing system (PABS), where the main idea is for countries to share information on emerging diseases in exchange for access to vaccines and medicines.

It would have countries “commit to rapidly sharing information about pathogens, so that when they detect something, they quickly put it into a database so that countries can prepare, they can start developing technologies, they can start developing products,” he said. Piotr Kolczynski, head of health at Oxfam in the EU. political advisor.

In return, countries use the system to access goods, but diplomats said there are outstanding differences over how it will work.

Countries must still agree on a manufacturer contribution of a percentage of safe vaccines and therapies to share during a public health emergency.

Activists say there has been little movement by high-income states to force companies to share, while some diplomats from those countries argue that states must compromise and that the deal cannot change the world order. .

Mohga Kamal-Yanni, senior policy advisor at the People Medicine Alliance, said developing countries generally want “a binding benefit-sharing commitment.”

“Developed countries and the North want a commitment to surveillance and health and sharing (of information) on pathogens immediately,” he added. One Health recognizes the connection between the health of people, animals and the environment.

“The South wants more committed language on technology transfer, while the North wants it to be basically what it is now,” Kamal-Yanni said, and for companies to decide what and when to share products.

“There are underlying divisions in global health that have existed for the last 20 to 30 years and that have worsened with the pandemic; these are about access to innovation and research priorities,” said Jaume Vidal, senior policy advisor at European Projects. from Health Action. International.

In the current draft of the treaty, there are parenthetical additions urging manufacturers to share information “voluntarily,” but some experts want stronger language.

“Perhaps the nature of global public international law is that it does not sanction countries directly,” said Yuanqiong Hu, legal and political advisor at Médecins Sans Frontières (Doctors Without Borders).

“But the language should reflect workable obligations so that when the implementation stage comes, there is a clear obligation to check whether any government actually complied with that,” he added.

A diplomat from an EU country said each country wants to add caveats according to its own interests, with many changes to organize each of the different parties interested in the agreement.

Disagreements over the role of pharmaceutical companies

A senior US administration official told Euronews Health that the country had a strong interest in ensuring that what happened during the pandemic, when low- and middle-income countries watched vaccines being administered in developing countries, does not happen again. high income for months before having access to them. .

The official, who spoke on condition of anonymity about the negotiations, said that because the private sector operates independently of the government, the United States could not sign an agreement on behalf of private companies and that it was key to build something that the industry could also decide to opt into. for participating.

The International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), the global voice of the industry, said that given its role in the “research, development and application” of pandemic countermeasures, “it is paramount that the industry is at the table so that “we can contribute constructively to the dialogue.”

“The industry is committed to playing its part in addressing inequalities in access in real time,” CEO David Reddy said in a statement provided to Euronews Health.

A diplomat from a developing country lamented that some of the positions of Global North countries were aligned with those of major manufacturing companies, adding that low- and middle-income countries are also not trying to redesign the entire global system, but rather They need to agree on a firm position.

Some say the European Union, like other G7 members, has been too close to the industry’s position, specifically on issues related to intellectual property.

“The Commission speaks on behalf of the EU Member States and its alignment with the industry position is truly surprising,” Kolczynski said.

This view was shared by two diplomats from high-income countries who spoke to Euronews Health.

While the Commission leads negotiations, member states follow the lead of the EU as a negotiating bloc, and some diplomats say the bloc is stronger if it is made up of 27 states together.

Another diplomat from an EU country, also speaking on condition of anonymity, said there was not always a balance between the positions of different member states and that an evaluation of the negotiations will need to be carried out in the future.

The European Commission declined to comment on specific aspects of the pandemic deal negotiations, but a spokesperson told Euronews Health that “the EU remains fully committed to concluding a Pandemic Agreement that would create a stronger global health architecture, more resilient and more equitable around the world. .

Will interest in negotiations wane?

Negotiators agreed to give themselves up to a year to finish treaty discussions and will meet in July to determine rules for next steps.

The World Health Assembly, the decision-making body of the WHO, was marked by amendments to the International Health Regulations (IHR), legally binding rules for countries that apply to the WHO.

These amendments include a financial mechanism to address the needs of developing countries.

Several diplomats said there is hope that the push to finalize those changes will lead to renewed motivation for the treaty rather than the IHR being seen as a sufficient step to address pandemics.

The senior US administration official confirmed that the IHR was not “the whole puzzle” and that the country remains committed to pandemic treaty negotiations.

Experts and diplomats agreed that negotiators must stick to what has already been agreed if the treaty is to be finalized within the next year.

Many also said there needed to be clearer rules and better organization of the negotiating body for the rest of the discussions.

The extension of the negotiations, for some, could also be seen as a victory, as it shows that countries are still willing to continue discussing the treaty, even as it has come under attack from right-wing commentators who falsely accuse the WHO of a power grab. . .

Keeping engagement and the importance of the pandemic threat in the room is also key, activists said.

“It’s really important that no one has left the table yet. “I’m not saying this can’t happen in the future, but it hasn’t happened yet,” Health Action International’s Vidal said.