Pandemic Treaty continues to negate principles of equity and justice

The seventh round of intergovernmental negotiations (INB 7) for the Pandemic Treaty recommences on December 4. In the deliberations, government officials will put forth positions regarding the current draft and negotiate for a common position. So far, arguments from pharmaceutical companies, represented by the Global North, are taking precedence over a just and fair deal – a deal that should represent people and not greed.

High-income countries are also pushing for a focus on surveillance and security, ignoring concerns regarding prevention and equitable access to medical products during a pandemic.

While there is some language in the draft text addressing these concerns, it falls far short of what is needed. The death and destruction caused by COVID-19 should have taught world leaders about the dangers imposed by a business-as-usual approach during emergencies.

However, that experience does not seem to be guiding the negotiations, and this is a dangerous sign.

The draft negotiating text proposes binding obligations on surveillance, One Health, and information sharing, raising concerns about potential imbalances favoring the Global North, particularly corporations based there. The glaring absence of legally binding commitments on equity, especially in the context of equal access to pandemic-related medical products, deepens apprehensions.

The stark disparities highlighted by the United Nations Conference on Trade and Development (UNCTAD) in October 2020 and the subsequent inequality in COVID-19 vaccine distribution underscore the urgency of addressing structural issues perpetuating global health inequities.

Equity at the heart of the Pandemic Instrument

In response to these concerns, there is a collective call for the Pandemic Instrument to embody provisions ensuring a sustainable, prompt, predictable, and affordable supply of pandemic-related health products to all countries, irrespective of their financial or technological capabilities.

Countries in the Global South are asking for publicly funded research, access and benefit sharing, and common but differentiated responsibilities. Such proposals are facing challenges, raising questions about the commitment to a fair and just global health framework.

The calls extend to equitable access to affordable medical tools, emphasizing the removal of intellectual property barriers such as patents and trade secrets, and accessibility of medical countermeasures from public-funded research. It is evident by now that voluntary measures to share technical know-how of medical products do not work.

Corporations are not willing to share knowledge that could result in other companies producing the same goods. Yet, sharing knowledge is crucial to increasing production and making tools like vaccines and masks available to everyone who needs them. One or a few companies cannot fulfill the needs of the whole world during an emergency.

Thus, the new instrument should have compulsory measures and patent waivers to break monopolies during pandemics. Transparency in research and development costs is equally essential.

Article 3.3 of the draft negotiating text mentions equity as a principle and approach. It emphasizes “unhindered, fair, equitable, and timely access” to pandemic-related products and services. However, the absence of a legal obligation to translate these principles into reality is a cause for concern.

When the negotiations begin on December 4, they should move in the direction of concrete action points rather than mere tokenism. Proposals from developing countries should not be relegated to informal sessions, ensuring that equity is concretely operationalized in the pandemic instrument.

Despite the need of building a response mechanism based on equity and solidarity, there are indications that negotiators from low- and middle-income countries are exposed to mounting pressures. Only days ahead of the next round of negotiations, Geneva Health Files reported on a surprise decision by Namibia to recall a delegate from the process, supposedly on the grounds of an expired mandate.

Yet, as Geneva Health Files reports, the decision seems to have come after pressures from the United States and the European Union. It also applies to one of the strongest voices of the Africa Group in the negotiations. Until this decision, the Namibian delegation had played an important role in responding to high income countries’ proposals on surveillance measures and “taken a strong public stance against involving the pharmaceutical industry in the drafting group processes in these [WHO] negotiations,” according to Geneva Health Files.

Ensuring health workers’ rights

The final Treaty needs to have strong language on deliverables for workers, including frontline health workers. We witnessed immense shortages of personal protective equipment (PPE) and N-95 masks during the COVID-19 pandemic. That affected health workers the worst as they had to deal with people who had contracted the infection without safety measures to deal with it.

Frontline workers were in the field providing services, exposing themselves to the virus. While the health staff worked overtime in dire situations, most of them faced delayed salaries and a lack of social security including medical benefits. This cannot be allowed to happen in future pandemics. The Pandemic Treaty has to respond to a collective demand for fair and just working conditions.

In a positive development, the June 2023 draft of the negotiating text specifically recognized the role of frontline health workers after trade unions across the world fought for it. Sadly, this has been removed from the current draft. That language should be brought back during the upcoming round of negotiations.

Upholding the right to decent work for all health and care workers is crucial, alongside provisions directing governments and multilateral agencies to engage in social dialogue. Unions should be given a seat at the table for all pandemic-related discussions.

Pathogen access and benefit sharing: a vital element

An important aspect of innovation during a pandemic is pathogen sharing. That represents the basis for making vaccines, medicines, and diagnostics. However, ensuring access to resulting medical tools is also crucial.

Thus, the Pathogen Access and Benefit Sharing system should be a part of the final text along with concrete elements. We cannot have security and surveillance without accompanying binding agreements on sharing medical tools as an important part of the public health response.

Language on financing needs strengthening as well. Solidarity and a commitment to an equitable international order are fundamental. The Treaty should follow the principles of financial justice to ensure equity in financing for all countries. It should also include strengthening health systems for the prevention of pandemics. Strong health systems will also be better and stronger in the event of an emergency.

As the world watches the unfolding negotiations, the spotlight remains on the imperative for a Pandemic Treaty that goes beyond immediate measures, addressing the deep-seated inequities that have long plagued global health responses.

People’s Health Dispatch is a fortnightly bulletin published by the People’s Health Movement and Peoples Dispatch. For more articles and to subscribe to People’s Health Dispatch, click here.