Guest Editorial: "A New Pandemic Treaty Must Be Built for Accountability"
Treaty Talks #004 [Guest Op-ed]
We bring you a special edition of Treaty Talks today: a guest editorial by Dame Barbara Stocking who is a part of the Panel for a Global Public Health Convention.
The panel is an independent coalition of global leaders, that believes that accountability is central to any future pandemic response and preparedness.
In a new report released today it calls for “an accountable international system that enables countries at every income level to detect, alert and respond to health threats.” It also suggests incentives to improve compliance.
Accountability, the panel says, is missing in existing norms and regulations. “There were no consequences for gaps in preparedness and response,” the report says. We agree.
Apart from the emphasis on accountability, the panel suggests an independent assessment body.
“The overall responsibility for the implementation of the Convention lies with the Heads of State and Government who should form the Conference of Parties. This body should provide oversight of the functioning of the Convention and its protocols. It will also coordinate closely with the norm-setting and technical assistance provided by WHO. Given the imperative for accountability, the governance structure must coordinate closely with any eventual financial resource allocation body, and with bodies that may be charged to create or have influence on an equitable end-to-end research and development platform.
Independent monitoring, verification and assessment: Whatever the eventual form of that governance, our Panel believes an independent monitoring, verification and assessment body at arm’s length or separate from WHO is crucial to success of the international system for pandemic preparedness and response. The WHO Secretariat must be able to continue to play a supportive role to Member States and cannot be both supporter and monitor. Given the inevitability of politics, Member States cannot simply monitor themselves or each other.”
Some bold ideas here, that will no doubt be contested by member states, and even by WHO. These proposals contribute to the evolving discussions as countries sit down to define an outline on the substantive elements of a new instrument in the coming weeks and months ahead.
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“A New Pandemic Treaty Must Be Built for Accountability”
The initial COVID-19 outbreak and subsequent variant emergence has proven that the world’s ability to detect and respond to outbreaks is only as strong as its weakest link, and any gap in a country or the larger international system is a risk to people everywhere. Since the beginning of the pandemic, we have seen this narrative play out – from the “lost month” of February 2020 where multiple countries were slow to report information and respond, to today’s vaccine nationalism, which has left over 80% of the population across Africa unprotected against the virus.
The most consequential gap in our current system is the lack of accountability and compliance to ensure all countries prepare for outbreaks, act in concert if one spreads and distribute life-saving resources equitably. In the last two years, many countries took a piecemeal approach, defied what few regulations were in place and ignored sound public health recommendations from the World Health Organization (WHO).
The existing International Health Regulations (IHR), which require countries to address potential health security threats, were either completely ignored or inadequately observed. When WHO called for countries to stop imposing indiscriminate travel bans, countries didn’t listen. In both cases, there were no incentives, enforceability mechanisms or governing bodies with adequate authority to move from rhetoric to action.
In a new Call to Action, published today, the Panel for a Global Public Health Convention has proposed a path forward to address such gaps and build an accountable international architecture that enables countries at every income level to detect, alert and respond to health threats.
World leaders are also recognizing the cracks in our system and taking action to fill them. Late last year, stakeholders began the process of crafting a new international treaty, convention or instrument for pandemic preparedness and response. An Intergovernmental Negotiating Body (INB) is taking this forward, with a two-year mandate to negotiate and deliver a plan for consideration to the World Health Assembly in May 2024.
Now is the moment for all those involved to take advantage of this historic opportunity to build a healthier and safer world, learn from the last two years and implement evidence-based solutions.
In the Call to Action, the Panel makes the case for a positively incentivised system where compliance with agreed preparedness standards, alert protocols and response efforts is overseen by an independent monitoring and assessment body, situated at arm’s length to the WHO. Unlike the status quo, such a system would need to be coherently governed by an overarching body overseen at the heads of state level to ensure equity and inclusion, coordination, trust between all parties and accountability.
An independent body is a key element that would help unlock the accountability and compliance we are sorely lacking. Unlike WHO, it would have the independence and authority to both publicly praise and criticize countries depending on their adherence to agreed requirements. Though WHO must be further empowered to adequately set international standards and support countries achieve targets, an independent body would further support their mandate by having the authority to call on and call out countries.
While setting agreed standards for preparedness is essential, those standards are no good if we don’t ensure all countries are financially capable of meeting them. For many low- and middle-income countries, insufficient resources over the last decade meant that health systems and economies were ill-equipped to monitor outbreaks, deal with the tsunami of knock-on effects caused by COVID-19 and source the necessary “countermeasures” to respond like PPE, tests and vaccines.
In many cases, COVID-19 funds that were distributed were imbalanced and resulted in further debt. In the first six months of the pandemic, more than 90% of funds committed to low- and middle-income countries by multilateral agencies was debt – this also meant richer middle-income countries with more substantial borrowing power tended to receive more finance than poorer countries.
It is in all countries’ self-interest to ensure this doesn’t happen again. A new multilateral financing facility to ensure all countries can access predictable and sustainable funding without incurring catastrophic debt will be a necessary step in a new Pandemic Treaty.
While predictability during a crisis is hard to come by, we must do our best to set up a system that instills as much mutual assurance as possible along the timeline of events. That means determining who is required to take what action and when must be negotiated and agreed ahead of time to ensure that countries and agencies are ready to go the moment a signal is heard. This includes accountability for preparation; incentives for transparent and real-time reporting of health threats; assured implementation of evidence-based public health measures; timely information sharing, including of genetic sequences, specimens and samples; and equitable distribution of pandemic goods like treatments and vaccines.
Finally, a Pandemic Treaty must be rooted in solidarity, transparency, accountability and equity. The world must wake up and realize that pandemic preparedness and response is not charity, but rather a global good, and demands countries work in solidarity and take responsibility. When countries succeed in reducing greenhouse gas emissions, we do not see this as charity, rather, an obligation on all countries to safeguard life as we know it. Building an international system to save lives and livelihoods against the next health threat is no different. A new Pandemic Treaty must not leave this to chance.
The opinions published here is of the author. Get in touch with Barbara Stocking here. She can also be reached at firstname.lastname@example.org.
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