Extended pandemic shows the need for a pandemic treaty

As the world enters the third year of the COVID-19 pandemic, a wave of omicron BA.2 is sweeping through Europe and Asia, driving up cases, hospitalizations and even deaths. The origins of COVID-19 still remain unknown and while rich countries are already rolling out fourth doses of vaccines, one-third of the world remains completely unvaccinated and lifesaving treatments are only available in a handful of countries. Moreover, in the midst of the worst pandemic in a century, agreement on temporary waiving of intellectual property rights for COVID-19 vaccines, essential to prevention and the end of the pandemic, remains elusive. 

While the heightened conflict in Ukraine, spiking food prices and inflation have packed the nightly news, the pandemic endures and despite the years of pain, countries are no better prepared to face the next health crisis. The bottom line is that the world lacks effective global systems to detect, prevent and respond to life-threatening pandemics and to protect our societies and economies from these shocks.

Released today, the Panel for a Global Public Health Convention has called for a new “Pandemic Treaty” anchored in solidarity, transparency accountability and equity. These principles are crucial to stopping the nationalism, finger-pointing and inequitable responses that have led to millions of preventable deaths, and trillions of dollars lost to the economy and to the inexcusable delay in the recovery from the COVID-19 pandemic.

The treaty must move from global rhetoric to an incentivized system where compliance and accountability are locked in. The inability to control outbreaks and manage an efficient and effective pandemic response largely stems from the lack of compliance with existing International Health Regulations — a set of rules designed after SARS to enable countries to more quickly respond to new epidemics — and the failure to follow the World Health Organization’s (WHO) recommendations. We know what remains to be done. We must now urgently set ourselves to doing it.

More authority needs to be given to the WHO to set the standards in preparedness and response while, as the panel suggests, an independent monitoring body could help ensure the accountability of countries in terms of their compliance with these standards.

For such a scheme to work, and for it to rebuild the trust lost within the multilateral system and among and within countries since the pandemic began, there needs to be coherent and transparent governance through an overarching body able to oversee the spectrum of global pandemic preparedness, alert and response efforts.

Preparedness starts with accountability

Just as countries find themselves at different stages of reducing carbon emissions and transitioning to clean energy, they also find themselves at different stages of pandemic preparedness. Some countries will require substantial financing to achieve the required level, which is estimated in the billions of dollars. These amounts are, however, inconsequential when compared with the trillions that have been needed to contain COVID-19 and its economic consequences.

It’s clear that set targets to measure preparedness and meet global standards will vary based on a country’s capacities and financial situation. Yet, regardless of the income-level, preparedness must be practiced, and targets must be ambitious and take a whole-of-government approach.

The Paris Agreement for climate change has followed this road. Countries commit to actionable but ambitious delivery on five-year cycles, with progress measured through independent assessments. Just like countries should be held accountable if they do not reduce carbon emissions, they must be accountable if they do not meet pandemic preparedness targets. They are risking lives and collective global security, which is only as strong as its weakest link.

Make or break alert systems

Once an outbreak is detected, there are a few critical hours to report, assess and act to stop the spread of a disease. To face and hopefully stop the next pandemic, enhanced incentives could encourage transparent and timely reporting, especially for individuals or lower-level institutions that often report health threats faster than national bodies. If alarm bells are silenced, or information withheld, an independent body with the authority to swiftly assess the situation, verify data and warn the world must exist. 

Late last year, South Africa was unjustly punished for detecting and reporting the omicron variant, with near-immediate travel bans, resulting in consequential economic loss during its tourist high-season. The future Pandemic Treaty must ensure that countries clearly justify international travel and trade restrictions and that funds are made immediately available to countries that incur loss.

An equitable response

Once an outbreak is underway, all countries must be held to account under the new treaty to implement public health measures and protect their populations. Piecemeal responses are ineffective, cost lives and livelihoods and ultimately can have other impacts like civil unrest and undermined national security.

For countries that comply, there should be incentives for reporting, coupled with assured and immediate support for those countries that need and request a response. This should include equitable access to emergency measure resources like vaccines, therapeutics, tests and personal protective equipment, as well as easy access to assistance and funding.

As global health leaders convene to negotiate the bricks and mortar of our future global health architecture, we must seize the opportunity to build a healthier and safer world and move with haste and conviction. History will not be kind to those who risked our future security on the same narrow nationalism that prolonged COVID-19.

Barbara M. Stocking, M.A., is the dame commander of the British Empire, the chair of the panel for a Global Public Health Convention, former president of the Murray Edwards College, University of Cambridge, the former chief executive of Oxfam Great Britain, as well as the former chair of the Ebola Interim Assessment Panel.

Danilo Türk is the president of the World Leadership Alliance-Club de Madrid, and the former president of Slovenia.