Published On November 20, 2021
The decision-making arm of the World Health Organization, the World Health Assembly, begins to meet in special session on November 29, 2021. Delegates from its 194 member states will meet virtually and in person to focus on one question: whether to begin the process of creating an international “pandemic treaty.”
The uneven, uncoordinated responses to the COVID-19 pandemic so far have sharply underscored the need for global cooperation. Even now, experts argue that worldwide health authorities should be working together to monitor regions where the next dangerous pathogen might take hold. Many voices have called for a coordinated, equitable policy for producing and distributing protective equipment, effective treatments and vaccines. When one country is unsafe, they say, all countries are unsafe.
Some laws already on the books could help. In 1969, the WHO adopted what would become the International Health Regulations, which are binding on all of WHO’s member states. The code stipulates, for instance, that countries must notify the WHO within 24 hours of any event that might lead to an international health crisis. It also prohibits countries from enacting travel bans or taking other extreme steps in advance of scientific consensus. Yet these statutes and many others were violated during the COVID-19 pandemic, in part because the WHO system has no mechanism for enforcement.
A legally binding treaty with more bite—such as those that govern nuclear arms control and climate policy—might discourage scofflaw attitudes. “In every phase of this pandemic, there has been no solidarity and no global cooperation,” says Lawrence Gostin, professor and faculty director of the O’Neill Institute for National and Global Health Law at Georgetown Law. “But we can’t let the world unravel. No single government or institution, no matter how powerful, can address the threat of future pandemics alone.”
“The politics of creating an enforceable treaty are likely to be devilishly tricky, and countries around the world have been evaluating whether such an agreement is in their best interests,” says Ilona Kickbusch, founding director and chair of the Global Health Centre at the Graduate Institute in Geneva. Notably missing from the initial treaty supporters are the United States and China. The Biden administration, although not directly opposing the proposal, has expressed concerns that negotiating a treaty now could derail the momentum necessary to tackle the worsening pandemic. But more than 60 countries have now joined a “Friends of the Treaty” group that supports the initiative, Kickbusch says: “From some countries, we are seeing a very, very strong commitment.”
But broadening that commitment and getting a treaty negotiated and signed could depend on support from outside the halls of policymakers. “If we are serious about getting a pandemic treaty in place, it’s important that we involve scholars, academics, human rights lawyers, civil society groups and affected communities,” says Allan Maleche, executive director of the Kenya Legal & Ethical Issues Network on HIV and AIDS. Maleche has been meeting with local and global organizations to drum up interest and discuss the feasibility of the treaty: “We need people to understand what’s at stake and put the pressure on.”
Almost everyone understands that this is likely to be a slow process. Just creating a draft treaty that countries could review and endorse may take years, and some experts want to put off that effort until the current contagion is under control. “We’re in a public health emergency,” says Kelley Lee, a professor of global health governance at Canada’s Simon Fraser University. “Negotiating a new treaty will take three to five years. We need to consider whether that process should take priority over ending the current pandemic and understanding why countries are not adhering to the obligations already in place.”
Still, others are optimistic that the WHA meeting now underway will lay a path for future action and could save untold numbers of lives in future pandemics. And while it’s possible to delay action, the shadow of COVID-19 may be just the impetus to make global consensus possible. “We experienced a once-in-a-lifetime level of suffering, death and economic destruction,” says Georgetown’s Gostin. “So if not now, when?”
Stay on the frontiers of medicine