Pandemic treaty talks in Geneva get one final push
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They think it’s all over, but it’s not quite. Representatives of the 194 member states of the World Health Organization will gather again next week in a final bid to agree a pandemic accord or treaty.
The full time whistle was blown last Friday but the bruised and bloodied players have been given extra time. They now have from 9am on Monday until the end of next week to agree on a text that might one day save the world – or at least improve it a tad.
The negotiations will go to the wire. There are still some 200 paragraphs to review, negotiate, and agree on, says Nina Schwalbe, founder of the public health think tank Spark Street. “Only a handful have been fully agreed”.
Whether the text will be finished in time for the grand opening of the World Health Assembly (WHA) in Geneva on 27 May is anyone’s guess – but that’s the dream.
What’s at stake very much depends on who you talk to. Most agree a Pandemic Agreement (as it is officially known for the moment) would have “symbolic importance” in the wake of SARS-CoV-2. It would mark a coming together of nations at a time when pestilence, war and other nasties have pushed us apart.
That’s not great for many hedge fund managers and populist politicians who thrive on volatility and division but is likely to be welcomed by the stability-yearning majority.
A “symbolic recognition that this is a collective problem that needs cooperation at the highest level for us to be prepared is, is really, really important,” said a well-placed former US government official and veteran virus battler last week.
But few believe the current text is likely to bring about radical change. At best it is something to build on. The gaps between the parties remain far too wide to bridge with wriggle-proof wording in the short negotiating time left, say experts.
In place of precise words will come “qualifiers” – loose phrases like “best endeavours” which you could drive a coach full of Ebola patients through if push came to shove. “Qualifiers are words that intentionally weaken the meaning of a sentence, although they may give the author a feeling he is being more honest,” notes a slide shared by Ms Schwalbe.
Much has been made in the op-ed pages of The Telegraph and other media of the issue of “sovereignty” but the issue has hardly surfaced in the Geneva talks because of a long standing clause in the proposed text which explicitly rules out any land grab.
Clause 24, paragraph three says: “Nothing in the WHO Pandemic Agreement shall be interpreted as providing the WHO Secretariat, including the WHO Director-General, any authority to direct, order, alter, or otherwise prescribe the national and/or domestic laws, as appropriate, or policies of any Party.”
Writing in today’s Telegraph, former Prime Minister Gordon Brown adds: “The agreement also states that the World Health Organization has no power ‘to mandate or otherwise impose any requirements that parties take specific actions, such as ban or accept travellers, impose vaccination mandates or therapeutic or diagnostic measures, or implement lockdown’”.
A global insurance policy
Those of a conspiratorial mindset might be better alighting on the concepts of Great Power Competition and first mover advantage to explain what’s really going on.
While diplomats have been talking in Geneva for the last two years, the US has signed bilateral deals with no fewer than 50 pathogen-rich countries including Nigeria and the Democratic Republic of Congo as part of a new $1.2 billion investment in biosecurity.
If talks on the Pandemic Agreement collapse next week, expect the European Union and China to announce similarly grand initiatives of their own soon after.
China, it should be noted, gifted more vaccine to the developing world than any other block or nation during the Covid-19 pandemic, according to the UK data and analytics company Airfinity.
To add to the cold war vibe, Nasa is even being urged by the US Bipartisan Commission on Biodefense to set up a program which – wait for it – will look for BUGS IN SPACE.
“Astrobiodefense aims to identify, characterise, and manage biological threats emerging at the intersection of space exploration and infectious disease,” says the Commission. “We must act now to address these threats before they materialise.”
Back on earth, the veteran British health diplomat Sir David Nabarro likened the proposed Pandemic Agreement to a “global insurance policy”. It was a bureaucratic device that would reduce risk and mitigate harm, and would likely prove excellent value to a middling country like Blighty, he said.
“These diseases do not respect national borders and our world is a pretty small village with people always going on holiday all over the place,” he said. “It’s part of the overall insurance mechanism that citizens everywhere need because we know that these kinds of diseases can appear without warning.”
A ‘one health’ agenda
So why is a Pandemic Agreement proving so difficult to land? At its most simple, it’s about money.
The developed nations of the global north want the cash-poor but pathogen-rich countries of the south to institute a wide ranging series of reforms to improve biosecurity.
First, they want them to adopt a “one health” approach to the regulation of human, animal and environmental health in order to reduce the risk of new outbreaks occurring.
Among many other things, this would mean better regulating wet markets, cracking down on the trade in bush meat and exotic animals and cleaning up small scale fur farms, or at least moving them away from bat caves, for example.
The rich nations also want to see an early warning system established across the global south, whereby local laboratories and clinics constantly scan for new pathogens and share the data they gather with the north in real time.
“There’s a huge value in containing and controlling these outbreaks close to where they start, rather than waiting a few days, watching them grow and then suddenly finding we’ve got a global crisis on our hands,” said Sir David.
Structured access to genetic data on new viruses and other pathogens is also “crucial to the research and development of vaccines and other countermeasures”, said Peter Bogner founder and president of GISAID, the world’s largest genomic database of viruses.
Most developing countries are happy to accept these changes in principle but they don’t have the money to do it alone. They also note it is the developed world with its vast pharmaceutical industries, ageing and obese populations and delicate supply chains that probably have most to gain.
As a result of this imbalance, the pandemic treaty negotiations have centred on issues of fairness or “equity”.
Transfers of money, expertise and intellectual property from north to south are proposed to smooth the implementation of the “one health” agenda.
Bugs and drugs
Meanwhile, a new Pathogen Access and Benefits Sharing system (PABS) is seen as the solution to the “bugs and drugs” divide.
The idea here is that the north promises to provide free or deeply discounted vaccines and other pharmaceuticals in return for the south’s “bio-prospecting” and sharing of genetic data.
It’s from PABS that the idea of manufacturers putting aside up to 20 percent of all pandemic vaccines and other pharmaceuticals for “equitable global distribution” has come from. A similar arrangement already exists in relation to the tracking and sharing of influenza viruses.
While a quid pro quo arrangement sounds neat in principle, in practice it has proved anything but. A clear and present danger is one thing but a distant and uncertain one quite another when it comes to motivating politicians and their diplomats.
As things stand, the global south fears being locked into too much expensive reform and the developed north worries about forking out too much to pay for it. As a result, the wording of the text has become looser and looser with every round of negotiations.
Big pharma in particular has been very hesitant to support anything that limits its room for manoeuvre or threatens its intellectual property. It’s modus operandi, says one observer, has been to “grandstand and then lobby behind the scenes to have everything watered down”.
There is also no independent compliance mechanism as things currently stand, with participating countries expected to mark their own homework in the event a deal is done.
“Non-compliance with the new pandemic agreement risks another COVID-like pandemic, including inequitably distributed economic, social, and health consequences”, says Ms Schwalbe.
On a more positive note, some experts believe the rapid advances being made in vaccine science and artificial intelligence will eventually make the impasse over intellectual property and benefits sharing less relevant.
All around the world now university labs are racing to play their part in CEPI’s 100 Days Mission, which aims to have the world ready to respond to the next Disease X with a new vaccine in just 100 days of it first being detected.
Endorsed by the leaders of all G7 and G20 countries, this research is virtually all government or philanthropy funded and is tightly focused on producing prototype vaccine designs for all the major families of viruses that pose a pandemic threat.
The idea is that these designs – together with their patents – are banked by governments ahead of time and distributed to commercially run mRNA vaccine manufacturing platforms around the world on a non-exclusive basis if and when they are needed.
It is hoped the vaccine designs will essentially be “plug and play” thereby negating the commercial intellectual property problem – at least for transfers between friendly states.
“For two or three decades we’ve been arguing over IP for products but products very soon won’t matter any more”, said the former US official.
“What’s important will be access to the mRNA platforms used to make those products, and pretty soon those platforms are going to be globally distributed.”
Mr Bogner also believes the Covid-19 pandemic brought some positive change.
“The pandemic saw huge advances in data sharing and it’s really important to preserve that in any treaty,” he said. “There will always be compromise but it must be transparent and it must be easy. Adding bureaucratic things is not good”.
If the WHO member states can agree on a text for a Pandemic Agreement next week it will likely be approved at the World Health Assembly the following week.
It would then go to individual member states who – via their own parliaments – would have to decide whether to “opt in” to the legally binding agreement or remain out of it.
At the end of last week, most experts thought the process had died a death but now some are more optimistic.
A final burst of energy was needed and, ironically, it is Putin-aligned populists like Slovakian Prime Minister Robert Fico, the victim of an attempted assassination this week, who seem to have provided it by railing against the proposed treaty with conspiracy nonsence.
Their focus on “narrow political point scoring, and spreading lies”, as one Geneva insider put it, seems to have reinvigorated the negotiation process at the eleventh hour.
Meanwhile, Russia itself has spent the bulk of the last two years of negotiations hunkered down with Iran and other pariah states pushing for sanctions relief as the price of its cooperation.
Ultimately, no one wants to find those 100 day vaccine designs are out of reach when the next pandemic strikes.
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