During the World Health Organization's (WHO's) 76th World Health Assembly (WHA), WHO Director Dr. Tedros Adhanom Ghebreyesus told members the threat of "another pathogen emerging with even deadlier potential remains." The WHA, which closed its meeting on May 30, moved one step closer to its plan for a "legally binding" Pandemic Treaty that will coordinate the prevention, preparedness, and response to a global health emergency with its member states.
According to reporting from Think Global Health, those arguing for a Pandemic Treaty "have variously argued that it should address—among other things—surveillance, outbreak notification, the sharing of pathogen samples and genetic sequence information, zoonoses, pandemic prevention, trade, and travel measures, equitable access to health countermeasures, health capacities in low-income countries, universal health coverage, social determinants of health, intellectual property rights, misinformation and disinformation, financing for pandemic preparedness and response, human rights, and strengthening the WHO."
The organization and its 194 member nations began negotiations in March 2021 in response to the COVID-19 pandemic. The final ratification of the treaty will occur a year from now, in the Spring of 2024, with many more meetings and events scheduled in the interim. Notably, some member states suggested there should also be a simulation exercise (remember EVENT 201?) based on the draft proposal in advance of a future pandemic to test the effectiveness of the proposed treaty, as seen in the video below.
Independent Panel for Pandemic Preparedness and Response
According to a written briefing from the U.K. on the 2023 meeting, using "insights and lessons learned" from the COVID-19 crisis, the WHO set up an Independent Panel for Pandemic Preparedness and Response. The panel sought to "provide an evidence-based path for the future, grounded in lessons of the present and the past to ensure countries and global institutions, including specifically WHO, effectively address health threats."
The independent panel began its work in September 2020 and was established at the request of the WHO Director-General at the request of the WHA. It presented its first report, COVID-19: Make it the Last Pandemic, to the 74th WHA in May 2021.
Health Equity Is Central To WHO Treaty
The WHO wants to create "equity" concerning health emergencies because many member countries are poor and need assistance from wealthier nations. The thought is that "no state or multilateral agency can address these threats alone," according to the U.K. briefing. The Feb. 6 working document of proposed amendments can be found here.
A package of US-proposed measures was also submitted in May at the 76th annual assembly. According to Health Policy Watch, "The aim [of the proposed measures] is to have a package of reforms ready for the World Health Assembly 77 in 2024 and for any new rules that are approved to take effect as of May 2025."
The treaty will reflect a "One Health," "whole of government and whole-of-society" approach to public health.
WHO/One Health Approach
The WHO is also laser-focused on "ensuring universal and equitable access to safe, efficacious and affordable vaccines, medicines and diagnostics for this and future pandemics." The WHO contends that only with global coordination can nations "develop, manufacture, and deploy vaccines quickly" to achieve global access.
Prime Minister Boris Johnson wrote a joint article on Mar. 30, 2021, explaining why nations "must come together" to address the threat of pandemics. An excerpt below speaks to the need to develop a treaty that would "lead to more mutual accountability and shared responsibility, transparency and cooperation within the international system and with its rules and norms."
Boris Johson/Joint letter/https://www.gov.uk/government/speeches/no-government-can-address-the-threat-of-pandemics-alone-we-must-come-together
The treaty's rules and norms are highly influenced by the WHO's constitution, which prioritizes the principles of health equity as its primary underpinning and aspirational goal.
WHO Equity/Constitution/https://apps.who.int/gb/ebwha/pdf_files/WHA75/A75_17-en.pdf
Two major items are central to the "roadmap" as the body continues to prepare for its treaty; one centers on amendments to the International Health Regulations, and the other is the development of a pandemic accord.
Ratification of Amendments
WHO member states want to ratify amendments to the 2005 International Health Regulations and develop a "legally binding" set of rules and agreements concerning the management of pandemics.
According to James Roguski's StoptheWHO.com website, the top ten reasons to oppose the amendments to the International Health Regulations include mandatory medical treatments, global health certificates (digital passports), loss of sovereignty, expanded censoring of mis-and disinformation, and "enormous financial costs." According to the Heritage Foundation, the Independent Panel called for "the creation of an International Pandemic Financing Facility (IPFF) with 'the capacity to mobilize long-term (10–15 year) contributions of approximately US$5–10 billion per annum to finance ongoing preparedness functions. The IPFF will have the ability to disburse up to US$50–100 billion at short notice by front-loading future commitments in the event of a pandemic declaration.'"
Article 19 of the proposed WHO treaty demands "a minimum of 5%" of every member's health budget and an "undisclosed percentage of the country's GDP." The treaty also opens the possibility of demanding more once a pandemic is declared. Accountability for the destination of such funding could be difficult to hold.
The top ten reasons to oppose the proposed amendments, according to Roguski, are pictured below:
Proposed Amendments/StopTheWHO.com/Roguski
The Pandemic Treaty
According to Roguski, the top ten reasons to oppose the Pandemic Treaty include impingements on human rights, censorship, potential disregard for the safety of new drugs because of accelerated timelines for their development, and support of gain of function research.
Top Ten Reasons Against Pandemic Treaty/https://wehurtothers.com/home/NoorBinLaden
Would This Treaty Be Binding for the U.S.?
The U.S. is a sovereign nation with what should be a sturdy Constitution and Bill of Rights. There is plenty of language in the working documents thus far that would permit the U.S. to make independent decisions during health emergencies. It is challenging to make such a treaty legally binding for every member nation, regardless of the WHO's aspirations to do so.
However, there is also plenty of room for concern, given what happened during the 2020 pandemic. Americans suffered unprecedented violations of their constitutional rights, touching on all areas of the 20 points listed above. The unfortunate reality is that such a treaty could be weaponized and overly influential in the wrong hands.
Nevertheless, the U.S. has a choice about its membership in WHO. As the top Executive in the U.S., President Trump exercised his right to sever ties with the WHO in the Spring of 2020 because of how it handled the pandemic. Therefore, it seems that adherence to the terms of the treaty is ultimately in the hands of the leaders of a given nation.
In one of his first acts as President, Biden reinstated U.S. membership in WHO and restored the NSC Directorate for Global Health Security and Biodefense, which disbanded in 2018. Biden also signed an executive order (E.O.) in September, urging a whole government approach to "advance biotechnology and biomanufacturing towards innovative solutions in health, climate change, energy, food security, agriculture, supply chain resilience, and national and economic security." The E.O. states this approach should reflect "principles of equity, ethics, safety, and security," mirroring much of what the WHO holds near and dear.
If past behavior indicates future cooperation, then there are precedents for ignoring such a treaty. For example, during the 2020 pandemic, the WHO was the first to alert the world about a potentially serious disease event emerging in China. However, according to reporting from Think Global Health, WHO "Director-General Tedros undercut those early warning efforts by praising China when WHO staff suspected that it was not being transparent about human-to-human transmission. Nothing in the IHR required Director-General Tedros to praise China in this way."
In the past, countries have tended to follow the rules that benefitted them and ignore the others. As the article from Think Global Health points out, there was a "collapse of cooperation during COVID-19" in many instances. Often, wealthier countries, influenced by the politics at the time, seem to cherry-pick when they will and won't participate in "equitable health care." In many cases, There is no incentive to cooperate because nations first seek to protect their own in an environment of scarce resources. The article says that "COVID-19 demonstrates that this proposition has no clothes. Government responses to COVID-19 have purportedly violated or manipulated many treaties, including the WHO Constitution, International Health Regulations (IHR), and human rights agreements.
As UncoverDC reported on Jun. 2, North Korea was given a seat on the WHO Executive Board, a strange invitation given North Korea's abysmal human rights record. If equity is genuinely a guiding principle, it makes one wonder why countries like China and Iran can also be members. These two countries are not exactly shining examples of transparency or equitable treatment of their citizens. It seems that much of what comes out of WHO at any given moment is most likely driven by the geopolitical winds at the time and not a stable, transparent set of expectations and guidelines.
It, therefore, begs the question as to why the U.S. would want to participate in a global organization with members who so clearly violate the ethos and values of the United States. Given that the Pandemic Treaty is probably not legally binding, the biggest question is whether such a treaty will give the American government additional cover to erode Americans' constitutional rights further. It may be a distinction without a difference because of what has transpired in the last three years. Most people will attest that the U.S. government's behavior during the 2020 pandemic did not set a soothing precedent for protecting American rights in its responses to a global health emergency.