The international community’s recent failure to conclude a global pandemic agreement leaves large gaps in our capacity to deal with the next major infectious disease emergency.
The risk of another pandemic like COVID – the worst in a century – is increasing.
The World Health Organization (WHO) took an important step by adopting useful revisions to the existing legally-binding International Health Regulations.
But while this advance is something to celebrate, it is not enough. Even if governments approve the revised regulations, our best chance of preventing history repeating itself lies in a pandemic agreement.
Global responses to health hazards that cross borders date back to an international sanitary conference in 1851 which focused on measures to limit the spread of cholera. Since then, several initiatives have aimed to improve global health security, including the formation of the WHO itself in 1946.
The International Health Regulations of 2005 were a major step in this evolution. They ushered in the modern era of risk assessment and created a global surveillance system for public health emergencies of international concern.
Nonetheless, it was soon evident the new tools were limited in dealing with the increasingly complex and fast moving threat of zoonotic diseases (when an animal pathogen “spills over” to infect people).
Key changes to the International Health Regulations
Earlier this month, the 194 members of the WHO World Health Assembly passed by consensus several important amendments to the International Health Regulations, including:
- adding a definition of a “pandemic emergency” to emphasise the importance of such events within the broader category of public health emergencies of international concern
- increasing the focus on prevention with specific mention of “preparedness”
- strengthening equitable access to medical products and finance, with specific mention of “equity and solidarity”, and a dedicated “coordinating financial mechanism”
- requiring each state to establish a “national authority” to improve the implementation of the international health regulations within and among countries
- requiring countries to build a core capacity for “risk communication including addressing misinformation and disinformation”
- and modifying the “decision instrument” to enhance the detection of emerging respiratory infections with high pandemic potential.
The proposals that didn’t make it
Not all proposed amendment were achieved. Some commentators had advocated to incorporate the experience of countries in the Asia-Pacific region that used an elimination strategy to delay the spread of COVID, giving time to roll out vaccines and other interventions.
Such measures protected both high-income islands (Aotearoa New Zealand, Australia, Singapore, Taiwan) as well as low and middle-income countries in continental Asia (Vietnam, Thailand, Cambodia, Laos, Mongolia).
These nations generally achieved lower excess mortality than countries where the pandemic was less controlled. Similarly, the concept of elimination at source (sometimes called containment) wasn’t included in this revision.
A range of other potential improvements also failed to make it into the final text. These included an emphasis on preventing zoonotic spillovers from animals, enhanced sharing of scientific data and specimens, and strengthened accountability.
New Zealand now has 18 months to consider the proposed revisions. Along with other states, it may enter reservations to parts it disagrees with, even though this may weaken the coherence of the proposed amendments.
Why we need greater global cooperation
A pandemic agreement could address the many needed reforms that go beyond the International Health Regulations.
But the negotiations to reach global agreement are proving contentious. There have been deep divisions between rich and poorer countries over the sharing and affordable pricing of vaccines, treatments and diagnostics for developing states. The sharing of pathogen data has also proven problematic.
The negotiations have been further undermined by completely unfounded assertions that the WHO will be given power to impose restrictive measures such as lockdowns and vaccine mandates.
Due to these challenges, the international community has not yet agreed on a text for a pandemic agreement. The WHO has announced the next steps for further negotiations, which are already years past their start date.
From the threats of war to environmental devastation and pandemics, no country can unilaterally protect its citizens from the gravest shared threats to humanity. But while the need for global solidarity and cooperation is greater than ever, support for many of the key areas of international law is failing.
We owe it to the memory of the more than 27 million people estimated to have died so far from COVID, and the rising threats to future generations, to do the best we can to achieve a safer and more secure world.
Michael Baker is Professor of Public Health, University of Otago, New Zealand. Alexander Gillespie is Professor of Law, University of Waikato, New Zealand.
The Conversation is an independent and nonprofit source of news, analysis and commentary from academic experts.
© The Conversation
20 Comments
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Banthu
Bodily autonomy and the right to refuse people who want to insert things into your body against your will is paramount and inviolable.
When it comes to the body, no means no and trying to change a no to a yes by coercion is wrong.
Aly Rustom
One thing we can do is improve our ability to work and study remotely. This will help us tremendously- not only with social distancing during the next pandemic but also with global warming as the less people commuting to work and school every day the less pollution we'll have in the environment.
falseflagsteve
Sounds like there’s a cunning plan afoot.
Plenty more gain of function being done worldwide.
isabelle
It depends totally on who is involved in the outbreak, agreement or not.
If a pandemic begins in a responsible country like Japan, it will share the necessary data speedily, allow full and transparent investigations, and do everything it can to help the international community.
If it's a country like China, as we saw with COVID-19, it will deny, obfuscate, lie, and stymie investigations. Even today, the CCP continues to prevent a full, transparent investigation, meaning that the world does indeed remain "ill-prepared for the next pandemic."
A pandemic agreement will only work if those involved actually live up to their word, and authoritarian countries simply will not.
Moonraker
I might agree but we will have to apply such reasoning to clean air, microplastics and products of the petrochemical industry too. Some of those who were against big pharma and WHO don't seem to apply the same reasoning to other industries.
Desert Tortoise
In case you haven't noticed there is a variety of bird flu that has jumped species to mammals including cattle and there multiple documented cases of this bird flu jumping from cattle to humans. No human to human infections know as of now but it is only a matter of time.
No cunning plan or gain of function involved. Just the natural evolution of a virus that will very likely become a pandemic unless people pull their heads out of their rectums soon.
Desert Tortoise
There are matters that are larger than your individual wants. Nobody lives in a bubble free from interactions with others. We have obligations that transcend your individual wants and one of those obligations is to be vaccinated against communicable diseases. You emphatically do not have a right to pass an infection on to others. In fact everyone has a right to expect their neighbor to be vaccinated and take other precautions to prevent death and serious injury from a pandemic. It is called being a mature adult. You might try being one sometime. It's not all about you!
Mr Goodman
Only Konbini is speedy in Japan
We know how Japan responds to disasters and the covid pandemic
Dithering aimlessly
virusrex
As long as the people are willing to assume the logical consequences of that choice when it increases the risk for everybody else. That is the whole point of public health, to make people assume the consequences of their own choices instead of forcing others to assume a higher risk just because someone else have irrational beliefs.
Imagine that, those evil scientists that develop safe and effective health measures thanks to responsible research being done in infectious diseases that do what they have done since before humans appeared on the planet, adapt to new hosts.
Raw Beer
Yes, especially since many of the approved and mandated products are increasingly been proven to have serious adverse effects and low or no effectiveness.
Before anyone is granted any power, there must be an open, honest, and in-depth discussion of what happened in the last pandemic. Until then, no thank you!
virusrex
Making this claim and not being able to actually provide evidence of those adverse effects and lack of effectiveness is not "proving" anything, it would be the opposite instead.
The medical and scientific consensus have clearly and unequivocally proved that the interventions it recommends are effective and safe, claiming every single respected institution of the planet is wrong (or even more incredibly in a global conspiracy to damage the world population) is not an argument that proves so, is an excuse being used instead of an argument.
zibala
The WHO agency has failed miserably over the past few decades.
Thankfully, scientific experts and authorities are prepared to pick up the slack.
virusrex
Yet when asked for any communication where a respected institution on public health supports this personal claim you make, you end up accepting nobody says so, only you.
This would mean there is no such failure, the WHO is still the world public health authority and its work respected and considered important by the institutions related to human health.
As you have implicitly accepted before, nobody has made as much for the global health as the WHO.
gcFd1
The WHO has ignored its duties especially in Africa, where it has performed miserably with its malaria vaccine programs.
A true tragedy.
/dev/random
The WHO has no duties in Africa, or anywhere else. The WHO is an advisory agency, it does not execute health policies or even its own recommendations.
The WHO has no vaccine programs. Those would be the responsibility of the respective governments.
You seem to be confused about what the WHO is and what it does.
gcFd1
Here we go--hope it eases your confusion:
Our work involves translation of global health initiatives into regional plans that respond to the specific needs and challenges of countries in the Region
https://www.afro.who.int/about-us/en
gcFd1
*Essential *Programme on Immunization
https://www.who.int/teams/immunization-vaccines-and-biologicals/essential-programme-on-immunization/
/dev/random
Correct. They advise countries in the region how to implement global health initiatives.
The work has to be done by the countries.
This is difficult, so bear with me:
A "programme on immunization" is not an "immunization programme".
The work has to be done by the countries.
I hope this eases your confusion.
gcFd1
Despite improved WHO regulations,
Obviously the old regulations were failures.
virusrex
That would be the opposite, since the vast majority of the programs work precisely with the support and guidance of WHO, no success have happened in spite of their actions as you misrepresent, but because of their support.
The moment you are unable to produce any reference for this claim you are accepting this is just a personal opinion not shared by the actual experts working in regulations for global public health.