Health leaders hail adoption of WHO Pandemic Agreement which could make the world a safer place

Health leaders and experts have expressed hope that the momentum stemming from the adoption of the world’s first Pandemic Agreement by member states of the World Health Organization (WHO) on Tuesday can be sustained, leading to an international community safer from future pandemics.

Helen Clark, the former prime minister of New Zealand and co-chair of the Independent Panel for Pandemic Preparedness and Response, said that although the adoption of the agreement was a cause for celebration, “there’s going to be a lot of work to do”.

“The agreement has been reached at a time when global health financing has been thrown into crisis. The … sudden cuts have been very adverse, not only obviously for WHO, which is undergoing painful measures and budget changes, but also particularly for low-income countries who’ve been given no time to adjust to funding cuts. So, we’re at a crossroads, but we have to move forward,” she said.

These remarks were probably a reference to foreign aid spending cuts by the US administration under President Donald Trump, which have led to major shifts in global health financing in recent months. The US also announced its withdrawal from the WHO in January.

Clark was speaking at an event hosted by the International Geneva Global Health Platform and the Independent Panel for Pandemic Preparedness and Response at the Geneva Graduate Institute in Switzerland on Tuesday. It brought together health experts for a discussion on “Pandemic Readiness in an Uncertain World”, and explored the prospect of delivering pandemic response reforms over the next 12 to 18 months.

Negotiations 

The adoption of the Pandemic Agreement by the 78th World Health Assembly came after more than three years of intensive negotiations launched by governments in response to the impacts of the Covid-19 pandemic. It followed an approval of the agreement by vote on Monday, 19 May, with 124 votes in favour, 11 abstentions and no objections from member state delegations.

Precious Matsoso, the former director-general of the South African National Department of Health, co-chaired the Intergovernmental Negotiating Body that coordinated the process to draft and negotiate the Pandemic Agreement.

“I was waiting … to see one country voting no [on the adoption of the agreement by the WHO], and there were none. For those who abstained, I was actually pleased that for some … they explained why they did so. They were still going through their own internal processes, and they had not been given a mandate to vote,” she said at Tuesday’s pandemic readiness discussion in Geneva.

“There were two outliers who had principled positions about the Pandemic Agreement … but I’m pleased that, even in their case, they still did not vote no. So, there is hope.”

Matsoso said she was “proud” that the African Union had shown a “unity of purpose” from the beginning of negotiations on the agreement.

The Pandemic Agreement sets out the principles, approaches and tools for better international coordination towards pandemic prevention and responsiveness across a range of areas, including through the “equitable and timely access to vaccines, therapeutics and diagnostics”, according to the WHO.

Although the Pandemic Agreement has been formally adopted by the WHO, there’s still a way to go before it can be effectively implemented. A key step will be the drafting and negotiation of a Pathogen Access and Benefit Sharing system (Pabs) through an Intergovernmental Working Group.

According to the WHO, the result of the Pabs development process will be considered at next year’s World Health Assembly.

“Once the assembly adopts the Pabs annex, the WHO Pandemic Agreement will then be open for signature and consideration of ratification, including by national legislative bodies. After 60 ratifications, the agreement will enter into force,” said the WHO.

The adoption of the Pandemic Agreement coincided with the launch of four policy briefs by the Independent Panel for Pandemic Preparedness and Response, which set out a path forward to “continue making the world safer from pandemic threats”. These briefs look at:

• The financing of pandemic preparedness and response;
• Building regional self-reliance;
• Monitoring of pandemic risks; and
• The roadmap to the United Nations General Assembly High-Level Meeting in 2026.

A new normal 

Dr Raj Panjabi, a US physician, entrepreneur, professor and former White House official, said the Pandemic Agreement was important as it highlighted that the disparity in vaccine access between different regions during the Covid-19 pandemic was “not normal”.

“The idea that the most powerful nations in the world, and those who are the most powerful within those nations, are more likely to get access to vaccines, tests and treatments than those who are less powerful is not normal. What is normal is the promise of being able to have a more equitable, fairer and more clear system, more efficient system,” he said.

Panjabi said there were three key areas where work would be needed to ensure the execution of the agreement.

“Number one is ensuring that there is independent monitoring and clear accountability. Number two is ensuring that financing is stepped up. That’s very hard in this moment when overseas development assistance is being pulled back, not just by my country, the United States, but by several others. And it’s critical, because the World Health Organization is now facing its biggest cuts,” he said.

“The third area that we need to focus on is increasing regional self-reliance. What does that mean? It means an entire end-to-end focus, from research and development investment and innovation to enhancing manufacturing, and ensuring that the delivery of countermeasures in the next pandemic occurs.”

South Africa’s G20 presidency would be a “very important” part of strengthening the Pandemic Agreement in the months to come, said Clark.

“South Africa has a very active Health Working Group. There’s definitely been a big reaching out of South Africa to get the range of voices … and we hope that will feed through and lead to a good health ministers’ outcome document,” she said.

“What we don’t know about next year is the role of the G20, because, in theory, it goes to the United States of America. If they take the chair, it could be treading water for a year … so a lot hangs on a solid base from South Africa this year, building on the Brazil effort, on the regional mechanisms, and building on Indonesia’s [effort] before — the country that saw the Pandemic Agreement [put] into place.” DM