“In our globalized world, health threats do not respect borders.” This sentence has become the most popular opening line for articles on COVID-19, calling for pandemic preparedness and the need for action. But ‘action’ as a noun can often be unrealized aspirations until we choose to act.

Reflecting on this long-stretched pandemic, one thing is clear –to tackle future pandemics, something must change because our current approach is not working.

Reflecting on this long-stretched pandemic, one thing is clear –to tackle future pandemics, something must change because our current approach is not working

In December 2021, the World Health Assembly (WHA) agreed to “draft and negotiate convention, agreement, or other international instrument on pandemic prevention, preparedness and response”. This followed the initial call for a pandemic treaty in March 2021, which was signed by over 20 countries, the European Council, and the World Health Organization (WHO). It generated great interest and debate in the global health community. The vision is to be “guided by a spirit of collective solidarity”, according to the EU.

As we approach the first meeting of the intergovernmental negotiating body (INB) by 1 March 2022, discussions for and against developing a new treaty have not slowed down.

Gaps in global governance exposed during the pandemic, like the insufficiency of the International Health Regulations (IHR) and the limitations of WHO’s response due to its lack of power, are among the justifications for a new pandemic treaty. A legally binding document would leave no room to break the rules. And it will provide the capacity to react when they are. In addition, there will be an opportunity to include topics that are usually neglected, including One Health, biosecurity, and equitable vaccine distribution.

Power imbalances at play in the negotiations also need to be considered, as "Global South" countries often lack the capacity and the technical knowledge to negotiate effectively. Moreover, major pharmaceutical players are based in high-income countries (HICs), and there is further pressure to amend the IHR at the same time. The high dependency on private players needs to be questioned and countries need to shift towards overall investments in public health system strengthening as they are the foundations for timely outbreak detection and effective response. This applies to low-income countries (LICs), where health systems are sometimes barely existent, as well as HICs, where health systems were overwhelmed.

Power imbalances at play in the negotiations also need to be considered, as "Global South" countries often lack the capacity and the technical knowledge to negotiate effectively

A treaty will only be successful if it ensures continuous monitoring, keeping countries on track. In addition, open access data sharing, outbreak data analysis and transparency are some of the other key factors for success. The WHO has taken some initial steps to address the calls for better data and surveillance by launching the WHO Hub for Pandemic and Epidemic Intelligence. It remains to see whether a pandemic treaty can improve transparency and willingness to share data.

The timing of treaty negotiations has been another topic of great debate. Should a new treaty be negotiated while the pandemic is far from over? Would it make sense to wait to thoroughly investigate the weaknesses of WHO’s response mechanisms? Or should it be cemented as soon as possible, before high-income countries lose interest as the pandemic becomes less threatening to their highly vaccinated populations while the rest of the world struggles to administer first doses? Many questions remain, yet it is clear: drafting, negotiating, and passing a new instrument will take a while, and the INB is only expected to present its conclusions at the WHA 2024.

A treaty will only be successful if it ensures continuous monitoring, keeping countries on track. In addition, open access data sharing, outbreak data analysis and transparency are some of the other key factors for success

In the meantime, the slow development of a new instrument must not become an excuse for inaction –countries can already prove their commitment to pandemic prevention and preparedness by investing in health system strengthening, participating in transparent data sharing, fostering international collaboration, and enabling fair sharing of vaccines in the still ongoing pandemic.

Referring back to the beginning of this post –words only turn from promises into actions once the results become visible. Time will tell whether the promises of acting as a global community will prevail in the negotiations of the pandemic treaty and in the eye of the next global health storm.