One vaccine treaty to help all the world

Vaccination rates were vastly different between rich and poor nations during the 2009 flu pandemic, which killed 280,000 people. Clearly, a new paradigm was needed. — Filepic/The Star

Lately, there have been a number of false claims made on social media about a new pandemic treaty that would supposedly lead to countries losing their sovereignty to the World Health Organisation (WHO) and sweeping vaccine mandates. I’ve seen claims that the treaty will allow the WHO to “take over” Malaysia’s administration in a pandemic.

Now that’s just ludicrous. The WHO has no powers to control any nation’s decision-making. It just recommends.

Beyond the barrage of baseless claims, the real issue here to me is not sovereignty but equity.

The idea of a pandemic treaty to strengthen global coordination and vaccine equity evolved in 2021, after the “catastrophic failure” of the global response to the Covid-19 pandemic that began in 2020. That was when rich nations were receiving the bulk of Covid-19 vaccines, with only 1% of vaccines going to poor nations, in what some called a “vaccine apartheid”.

Such inequity has been seen before. Vaccination rates were vastly different between rich and poor nations during the 2009 flu pandemic, which killed 280,000 people. And for years, lifesaving drugs to treat HIV/AIDS were prohibitively expensive for people in developing countries.

Clearly, a new paradigm was needed. There was also a need to step up surveillance to detect future pandemics, and to improve information and data sharing, accountability, and transparency.

The draft pandemic treaty – the WHO agreement on pandemic prevention, preparedness, and response (or the WHO CA+) – has laid bare global rifts. Drug companies object to it because it calls for transparency in the use of public funds and clinical research. But NGOs bemoan that it lacks teeth.

It’s important to set the record straight on this treaty.

First, this is not “WHO’s treaty”. While the WHO facilitates the process, it was the organisation’s 194 member states who decided on it and who will approve the final draft at the World Health Assembly in May 2024. An intergovernmental negotiating body – not the WHO Secretariat – is drafting and negotiating the treaty and has had several meetings to date.

Second, the draft text confirms national sovereignty. The WHO advises, recommends, sets standards, and coordinates global responses. But it has no powers to police countries. Countries set their own policies. That’s why we saw such divergent national policies on Covid-19.

Third, a pandemic treaty is not a radically novel idea. We already have some frameworks that address pandemics. Under the 2005 Inter-national Health Regulations (IHR), drawn up after the SARS (severe acute respiratory syndrome) epidemic in 2002-2004, countries must report public health events that cross borders. They also must have capacities to detect and respond to outbreaks.

All countries are on board, and much progress has been made due to the IHR. But Covid-19 showed we needed something stronger – thus the pandemic treaty.

Fourth, although the pandemic treaty will be legally binding, countries can opt out. Consider the WHO’s Framework Convention on Tobacco Control (FCTC). Many countries signed it right away in 2005, but a few have yet to sign it – a big outlier is Indonesia. Still, the FCTC has had a massive impact in spearheading myriad tobacco control measures.

For example, smoke-free environments are now a norm, a far cry from the smoky newsroom I knew as a young journalist.

Fifth, we really need a treaty to steer us in a pandemic. Experts believe that the next pandemic will happen sooner rather than later due to climate change and human encroachment into wildlife areas. “Disease X” could be far more lethal and contagious than Covid-19. So it’s critical that when – not if – the next pandemic hits, we waste no time to curb it with vaccines and medicines.

This is why the pandemic draft treaty calls for temporary waivers on intellectual property rights. Of course, pharmaceutical companies – and the governments of the countries in which the companies make their billions and pay taxes – aren’t happy. One industry leader said he’d rather have no treaty. I’m sure he would!

But a waiver would not cancel all profits or patents forever, it would simply be a temporary measure to allow a rapid response.

The draft also calls for more transparency so companies receiving public funds are held more accountable.

During the Covid-19 pandemic, some big pharma firms received vast sums of public funds to develop a vaccine, yet did not factor this in their pricing and also kept deals confidential.

They cited innovation costs, yet the People’s Vaccine Alliance says the world’s 20 largest pharmaceutical firms spent almost as much on payouts to their executives and shareholders (US$378bil or RM1.7 trillion) as they spent developing new Covid-19 vaccines and medicines from 2020 to 2022.

This is shameful. We have to do better next time. Yet the pandemic treaty has already been diluted. Critics such as Third World Network are calling for greater equity. And all the fake news doesn’t help.

Still, this treaty is our best chance to put people before profits in the next pandemic. I’m not holding my breath, but I can only hope that the world does not waste this opportunity.

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Human Writes columnist Mangai Balasegaram writes mostly on health but also delves into anything on being human. She has worked with international public health bodies and has a Masters in public health. Write to her at [e-mail]. The views expressed here are entirely the writer's own.