Five years after the world was in the grip of the COVID-19 pandemic, the deadline looms for finalizing a global pandemic preparedness treaty. The completion date for the treaty, which aims to address profound disparities in global health systems exposed by the COVID pandemic, has already been extended by one year to the World Health Assembly in May.
But the likelihood of reaching a comprehensive agreement by then is small. The impasse between developed economies and the Global South on issues from financing to benefit sharing is resulting in a dilution of the treaty’s commitments. The recent withdrawal of the United States from the World Health Organization suggests that even if a treaty is agreed, it may not be universally adopted.
But hope is not lost. To advance towards global health equity, lower-income countries must sidestep the deadlock with developed economies and look to each other for solutions.
A pandemic of disparities
Launched by the World Health Assembly in December 2021, the pandemic treaty was intended to end the stark inequalities in the COVID response and access to health resources between low-income and developed countries. By mid-2021, more than 70 per cent of COVID vaccines had been administered in high-income countries, while low-income nations received less than 1 per cent.
By strengthening global cooperation, the treaty aims to close these gaps and ensure fair distribution of vaccines, diagnostics and other critical resources for the next pandemic. Over the past three years however, developing and developed countries have remained diametrically opposed on some of the core issues.
One of the key fault lines is over the requirement for all countries to share data on pathogens and genomics to enable the production of new vaccines, tests and therapeutics. A significant proportion of this data comes from poorer countries, which account for 85 per cent of the global population.
However, after their experience in the COVID pandemic, developing nations are reluctant to share this information with pharmaceutical companies – primarily based in the Global North – without being guaranteed access to the resulting products. Pharmaceutical companies on the other hand are lobbying their host governments against the mandatory sharing of these products and argue that any restrictions on accessing pandemic data ‘would deter researchers and manufacturers from working on pathogens with pandemic potential’.
During talks last year Global South representatives accused developed countries of ‘diluting the intent’ of the treaty with their rejection of binding commitments. Developing countries have also called for robust funding to support their pandemic preparedness and response. But with key donors, including the United States, cutting back on health and development aid, concerns are growing over how poorer countries will fund the prevention measures outlined in the draft treaty.
Disparities in negotiating capacity have also been stark. African countries entered the negotiations underprepared and under-resourced, often represented by a single delegate. By contrast, the US fields expert negotiators supported by legal and subject matter specialists. Such mismatches reduce the chances of a fair agreement being reached. Yet rather than despair at the slow progress of the pandemic treaty, countries from the Global South, particularly African nations, should learn lessons and embrace their own means of achieving health equity.
Looking South
‘South–South’ collaboration represents the most viable path. The expanding Brics nations are important in this respect because they have the resources, technology and expertise to strengthen regional manufacturing capacities and reduce the dependence of poorer countries on imports from the Global North.
Brazil, for example, has a long tradition of producing vaccines in the public sector and is in discussions with the African Union (AU) about developing the continent’s manufacturing capability. This cooperation must be expanded if the AU is to meet its target of increasing vaccine manufacturing in Africa from the current 1 per cent of local needs to 60 per cent by 2040.
In the absence of a fair pandemic treaty, deepening partnerships with like-minded nations could help lower-income countries pool resources and build up reserves. Promising steps have already been made. In 2021 Caricom – an intergovernmental group of Caribbean countries – was invited to join the AU’s pooled procurement mechanism for Covid vaccines. Other partnerships, like the Brics Vaccine Research and Development Centre, are helping increase regional manufacturing power, but need more investment and support.
A path forward
For African countries in particular increasing regional partnerships would strengthen their negotiating power at global forums, including the World Trade Organization. Creating collective policies through instruments like the AU Free Continental Trade Agreement would clarify their negotiating position and prevent bilateral agreements undermining collective interests.