Table of Contents
THE CONTEXT: The 77th World Health Assembly (WHA) in Geneva marked a critical juncture in global health governance, as 194 WHO member states failed to finalize the much-anticipated Pandemic Agreement after over two years of negotiations. Despite this setback, significant progress was made with adopting amendments to the International Health Regulations (IHR) 2005 and extending the mandate for the Pandemic Treaty negotiating body.
THE ISSUES:
- Pathogen Access and Benefit Sharing (PABS): The PABS mechanism, particularly Article 12, is a major point of contention. It aims to ensure that genetic resources and pathogen samples shared by developing countries are reciprocated with benefits such as vaccines and diagnostics. The debate revolves around the percentage of shared pandemic products, with low- and middle-income countries (LMICs) pushing for a guarantee of at least 20%. In comparison, many high-income countries argue for a maximum limit of 20% or less.
- Technology Transfer and Intellectual Property: Strong provisions for technology transfer and local production are essential to address vaccine inequity. The negotiations are divided over the conditions for technology transfer, with high-income countries advocating for Voluntary and Mutually Agreed Terms (VMAT), which could discourage mandatory approaches recognized under the WTO-TRIPS Agreement. The debate also includes the ‘peace clause’ to respect the use of TRIPS flexibilities without external pressure.
- One Health Approach: The One Health approach emphasizes the interconnectedness of human, animal, and environmental health. While high-income countries, especially the European Union, strongly support this approach, LMICs view it as an unfunded mandate that could strain their resources further. This approach aims for a coordinated effort among all relevant sectors and actors.
- Equity and Solidarity: The amendments to the IHR and the proposed Pandemic Agreement emphasize equity and solidarity. This includes ensuring equitable access to health products during emergencies and mobilizing financial resources to support developing countries in building and maintaining core health system capacities. The creation of a National IHR Authority is also mandated for better coordination.
- Compliance and Enforcement: Enforcing agreements is a significant challenge in international law. The proposed Conference of Parties (COP) is expected to play a crucial role in monitoring and evaluating the implementation of the Pandemic Agreement. The effectiveness of this mechanism remains a critical concern, especially regarding the accountability of high-income countries.
- Financing Pandemic Preparedness: Financing is a critical issue, with debates on creating a new funding mechanism or reforming the existing Pandemic Fund. Ensuring sufficient financial resources for preparedness and response, especially for LMICs, is essential. The negotiations also stress the importance of domestic financing to show commitment from all countries.
THE WAY FORWARD:
- Implement a Binding PABS Framework: Establish a legally binding framework that mandates equitable sharing of benefits from pathogen samples provided by low—and middle-income countries (LMICs). This includes vaccines, diagnostics, and treatments. Global Influenza Surveillance and Response System (GISRS) is a model in which countries share influenza virus samples in exchange for access to vaccines and antivirals.
- Mandate Technology Transfer: The Pandemic Agreement should include strong provisions for mandatory technology transfer and local production capabilities, leveraging TRIPS flexibilities like compulsory licensing. Advocate for sustainable and geographically diversified production to ensure self-sufficiency in LMICs. WHO’s initiative of the mRNA Vaccine Technology Transfer Hub to establish mRNA vaccine production in LMICs, starting with South Africa, is an example.
- Establishing a Robust Compliance and Monitoring Mechanism: Create a Conference of Parties (COP) to monitor and evaluate the implementation of the Pandemic Agreement, ensuring transparency and accountability. Regular meetings of the Paris Agreement COP to assess progress and compliance with climate goals, providing a model for pandemic preparedness. WHO Stresses the need for a strong compliance mechanism to ensure the effectiveness of international health regulations.
- Ensuring Financial Support for LMICs: Establish a Coordinating Financial Mechanism: Create a dedicated fund to support LMICs in building and maintaining core health system capacities, with contributions from high-income countries. The World Bank’s Pandemic Fund provides grants to help LMICs prepare for future pandemics, though governance reforms are needed to make it more effective.
- Promoting the One Health Approach: Mandatory inclusion of One Health principles in national pandemic preparedness plans, with financial and technical support to LMICs. The health of humans, animals, and the environment is interconnected, necessitating a coordinated approach to prevent pandemics. Zoonotic Disease Programs successfully integrate One Health principles in programs targeting zoonotic diseases like Ebola and Zika.
THE CONCLUSION:
The ongoing negotiations for the Pandemic Agreement remain crucial as the world grapples with the aftermath of COVID-19. The recent IHR amendments and the extended timeline for the Pandemic Treaty underscore the global commitment to building a more equitable and resilient health system, with the hope that the final agreement will be ready for consideration by the 78th WHA in May 2025.
UPSC PAST YEAR QUESTIONS:
Q.1 Critically examine the role of WHO in providing global health security during the Covid-19 pandemic. 2020
Q.2 What are the research in developmental achievements in applied biotechnology? How will these achievements help to uplift the poor sections of the society? 2021
Q.3 What do you understand by nanotechnology, and how is it helping in the health sector? 2020
Q.4 The COVID-19 pandemic has caused unprecedented devastation worldwide. However, technological advancements are readily available to win over the crisis. Explain how technology was sought to aid management during the pandemic. 2020
Q.5 Why is there so much activity in biotechnology in our country? How has this activity benefitted the field of biopharma? 2018
Q.6 In a globalized world, intellectual property rights assume significance and are a source of litigation. Broadly distinguish between the terms – copyrights, patents, and trade secrets. 2014
MAINS PRACTICE QUESTION:
Q.1 Discuss the significance of the proposed WHO Pandemic Agreement in addressing global health inequities highlighted during the COVID-19 pandemic. What are the major contentious issues that have stalled the finalization of this agreement?
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