The United Nations and the World Health Organization (WHO) were born out of a watershed moment following World Word II, created to be ready institutions for the global community in times of crisis. Unfortunately, the WHO was ill-prepared to tackle the COVID-19 pandemic when it fanned out across the globe — guidance came too slow and was largely ignored when valuable evidence-based recommendations were provided.
Poor preparation and weak regulations, among other factors, failed us.
Our current global pandemic has the potential to be a similar watershed moment. We must build on lessons learned. Global governance on pandemic preparedness is needed now more than ever. We can — and must — build a new, specific and binding agreement that will be effective in future crises.
It’s time we crafted and adopted an international pandemic regulation (IPR).
Such a new regulation would minimize both current threats and the potential disruption of new threats to global health. We simply cannot continue fumbling along, relying on countries’ individual self-interest and lukewarm concern for humanity as a whole.
The case for a distinct international pandemic regulation is obvious.
What should a new regulation encompass?
Foundationally, we need to recognize global health as a common good to which everyone is entitled. This would go beyond the current WHO support and appeals for vaccine equity.
Secondly, we also need to mandate and resource ongoing national infrastructure efforts to establish vaccine manufacturing capacity and distribution in order to address local health needs through international collaboration.
Importantly, we need to translate UNESCO’s November 2021 Recommendation on Open Science into meaningful rules for the sharing of data and knowledge related to vaccines and therapeutics.
Above all, we need binding rules for the governance of pandemic data. A new regulation should mandate the responsible, accountable sharing of data to further global security and human health.
What’s wrong with the current WHO regulations? They don’t go far enough.
The WHO International Health Regulations (IHR) aim to prevent, protect against, control and respond to the international spread of disease while avoiding unnecessary interference with international traffic and trade. They do not contain specific rules dealing with pandemics and do not oblige states to take either specific actions or be subject to sanctions.
This must change.
The good news is that the WHO has already taken steps in the right direction. Last month, they adopted a consensus decision to draft and negotiate a “convention, agreement or other international instrument” on pandemic prevention, preparedness and response. The details concerning the drafting and negotiation have not yet been crafted.
When it comes to the legal nature of the document, the idea of a treaty or convention has been promoted, or updating the 2005 International Health Regulations and adopting, as was the case in 2005 after the SARS epidemic, amendments.
To date, no one has proposed the adoption of a distinct regulation applying specifically – and exclusively — to pandemics. But this should be the path forward.
Why?
Whether it’s a treaty, amendment to existing regulations or the adoption of a new regulation, the rules would be binding for all member states. But there’s a major disadvantage in choosing the treaty avenue; it would require ratification by a minimum number of WHO states to come into force. In the case of the Tobacco Treaty, this minimum number was 40. And it has taken nearly 20 years to obtain the ratification of 182 States (still short of universal application).
In contrast, any amendments to existing regulations or the adoption of new regulations would have the potential of binding all members shortly after their adoption. The sole requirement for the adoption of regulations is a consensus without any additional procedures such as ratification for its entry into force (between nine and 24 months according to the past practice of WHO).
Adopting a new regulation would also avoid the very real and well-known danger of reopening existing regulations leading to multiple and endless amendments not necessarily related to pandemics.
But the major reason to opt for a new regulation is the necessity of adopting a specific regime that highlights the urgent, unique and global nature of pandemics; this requires immediate and effective international collaboration and resolution.
We need an international pandemic regulation that will bring about an effective, agreed-upon response to both the current and next pandemic.
While we cannot know when, where, or how the next pandemic will come about, we still have the ability to choose how we, as part of a global community, will prepare for and respond to future threats.
Photo courtesy of iStock
