A health worker prepares a booster dose of the Covid-19 vaccine in Yogyakarta, Indonesia, on February 16. Photo: Xinhua
Opinion
Inside Out
by David Dodwell
Inside Out
by David Dodwell
Sad state of global cooperation bodes ill for next pandemic; can Asia set a better example?
A WHO draft treaty on strengthening pandemic preparedness calls for improvements in global information sharing and resource distribution – and a lot more money
While geopolitical tensions make such aims more challenging, groups like Apec can contribute a range of best practices on regional cooperation and fundraising
Almost three years ago, as Covid-19 was sweeping across the world and we were spiralling into the worst global pandemic seen in a century, I wrote here in the Post that “some practical and globally agreed ground rules are urgently overdue”.
A couple of months later, with no vaccines yet in sight, I listed several lessons that I thought we had learned: that international cooperation and a unified approach were essential; that science had to lead our response; that large amounts of pre-emptive investment would be needed; that a short menu of simple actions would slow the spread (including wearing masks, avoiding crowded places, and conducting intelligently targeted testing and contact tracing); that even though Covid-19 was wreaking havoc worldwide, it was not “the big one” – which would be climate change; and finally, that we remain poor at judging the risks we face.
Today, I am still not certain all of these lessons have been learned. But after around 20 million deaths, and economic costs estimated by the International Monetary Fund (IMF) to be over US$12 trillion, the World Health Organization (WHO) has at last released a “zero draft” of a global treaty on pandemic prevention, preparedness and response, with serious negotiation set to start on February 28.
The paper starts with a sobering admission that a formal treaty was needed “in recognition of the catastrophic failure of the international community in showing solidarity and equity in response to the Covid-19 pandemic”.
What the treaty will eventually look like, only time will tell. The deadline for completion is a WHO World Health Assembly planned for May next year. But as Richard Horton, the highly-regarded editor of the Lancet medical journal, warned just a week ago, “delivering a global agreement on pandemic preparedness and response would be challenging even in the best of circumstances. And today’s fractured and hostile world does not present the best of circumstances”.
The “zero draft” contains some valuable detail on how to build an equitable, end-to-end health security ecosystem. For example, recommendations on supply chain resilience point towards detailed arrangements on the products that will be needed to ensure health security, where the products will be needed and in what quantities, how to ensure fair distribution, and the need for regional hubs and staging areas.
The draft focuses on improved pandemic surveillance, early warning systems and rapid information sharing on new pathogens. It emphasises the need for equitable access to technology, clinical trial networks, regionally distributed manufacturing capacity for things like vaccines, and arrangements to ensure equitable distribution.
Despite likely controversy, it flags the need for rules that relax intellectual property protections, and enable fast technology transfers worldwide.
Perhaps inevitably, the draft calls for more funds, and more powers, for the WHO. And it is vaguest on where the money will come from to underwrite the cost of this reinforced pandemic preparedness ecosystem.
Estimates of future costs vary. The Lancet puts the figure at around US$124 billion over the next five years. It argues, accurately, that this is “small in relation to the costs of the pandemic”. But it is huge compared to the US$1.4 billion allotted to the global pandemic fund last November. And it is daunting in a context where governments worldwide are under pressure to allot similar sums to tackle global warming, and even to lift military spending in the wake of Russia’s invasion of Ukraine – all while a global recession looms.
The zero draft calls on signatories to ensure that 5 per cent of their health budget goes to pandemic prevention. It also calls for funds for international cooperative assistance. The sum? Elusively, the draft suggests “XX per cent”, and will be tasking negotiators to fill in the blank. Getting agreement on this number is likely to be an ugly spectacle.
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Here in Asia, I wonder whether the 21-member Asia-Pacific Economic Cooperation (Apec) group can lend support to WHO efforts. First, Apec has a Health Working Group comprised of the region’s top health officials which could provide a valuable forum for progressing Asia’s input on the treaty.
Second, Apec’s Business Mobility Group – which created the greatly-valued Apec business travel card – might consider embedding vaccine records and agreed pandemic protection protocols in the card as a safe and trusted travel card across the region.
Apec’s finance ministers have also been driving the development of “catastrophe bonds” as a market-based mechanism for insuring the region’s governments against a wide range of natural disasters. Could such bonds be developed to underwrite the cost of building the pandemic preparedness infrastructure of the future?
While such thoughts might for now be a step too far, Apec’s valuable tradition of “best practice brainstorming”, where officials can seek out and share best practices without being under pressure to sign up to legally binding deals, could provide a helpful complement to the WHO’s more formal treaty negotiations.
Managed well, WHO efforts to forge a global treaty to ensure better international cooperation in protecting against future pandemics will be invaluable, while the terrible lessons of the past three years are still scarred in our memories.
Seeking such an ambitious multilateral agreement will be challenging at a time when habits of international cooperation are at their lowest ebb in decades. But failure would be a tragedy for which we would pay a terrible price – perhaps dangerously soon.
David Dodwell is CEO of the trade policy and international relations consultancy Strategic Access, focused on developments and challenges facing the Asia-Pacific over the past four decades
