PHM-Exch> "Do We Really Need a Pandemic Treaty?"
Claudio Schuftan
cschuftan at phmovement.org
Fri Aug 20 02:00:45 PDT 2021
From: Thomas Schwarz <schwarz at medicusmundi.org>
*Von:* Geneva Health Files [mailto:genevahealthfiles at substack.com]
Newsletter Edition #82 [The Friday Deep
Dives]
uest Essay: "Do We Really Need a Pandemic Treaty?"
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Newsletter Edition #82 [The Friday Deep Dives]
<https://email.mg2.substack.com/c/eJxl0EFuwyAQBdDThF0swGDsBYtueg1rgHGMgrEF41Tp6UuaVVUJoVl89JnngfC2l6c99krsdc30PNBm_KoJibCws2KZY7BCK9NLKViwKohRjyzWeSmIG8RkqZzIjtOl6IHinl8vzNRPA1stOOM4V5PX0gs3qmDUYlD0k8LetendC2eImD1afGB57hlZsivRUS_9x0V-tnPDjA9YERKtS0xYu3q6SuDvnd-3FjhwPxK2QUhjjBbqepRI8XoAZYh3Fq3kUvBRcm56rkUnuiVMg3NTgHEAHMzCB9C6l6gGt4Q-LBfFt5v8U8SKpXXfoHYrlu8Mfm0hl078irnz60thbrHtzJGeM2ZwCcMbiN7Ov2Tza53S_MMMZMUgJ6XUoJVusr8gTVC17wo1Ktb6Q6uM2f5D-AH8lZjs>
Priti Patnaik
<https://email.mg2.substack.com/c/eJxl0EFuwyAQBdDThF0swGDsBYtueg1rgHGMgrEF41Tp6UuaVVUJoVl89JnngfC2l6c99krsdc30PNBm_KoJibCws2KZY7BCK9NLKViwKohRjyzWeSmIG8RkqZzIjtOl6IHinl8vzNRPA1stOOM4V5PX0gs3qmDUYlD0k8LetendC2eImD1afGB57hlZsivRUS_9x0V-tnPDjA9YERKtS0xYu3q6SuDvnd-3FjhwPxK2QUhjjBbqepRI8XoAZYh3Fq3kUvBRcm56rkUnuiVMg3NTgHEAHMzCB9C6l6gGt4Q-LBfFt5v8U8SKpXXfoHYrlu8Mfm0hl078irnz60thbrHtzJGeM2ZwCcMbiN7Ov2Tza53S_MMMZMUgJ6XUoJVusr8gTVC17wo1Ktb6Q6uM2f5D-AH8lZjs>
Aug 20
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[image: Comment]
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[image: Share]
We continue to explore and understand the need for a pandemic treaty.
While there has been growing support for the need to craft new legal
measures in the wake of COVID-19, questions continue to be raised on
whether there is indeed “a legal vacuum” in governing health emergencies.
This week, we bring you a guest essay from lawyers affiliated with The
Third World Network. Nithin Ramakrishnan and K M Gopakumar recently
authored a comprehensive report: “*Proposal for a WHO treaty on pandemics
raises concerns
<https://email.mg2.substack.com/c/eJwtUk2PmzAQ_TXhiGwwBA4-tNFuQtS0SqpkUy7IH0Nw1hiETSj59TWbStaMPXozb8ZvBHNw64aZ9p11wWIqN_dADUxWg3MwBKOFoVKS4oSs4yjCgaRE4izJAmWregBomdLUDSME_ci1EsypziwZ6zzO06ChcQQyw2kuMSJ4LTHEiVjXdVLXWYZikr142SgVGAEUHjDMnYFA08a53q7ib6vo3Z-pD91kltZCA84HLBjZD2Ctv8O878tNkRb3c3x4HqdCTUq0l4nHe1TcO3V4nufDXNjClH15FeqX2iPRvt9ZdJkXrLzu7YJjuxMSu0N63eTiR3yKuUocXKaH3GrEt-fZxxWP8kHg6SG2p9a_j6LNPc_Phm88x7Z8CLX4N324f7_-fssW77kujdx9jmWrxz8ff3Xp65Ufx3GpURjkJwgUjVCEURYhtI5RgkMc1jJPOc8ly1IG6bpGKUsS_58k5bWMZb0iqL1FoR25dUx8hqJrg4G6pmuZDRsYnoaJxoO4HmFSJhTNIlLlYe1olJsrMIxrkC_93GsNvhStbmBg8OshK-YoTqOcEJImJEn-6-UFJr5dTDISeH7pKZWhS9aDNcC0a2qlwf4DIl7Pgg>”.
*
In this piece, they elaborate on some of the key issues that need to be
considered by WHO member states when discussions on the treaty resume in a
few weeks.
Priti* Feel free to write to us: patnaik.reporting at gmail.com
<patnaik.reporting at gmail.com> or genevahealthfiles at protonmail.com
<genevahealthfiles at protonmail.com>; Follow us on Twitter: @filesgeneva*
<https://email.mg2.substack.com/c/eJxlkM1uxCAMhJ9mOUZA-EkOHHrpa0QmmAWVkAjIrtKnL9s9VZUsn8aemW-Fhve9XObYayOvtbTrQJPxWRO2hoWcFcsSnWFS6JFzRpwRjk1yIrEuviBuEJNp5URynDbFFVrc8-tCz-OsSDDArVQoV6ln6bXyMKPm3nKJlFMQ-u0Lp4uYVzT4wHLtGUkyobWj3saPG__sc8eMDwgIqQUfE9ahnrY2WL-Gdd-6wCeooUJCEg2nnNGJU6pHKtnABu9mZe3sYFKASnuqQMqRo1DWu9H5m6Dbnf95SYppYd-gDgHLd4Y1dJFNJz5jHtbw6rt02Xbm2K4FM9iE7o2ivYn-wllewUsn7RZohik-CyGUFLIz_K3eWYkel4lJkO7vumXM5l_dH7mJkkg>
------------------------------
I. GUEST ESSAYDo we really need a Pandemic Treaty? By Nithin Ramakrishnan
and K M Gopakumar
The Member-State Working Group on Strengthening WHO Preparedness and
Response to Health Emergencies (the working group
<https://email.mg2.substack.com/c/eJwlkM2OhSAMhZ_msiSA_OiCxWzmNQw_VcggGsBrnKcfnJs0p2nS5vR8zjRY93LrY68NPTK3-wCd4aoJWoOCzgpljl5TwdXAGEVec09HMaJY56UAbCYm3coJ6Dhtis60uOfnQk3DJFHQXYliwjriPMjByUEJpRyVTgCTln58zekjZAca3lDuPQNKOrR21Nfw9WLfvcxxVHyFHcfc-rjaLtd6lN5Q1IwwSkZGiBqIoJjixU_S2smbURqQaiHSCDEw4NIufvDLi5NtZbietjbjfrDbN1R0C_tmKg5QfrNxoS_ZdMIVM3bhCTj3te3Msd0zZGMT-E_29kH4T2NeIUPpaP1smqaSTZxzKbjo0P6zdji8v0v5yFH3990yZv1cvU0Ak1pYYoL6B90Lip8>)
met during the 15th and 16th of July 2021 and adopted its method of work
<https://email.mg2.substack.com/c/eJwtkMuu3CAMhp9m2BWFa5IFi7Npt1U3XSITTEAnIRGQGU2fvsyZI1m2fNNvfws0XI_yNOdRG3k5254nmoyPumFrWMhVsdjkDVNyFJwz4o30bFITSdWGgrhD2kwrF5LzcltaoKUjvzbGWcyaRCPQeR_EBMoxISC4UWrOgWk_SyHk9NaFyyfMCxq8Y3keGclmYmtnvYmPG__ZDc6z0kc8aMqtp6vr7rGepYfTBxvShvW7xHr8--v3H2b5D8y0t0kyfOBsmPgwjGJQjDIa_Kydmz1MGlCPYdCglOAotQte-HCTw75yWi9XGyyfdDl2UkyLxw6VRiz_MiyxD7ntwkfKdIkvBLaP7VdO7Wkxg9vQv-m0N-QvXnbFjKXD9xaaYZrPUkqtpFLfNDo-2c9lcpKk6_sumbJ5bd0hImwtfr37H4CHljk>.
The 74th World Health Assembly (WHA) decision
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has mandated the Working Group to prioritize the assessment of the benefits
of developing a WHO convention, agreement or other international
instrument on pandemic preparedness and response, and report to the Special
Session of the WHA to be held from 29 November to 1st December 2021. The
Working Group is expected to start its work on this prioritised agenda.
However, there are many unanswered questions, which were left out by the
proponents of the treaty during their well-choreographed campaign for a new
pandemic treaty. This article brings attention to a few key questions to be
considered before taking any endorsement for a new treaty to govern
pandemic.
*No shared understanding on what constitutes a pandemic*
Although the WHA decision, commentaries and various other communications
call the proposed new treaty as the pandemic treaty there is no shared
understanding on this term. The logic behind the treaty as seen in the IHR
Review Committee (IRC) Report 2021
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is that it may “strengthen global coordination and collaboration during
global health emergencies and pandemics” (Paragraph 117).
The proponents of the treaty have so far not addressed the distinction
between a global health emergency and a pandemic. There is no clarity on
the usage of these terms, though WHO Director General declared COVID-19
outbreak a pandemic almost 4 weeks later after he announced the same as
Public Health Emergency of International Concern (PHEIC) under the
International Health Regulations (IHR) 2005.
The IRC 2021 report records a reason as to why this second declaration was
made; it has also not explained how a pandemic is distinctly understood
from PHEIC. It merely says that such a pandemic declaration allowed WHO to
utilize certain funds associated with WHO Pandemic Influenza Preparedness
Programme (Paragraph 79). It is clear that there is no legal definition of
a pandemic and also there is no shared understanding about the threshold
level or legal criteria by which a PHEIC becomes a pandemic. Further, it is
not clear whether the proposed treaty governs only health emergencies of
pandemic potential or all health emergencies falling within the category of
PHEIC.
Another confusion in the articulation by treaty proponents is the term
“framework”. According to the proponents, the proposed pandemic treaty is
going to be modeled as a framework convention. A framework treaty in
international law sets out only the broad legal principles and the
institutional mechanism to administer the treaty. Its implementation
requires the translation of these broad legal principles into more concrete
legal norms through the adoption of other legal instruments such as
additional protocols by the Conference of Parties (COP).
This means a framework treaty is opening up a permanent negotiating forum,
and may not immediately advance any new substantive law or result in an
upgraded standard of health emergency response. It raises the question why
Member States cannot strengthen existing mechanisms like the IHRs, which do
not require any additional institutional mechanism like the Treaty
Secretariat or the COP.
*Image credit: Photo by **Pixabay
<https://email.mg2.substack.com/c/eJwtUd1utSAQfBq5NPIj6gUXzfelT9B7g7AeSQENLPXYpy_2NNndi8lsZjJjNMJjT5c69ozkPjNeB6gIZ_aACImUDGl2VtFeDJwxSqwSlo79SFye1wQQtPMKUwFylMU7o9Ht8f4YJj5JsinJwKzTYE3PuZCjgJX2dKB0qivsRF-6ulgH0YCCL0jXHoF4tSEeueFvDXuvc55ne8ATfG7NHm5MdId76kVfDX8vGGazR4SIDf-vEZNbym3l335cH_DEhsmbE8C6EiolwQopaf-H570kAxV_SRCnWMdoN7KuG3jX05a2q53kskxWj1KDHNZO6r7nDIRcVsvtWv2EB2tzWTJq83m7JEnhtged2w3Sd9Rmq6TFFzhdbM12R1Zdh1Ciw2uGqBcP9pUmvkr5zXd-QIRUy7KzRkUlm4QQshd9reE3vRq3qHapGAWp-rZKuqjury-9gfa4rc5D_gEpHql3>*
* from **Pexels
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*IHR Reforms v. Pandemic Treaty Proposal*
In substance, it is clear
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that all those new provisions that the three committees (established under
WHA Resolution 73.1) look forward to including in the proposed pandemic
treaty, are available under the IHRs. However, the COVID-19 pandemic
response and its deficiencies have taught that the current health emergency
governance through the IHR requires urgent reforms, specifically to meet
the needs of developing countries.
At present, the legal obligation under the IHRs is effectively reduced to
an obligation to inform WHO on the outbreaks. It is an apparatus to
maintain the surveillance system to fulfill the above obligation. Though
the IHRs contain certain provisions to require WHO to assist in building
preparedness and response capacities of the parties, there is no provision
which ensures adequate mobilization of resources under the IHRs. The most
important need of the hour is to have adequate resources to build a
functioning health system, to ensure access to health products, and to
build other core capacities required to respond to health emergencies.
Reforms in the IHRs are required to address this and four of such areas are
highlighted below.
Firstly, there should be global access to diagnostics, medicines,
therapeutics, and prevention kits. This can only happen if the duty to
cooperate and assist
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in Article 44 is taken seriously by the Member-States and WHO. The clause
“to the extent possible” allows loopholes for the States to hold on to
“Nation First'' policies. Without a clear and objective legal obligation to
provide resources to protect and care for the infected populations beyond
national borders, the law of cooperation is inadequate. Therefore, the IHRs
needs to be amended to enhance its law of cooperation.
Secondly, the decision-making process of the Emergency Committees (EC)
under the IHRs needs to be more transparent
<https://email.mg2.substack.com/c/eJwlkMGOhCAMhp9mOBpAQD1w2Mu-hilShV1FA3Um7tMvziRtU0L__O03AeGy58seeyF2l5GuA23CV1mRCDM7C-Yxeiu06lopBfNWedHrnsUyzhlxg7hayiey43RrnIDinm5FN7SDYcE63bVV61sJUkveSRQOYO64kPUL3ccXTh8xTWjxifnaE7LVBqKjPNqvh_yusYTGbT_NtG_1Me2JMFHtVE1ZEzkXRtS1rORS8F5y3rVci0Y0sx-Mc4OH3gCabuYGtG4lKuNm3_r5ofi2yKacrhBMv7cFy5bCvkFpAua_BFOoQ2498RVTM4X71rGObWeKdI2YwK3oPxjoQ_MNZlwwYa6U_QhkhZGDUspopSu_99mVk6rrCtUrVv19tYzJ3qonBISVwhxXLP-OU4y7>
and freer from conflicts of interest. Currently there is a transparency
deficit with regard to the reasoning and decision making of the EC. The
dynamics between EC’s advice and WHO Director General’s declaration of a
PHEIC also needs more clarity under the IHRs.
Thirdly, the health emergency response often requires sharing of pathogen
samples among the researchers and commercial actors. As of now, such
sharing occurs in one direction i.e., access to samples without the
fulfilment of corresponding obligation of benefits-sharing with countries
which shared such samples as obligated under the Convention on Biodiversity
(CBD). The IHRs should be read with relevant articles of Nagoya Protocol
such that global access to countermeasures or health products developed
during a health emergency is not limited.
Fourthly, the IHRs do not envisage or recognize the role of communities in
health emergencies including the pandemic preparedness and response. The
current framework is guided by a top-down approach and often does not take
the community into confidence.
All these and many other required reforms take us to the important question
of whether we need a new treaty under Article 19 of the WHO Constitution
<https://email.mg2.substack.com/c/eJwlkMGOhSAMRb_msSSIgLpgMZv5DYNQhIyCgTrG-frB95KmSUNvTjnWIKy53PrIFcnTZrwP0AmuugEiFHJWKHN0upNi6DnviNPCdaMcSayzLwC7iZvGcgI5zmWL1mDM6UkMUz8pErQc5GDBT06AseAGZtmgeslc7zkHKz5cc7oIyYKGXyh3TkA2HRCP-uq_Xvy71XVd9AqZxoRtWnPbS6Yl2gDL8x7ybHOqGPF83wCJHs6TqDnjHRs5Y0PPZEc76t2klmVyZlQG1OCZMlL2HIRavOudfwm2r5zWc6lo7A-1eSdFY8i7qTRA-UvGhra0bCdcMVEbns83-r6fKeLd0GbZwH284Efv29S8QoLStLvZoO4Un4QQSgrZhL49NHGinduJUZDGdw0Zk35SvyaA2TD4uEH9B5PWlvM>
to reform the governance of health emergencies to enhance the preparedness
response capabilities. The answer is that strengthening the IHRs could
achieve the objectives with greater scope and intactness than that of a new
treaty.
The new treaty would lead to the fragmentation of the governance of health
emergencies since States need not become party to a new treaty under
Article 19. The IHRs on the other hand is a legally binding instrument
adopted under Article 21 which allows the WHA to adopt regulations that
automatically bind the member-states. If States want to opt-out as
mentioned in Article 22, they would still need to deposit their reservation
or decision within a stipulated time frame.
Further, the decision making with regard to the IHRs can be managed and
undertaken at the WHA with full participation of member-states. In the case
of the proposed treaty it would be carried out by COP of the treaty. This
fragmentation of the governance of health emergencies would lead to a lack
of accountability and a draining of resources. It will further legitimise
the back-door entry to non-state actors pushing their own agenda as seen in
the current pandemic response. Therefore, the most appropriate form of
reforming the law would be amending the IHRs or issuing further
implementation guidelines and annexing them to the IHRs 2005. Both forms of
reforms can be implemented via Article 57 of the IHR read with Article 21
of the WHO Constitution.
<https://email.mg2.substack.com/c/eJxVUl2PpSAM_TXXNw2fgg8-TDbZv2EKFCWj6ADe2Tu_fvG6L5uQ9lBoT9NTCwXnPb3GY8-lucxUXgeOEb_ziqVgas6MaQpupFIozhht3Cgc1VI3IU8-IW4Q1rGkE5vjNGuwUMIerww18KFvltGil70SUmtOQHNLnPFCWsUUB4mob144XcBoccQnptcesVnHpZQjP_jHg_2ux7rY5dPkAvazs_tWQ2GDGav3WOxy-Vqm7A_26-sG_GPed1fvfp2OtM8Jcw5PrPFcEI-acVMweZHIi6Yac9pPrO-pRSKNsVq0BoC3gitsB0l1C85wZlCpQYsu8w42-NkjfOe7r1rjnsUbvpvMbzgAEUZ53qJyvhVMu1Y7tK3rDXqn0RMjJ8oG9ocSyrsjzk0YGWGUaEaI4kTSjnbeDb0xgwPdA_bKkx6k5AxFb7zjzj8E2Wb236yaNJZl3yB3C6afCHVagpj1xO8QO7tc0k3123bGUF4TRjArulvVci_HW-dpxoipLo2boIy0Z4MQopdCyn8qVtlFbZcKLZrK7ypliOOV9YQFYS2LDyvmv4Dgz2E>
*Image credit: TWN report “Proposal for a WHO treaty on pandemics raises
concerns
<https://email.mg2.substack.com/c/eJwlkTGP5CAMhX_NUCIgQJKCYpvVdnfdlREJZoKWQATOjnK_fklGQn4u_HjW58UiPHM5zZ4rkqtMeO5gErxqBEQo5KhQpuAMV7LvhODEGen4oAYS6uQLwGZDNFgOIPsxx7BYDDldjn7sRk1Ww7ljvXagBsG7QUnO2TjAMsLovfAS3rn2cAHSAgZ-oJw5AYlmRdzro_t4iM_28JXodl5NwAiiNXPO37Xp7nyrf0tuP9n4EEown8ut9q7_vv7cigUsntSHZCO4gOBo85JgBBOcDYKxvmOKU069G_U8j84O2oLuPdNWqU6A1LN3XcuTbHsKWo-5ol2-6ZI3UgyuebOVrlD-J7usbWiOB7xCost64Zna2HakgOcEyc5thzc5fB_gZjk9IUFph3GTRcO1GKWUWknVkN-kGlrZ1uVykKTluxYZkrlcP3YFG3H1IUL9BRDxnnY>”*
A legal vacuum to govern emergencies?
In a way, the new pandemic treaty proposal and the proponents of the treaty
are steering the attention of health law analysts away from the IHRs, and
the much required reforms. As mentioned above, there is an urgent need to
reform the governance of health emergencies especially to address the needs
of developing countries, which are often at the receiving end of such
governance mechanisms. However, there is no convincing argument that it
could be carried only through a new pandemic treaty.
The three reviews carried out as per WHA 73.1 recommended for a new treaty
without providing any in-depth analyses for their recommendations for the
new treaty. Therefore, the Working Group, instead of falling into the trap
of the pandemic treaty rhetoric, needs to carefully examine the so-called
legal vacuum. It should seek the question whether such gaps can be
addressed through the reform of the existing framework of the IHRs or only
through a new treaty. Further, it should also look into the effect of the
new treaty on the fragmentation of governance of health emergencies in the
light of co-existence of the IHRs. The developing states and their
representative governments must therefore reinvest their time in reviewing
the existing legal regime and start aggressively articulating the IHR
reforms instead of becoming the norm-takers once again, as seen in the
history of International Law.
*Like this essay? Get in touch with Nithin Ramakrishnan here:
nithin.ramakrishnan at cvv.ac.in <nithin.ramakrishnan at cvv.ac.in>*
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