During the pandemic, inequalities have prevailed around the world. Until March 2023, in low-income countries, only 32.2% had access to a vaccine dose / Dossier

There pandemic of coronavirus It affected everyone. But the answer to deal with it public health emergency it was not with equity. Not everyone had access to diagnostics, vaccines oh treatments on time.

The World Health Assembly, made up of 194 countries and the decision-making body of the World Health Organization (WHO), seeks to avoid made mistakes before the possibility of future pandemics. He has already started to negotiatezero draft” by a global pandemic treaty which will be legally binding if approved. In other words, the countries that sign it will have to comply with it, even if this does not imply that they lose their sovereignty to establish national public health policy.

In the coming months, there will be negotiations between the countries on what the agreement will specifically establish. It could be approved in 2024. At the start of the draft, it is already acknowledged that there has been a “catastrophic failure” by the international community to act with solidarity and fairness during the coronavirus pandemic.

With the global agreement, we seek to improve preparedness and distribution in the face of the possibility of other pandemics (Gettyimages)
With the global agreement, we seek to improve preparedness and distribution in the face of the possibility of other pandemics (Gettyimages)

In high-income countries, 73% of the population have received at least 1 dose of vaccine. In contrast, among low-income people, only 32.2% had access to a dose so far in 2023 and after three years of the pandemic. The draft agreement – which has been promoted by the Council of the European Union – contains a series of measures aimed at ensuring that the global response to the next pandemic is not only stronger but also fairer.

One of the proposed measures is to create a new global pandemic logistics and supply chain network that ensures better and more equitable distribution of supplies, tests, vaccines and treatments.

It also proposes a “pathogen access and benefit-sharing” system, in which countries will be asked to share newly detected pathogens and their genomic sequences “within hours” for research to be conducted.

Draft pandemic agreement urges countries to share data on new pathogens and their genomic sequences
Draft pandemic accord urges countries to share data on new pathogens and their genomic sequences ‘within hours’/File

another point of eraser The 35-page document notes that diagnostics, treatments and vaccines developed from pathogen data must be shared equitably. This includes a provision for the WHO to obtain 20% of any production: 10% as a donation and the rest at affordable prices for use in developing countries.

This measure aims to prevent countries from facing the obstacle later of not being able to access vaccines or treatments developed from data on the pathogens that they have provided themselves.

The new director of the Pan American Health Organization (PAHO), Jarbas Barbosa, recently met with representatives of Latin American and Caribbean countries and discussed the agreement. “Countries in our region should take advantage of the ongoing negotiations for the new instrument, as this is a once-in-a-lifetime opportunity that may not happen again soon,” Dr Barbosa said in a statement.

The project is already sparking debate. in dialogue with GlobeLiveMediaRajat Khosla, director of the International Institute for Global Health at the United Nations University in Malaysia, stressed the importance of reaching an agreement. “The most important and invisible issues in the COVID-19 response were human rights and equity. The pandemic has exposed the health and social injustices suffered by millions of people around the world,” Khosla said.

According to Rajat Khosla, director of the International Institute for Global Health at the United Nations University in Malaysia, human rights and equity must be considered first when reaching the global agreement. against pandemics/REUTERS/Esther Ruth Mbabazi
According to Rajat Khosla, director of the International Institute for Global Health at the United Nations University in Malaysia, human rights and equity must be considered first when reaching the global agreement. against pandemics/REUTERS/Esther Ruth Mbabazi

“As has been repeatedly affirmed, the pandemic and our responses have revealed and exacerbated injustices that have always existed. Therefore, equity and human rights should be two main issues that the treaty should address or mitigate to ensure a justice-oriented approach to future pandemics,” the expert said.

But Khosla acknowledged there will be challenges to overcome. “Compliance and accountability will be the two main challenges in developing the agreement. And that’s where the current draft agreement is weakest and somewhat silent,” he said.

For the specialist, “if there is no meaningful approach to comply with the obligations of the agreement and an independent mechanism that guarantees accountability, the agreement would fail miserably when it comes to raising the type of challenges that the preparedness and response to COVID-19 revealed or that a future pandemic may require”.

The humanitarian organization Médecins Sans Frontières considers the agreement with "Hope" for change to happen in better access to vaccines and medicines during pandemics / Archive
From the humanitarian organization Doctors Without Borders, the agreement is envisaged with “the hope” that a change will occur in better access to vaccines and medicines during pandemics / File

In the meantime, for Francisco Viegas, medical innovation policy advisor for the access to medicines campaign of the humanitarian organization Doctors Without Borders, “the global agreement brings hope. Just as a legally binding treaty for tobacco control was reached in 2003, we believe that a similar agreement for future pandemics could mean many benefits for humanity, in particular by guaranteeing access to vaccines, treatments and to other health technologies.

But Viegas pointed out in dialogue with GlobeLiveMedia that the project needs to be improved. “He has weak language that doesn’t strongly engage with efforts like more global production and distribution of vaccines and treatments. We don’t want what happened with COVID to happen again: many states funded research and development, but later marketing and distribution was in the hands of private companies and access has been limited to a large part of the world’s population.

Viegas also considered it essential that pathogens be shared between countries in order to study them and develop vaccines and treatments. But this must imply a retribution to the countries as a quid pro quo. Another concern for Doctors Without Borders is the concept of “pandemic” which is defined in the project.

One point is that the draft agreement does not clarify what will happen to existing technologies for pathogens with pandemic potential, such as Ebola (Getty)
One point is that the draft agreement does not clarify what will happen to existing technologies for pathogens with pandemic potential, such as Ebola (Getty)

It says that a “pandemic” is the global spread of a pathogen or variant that infects human populations with limited or no immunity through sustained and high human-to-human transmissibility. This must involve overloading health systems with severe morbidity and mortality and causing social and economic disruption.

“It is not clear whether the agreement can govern the possibility that previously described pathogens such as Ebola virus or Marburg virus can produce epidemics. Technologies already exist to fight Ebola. Therefore, it should be clarified whether the measures proposed in the agreement would also apply to the pathogens already described,” Viegas commented.

In the negotiations to reach the agreement, there is limited scope for civil society participation/Noam Galai/Getty Images)
In the negotiations to reach the agreement, there is limited scope for civil society participation/Noam Galai/Getty Images)

He felt that the negotiations of the agreement give “limited participation” to civil society. “This does not allow for greater transparency and for the company to also contribute its opinions to make improvements to the project.”

From the pharmaceutical sector, there are also signs. “The deal must build on the strengths of the private sector for innovative research and development, rapid expansion of manufacturing and distribution, which are backed by a strong intellectual property system,” said Thomas Cueni. , CEO of the International Federation of Pharmaceutical Manufacturers Associations. , consulted by the agency Reuters.

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