After a year of nationalist approaches to Covid, securing world cooperation on disease control is unlikely to be easy
A sign at the Port of Dover after France closed its borders over concerns about a new coronavirus variant, December 2020. Photograph: Vickie Flores/EPA
Boris Johnson, alongside 24 other world leaders, has announced a pandemic treaty, a legally binding mechanism to protect against future pandemics and their impact on economies and societies. While the content of the treaty is not yet agreed, the aim is to bring political commitment to health security compliance between governments, using the language of global collaboration, cooperation and solidarity for mitigating future pandemics.
This appears to be a much-needed tonic for multilateralism after a year of nationalist approaches to pandemic control. However, for meaningful pandemic preparedness we need to address the elephant in the room: why did governments not abide by international law and the norms for pandemic management that were already in place?
The International Health Regulations (IHR) provide the legal architecture outlining what governments must do to prevent, detect and respond to outbreaks of infectious disease: this includes sharing information about emerging pathogens with the WHO; implementing public health interventions to prevent disease transmission; and in the longer term developing capacity within health systems to be able to identify and respond to emerging disease threats.
Alongside this, political norms of global health security have emerged through groups such as the Global Health Security Agenda, the G7 and multiple regional efforts such as the Mekong Basin Disease Surveillance Network. Governments have increasingly recognised the mutual vulnerability to global disease risk, and the necessity of collaboration within transparent systems to prevent and respond to health emergencies.
Yet many of those governments chose to abandon the law and norms established within pandemic preparedness, deciding to go it alone during Covid-19. They actively departed from WHO guidance on how best to respond to the virus, (despite previously recognising the WHO as the global disease coordinator); failed to support other states in their response to Covid-19; and have contravened the IHR by implementing travel restrictions in the absence of such recommendations from the WHO. Moreover, many states continue to sidestep norms of global solidarity with their stalwart commitment to vaccine nationalism over efforts for equity in the distribution of vaccines.
One of the key lessons learned from Covid-19 has been that politics drives epidemics. Political will to manage an outbreak is crucial to the success of any technical disease control intervention. This also stands for global governance of disease: the best norms and international law are only as effective as the political credentials given to them. A significant critique of the IHR is that it is a technical and legal tool, outlining government’s responsibilities to prevent, detect and respond to an emerging pathogen, without any incentive or enforcement mechanism to do so. Beyond public shaming, there are few ramifications for governments flouting the law. If the proposed pandemic treaty can bring greater political commitment to the established law and norms in global health security and is able to hold governments to account, it would certainly be the holy grail for pandemic preparedness.
What could this pandemic treaty look like? Economic or political sanctions for failure to comply with the IHR? Financial compensation for effective outbreak response? There is suggestion of drawing such power for enforcement or incentivisation from within the broader multilateral system. This could involve more powerful institutions that have such capabilities or resources, such as the International Monetary Fund, World Trade Organization or United Nations security council. However, both the carrot and the stick could have significant political and economic costs for the nations involved.
If governments are serious about a meaningful pandemic treaty, this would require them to cede a significant portion of their sovereignty when it comes to disease control – to give power and authority to the WHO to share pathogenic information; to recommend (or even implement) public health measures, even if these come at significant cost to a nation’s trade and travel; and permit the international power to enforce compliance.
I find it hard to imagine governments agreeing to a treaty that gives them less control at time of crisis, the inability to make sovereign decisions as to policy tools implemented, and for which noncompliance could risk economic or political side-effects. Saying you want a treaty is the easy part, negotiating it is where the hard work comes in.
The WHO Framework Convention on Tobacco Control, which is discussed as a potential model for this treaty, aimed to reduce tobacco consumption and trade, but several countries, including the US, failed to ratify the treaty because of competing industry demands domestically. Depending on the content of the proposed pandemic treaty, it’s easy to imagine a similar trajectory: in the joint letter published this week, the US and China are both notable for their absence.While much political fanfare was made of the commitment to a pandemic treaty, little of the goodwill and solidarity is likely to survive the negotiating process.
The pandemic treaty offers an opportunity to bring political power to a flailing governance mechanism. But there is no way of guaranteeing that governments would abide by it at time of crisis, as we have seen during Covid-19. Why do our current political leaders think that their successors will act any differently?
- Clare Wenham is assistant professor of global health policy at the London School of Economics