How to avoid chaos in a new pandemic

Recent drafts of the global pandemic treaty have been widely criticized as “shameful and unfair.” When the latest round of negotiations opened on March 18, it was clear that an essential lesson of the Covid-19 pandemic was being ignored: public health and the health of the economy are independent. To achieve both, it is necessary to rewrite the rules of how health and well-being are valued, produced and distributed—and how economies are governed. The success of the treaty will depend on the willingness of member states to include the capital on due terms. And that, in turn, will require a new economic paradigm. If the treaty is progressively restricted to make it as harmless as possible, it will fail.

The World Health Organization's Council on the Economic Aspects of Health for All, of which I chair, has already issued recommendations on how to proceed. For starters, negotiators in all countries must remain focused on the overall goal of preventing future health threats from becoming catastrophic. That means designing the terms of the treaty—including those related to innovation, intellectual property (IP), public-private collaboration, and financing—to be mission-oriented. Capital must be the top priority because, ultimately, all individuals—and all economies—suffer in a pandemic if life-saving tests, vaccines, and therapeutics are not available to everyone.

Likewise, the way innovation and knowledge is managed is as essential as the innovation itself. Governments have powerful mechanisms to determine who benefits from innovation. They are major funders of everything from early-stage research and development to product development and manufacturing. The mRNA vaccines against Covid-19, for example, benefited from a public investment in the United States of around $31.9 billion. Stronger conditions for private sector access to public financing would help ensure equitable and easier access to the resulting products, while facilitating the exchange and reinvestment of profits in productive activities (such as R&D) and not in unproductive activities (such as shareholder buybacks by pharmaceutical companies).

In each case, the point is to establish a more symbiotic relationship between the public and private sectors based on shared objectives, and shared risks and rewards. As we saw with the repeated spread of new variants of the coronavirus, a vaccine that only some can access will not stop a pandemic. Any pandemic treaty, without a doubt, should take this change into account and avoid clauses designed to favor private interests seeking only economic returns.

A key part of getting public-private collaboration right is establishing a strategy for knowledge governance and IP rights that serves the common good, rather than protecting monopolistic profits. This issue has become a major sticking point in the treaty negotiations. Lower-income countries are being asked to share pathogen data — which helps in the development of new tests, vaccines and treatments — without any guarantee that they will have access to the resulting products.

While the current draft alludes to the importance of IP rules that do not limit availability and access, it simply “encourages,” but does not require, measures aimed at knowledge sharing and limiting royalties. Even weak language asking governments to “consider supporting” patent exemptions has become a point of contention.

This suggests that an inappropriate intention to preserve current IP rules is complicating negotiations. To incentivize innovation and provide widely shared social benefits, patents should be more limited; They must promote continuous productive innovation and collective intelligence, and must be accompanied by commitments to transfer the knowledge and technology required for production.

Another obstacle to the success of the pandemic treaty is that it currently appears to be detached from clear funding commitments. The International Monetary Fund (IMF) estimates that the global economy suffered losses of $13.8 trillion due to both the Covid-19 lockdowns and the disruptions to supply chains that led the world into a recession. Additionally, governments spent trillions of dollars to respond to the crisis. It should be obvious that, in terms of health, prosperity and justice, it is preferable to scale investments preemptively than to later incur the costs of a crisis that spirals out of control. As the WHO advice noted, “prevention is more cost-effective than cure.”

The quality of financing is as important as its quantity. Lower-income countries need long-term financing for key health investments. The treaty's endorsement of the importance of debt relief to free up fiscal capacity for pandemic prevention, preparedness and response is welcome, but the language is worryingly evasive. Health financing must be understood as a long-term investment, and not as a cost that can be reduced to benefit short-term budget goals. It is also a responsibility that transcends national borders.

Finally, as the scope of the pandemic treaty cuts across ministries and government sectors, health should not be left exclusively in the hands of health ministries. Economic policy choices (for example, related to IP rights) strongly influence health, while government decisions impact the social, environmental and economic determinants of health. Governments – across all ministries – can and must redesign the way innovation is managed, the way the public and private sectors relate to each other, and how finances are structured to shape markets for the benefit of society. human health throughout the planet. Failure to prioritize “health for all” will have far-reaching ramifications for the resilience and stability of economies around the world.

As Member States debate the different clauses – removing references to health as a human right and easing IP restrictions and financial commitments – there should be no ambiguity about the choice they face. Focusing the treaty on the goal of preventing or minimizing pandemics would force policymakers to see this clearly—and abandon shortsighted assumptions about limited international and public-private collaboration. As Member States prepare for the World Health Assembly in May, this imperative should be at the forefront.

Follow all the information Economy and Business in Facebook and xor in our weekly newsletter

_