[Editorial] Global Pandemic Treaty & India’s Role

The COVID-19 pandemic has been one of the most severe pandemics in the last century. The disease has claimed an estimated 18 million people- a scale of loss not seen since World War II. It has pushed over 120 million people into extreme poverty and triggered such a massive global recession that no single government/ institution has been able to handle single-handedly. This has created a wider understanding of how nobody is safe until everybody is safe.

What is the current health situation?

Especially during the initial stages of the pandemic, the countries’ healthcare systems were stretched beyond their capacity. Gross health inequity was observed with respect to distribution of diagnostics, therapeutics and vaccines.
The WHO has now declared the monkeypox outbreak as a PHEIC (Public Health Emergency of International Concern) as the world logged over 32,000 cases across more than 80 countries (as of August 2022)- signalling the possible emergence of another health crisis, even before the COVID-19 pandemic subsides.
While the high-income countries are still reeling from the pandemic’s aftermath, the low and low middle-income countries have sustained irreversible socioeconomic consequences.
Since the beginning of the pandemic, major pharmaceutical firms like Pfizer, BioNTech, and Moderna have created a monopolistic situation, leading to the creation of at least 9 new billionaires and realization of over $1,000/ second in profits.
At the same time, a very small percentage of their vaccines have reached the people of low income nations. As of March 2022, just 3% of the people in low income countries were covered with at least 1 vaccine dose. Comparatively, 60.18% of the people in high income countries were covered.
We have missed the target to vaccinate 70% of the world population against COVID-19 by mid-2022.
- This is because the lower income countries were at the ‘back of the queue’ for vaccines.
- Even 6-8 weeks after the WHO declaration of PHEIC, countries, except for those in Asia, failed to take requisite precautions.
- When the world leaders pledged $8.07 billion for developing vaccines and treatments against the SARS CoV 2, the US didn’t send any representatives.
In short, inequality has been prolonging the pandemic and preventing health indicators from improving.

What is the Global Pandemic Treaty?

The pandemic had exposed the current global health systems’ shortcomings and the need for an updated set of rules.
In this backdrop, the idea of a Global Pandemic Treaty was proposed at the WHASS (World Health Assembly’s Special Session). In December 2021, the Assembly agreed to start drafting a global treaty to enable global pandemic governance- something that failed during the COVID-19 pandemic.
The Assembly adopted ‘The World Together’ decision, under which an intergovernmental negotiating body was constituted to draft and negotiate the treaty’s provisions- in accordance with Article 19 of Who Constitution.
The treaty is expected to cover data sharing, genome sequencing of emerging viruses, equitable distribution of drugs and vaccines, research, etc.
In addition to these aspects, the EU has proposed a provision in the treaty to ban wildlife markets. To put this in context, a widely accepted theory is that the SARS CoV 2 emerged from a Chinese wildlife market.
Countries are taking differing stances on the proposed treaty’s legal nature. For instance, the EU wants it to be legally binding while India, USA and Brazil have expressed reservations about the same.

Why is India well placed to take the lead?

India’s pandemic response and role in tackling the crisis globally has made it an example to legislators across the world.
India manufactures 60% of the vaccines and accounts for 60-80% of the UN’s annual vaccine procurement- a consequence of the ‘vaccine maitri’ policy. Notably, India continued its shipments of vaccines and other COVID-19 diagnostics despite domestic shortages. This vaccine aid was halted only for a brief period at the peak of the 2^nd wave.
India had shipped over 594 lakh doses of indigenously manufactured COVID-19 vaccines to 70 countries- as of 2021. Of these, 81.25 lakh doses were sent as gifts and 173.43 lakh doses were sent under the COVAX program (under GAVI), while 339.67 lakh doses were distributed commercially.
India is noted for moving the October 2020 proposal, with South Africa, at the WTO to free countries from the impediments posed by pharma majors’ COVID-19 related patents for the duration of the pandemic.
Though this proposal was resisted by several large economies, in June 2022, the WTO finally agreed to dilute the IP restrictions in manufacturing coronavirus vaccines.

What is the way ahead?

Since the start of the pandemic, many initiatives, like the Vaccine Alliance, have cropped up. While these are valuable, a treaty, under WHO, is necessary to build coherence and avoid fragmentation.
In addition to covering key aspects like data sharing and sequencing of emerging pathogens, the treaty should formally commit the governments to implement early warning systems and properly fund rapid response mechanisms.
It should mobilize countries to agree on a common metrics related to health investments and returns on such investments. Such investments must be aimed at reducing the public-private sector gap.

Conclusion:

A global pandemic treaty would not only reduce socioeconomic inequalities among the countries but also improve pandemic preparedness. India needs to take the lead in this.