After the coronavirus pandemic triggered once-unthinkable lockdowns, upended economies, and killed millions, leaders at the World Health Organization (WHO) and worldwide vowed to do better in the future. Years later, countries are still struggling to come up with an agreed-upon plan for how the world might respond to the next global outbreak.
A ninth and final round of talks involving governments, advocacy groups, and others to finalize a "pandemic treaty" is scheduled to end Friday. The accord's aim: guidelines for how the WHO's 194 member countries might stop future pandemics and better share scarce resources. But experts warn there are virtually no consequences for countries that don't comply.
WHO's countries asked the U.N. health agency to oversee talks for a pandemic agreement in 2021. Envoys have been working long hours in recent weeks to prepare a draft ahead of a self-imposed deadline later this month: ratification of the accord at WHO's annual meeting. But deep divisions could derail it.
U.S. Republican senators wrote a letter to the Biden administration last week critical of the draft for focusing on issues like "shredding intellectual property rights" and "supercharging the WHO." They urged Biden not to sign off.
Britain's department of health said it would only agree to an accord if it was "firmly in the U.K. national interest and respects national sovereignty."
And many developing countries say it's unfair that they might be expected to provide virus samples to help develop vaccines and treatments, but then be unable to afford them.
"This pandemic treaty is a very high-minded pursuit, but it doesn't take political realities into account," said Sara Davies, PhD, a professor of international relations at Griffith University in Australia.
For example, the accord is attempting to address the gap that occurred between COVID-19 vaccines in rich and poorer countries, which WHO Director-General Tedros Adhanom Ghebreyesus, PhD, said amounted to "."
The draft says WHO should get 20% of the production of pandemic-related products like tests, treatments, and vaccines and urges countries to disclose their deals with private companies.
"There's no mechanism within WHO to make life really difficult for any countries that decide not to act in accordance with the treaty," Davies said.
Adam Kamradt-Scott, PhD, a global health expert at Harvard University, said that similar to the global climate agreements, the draft pandemic treaty would at least provide a new forum for countries to try to hold each other to account, where governments will have to explain what measures they've taken.
The pandemic treaty "is not about anyone telling the government of a country what it can do and what it cannot do," said Roland Driece, co-chair of WHO's negotiating board for the agreement.
There are legally binding obligations under the International Health Regulations, including quickly reporting dangerous new outbreaks. But those have been flouted repeatedly, including by African countries during Ebola outbreaks and China in the early stages of COVID-19.
Suerie Moon, PhD, co-director of the Global Health Center at Geneva's Graduate Institute, said it was critical to determine the expected role of WHO during a pandemic and how outbreaks might be stopped before spreading globally.
"If we fail to seize this window of opportunity which is closing ... we'll be just as vulnerable as we were in 2019," she warned.
Some countries appear to be moving on their own to ensure cooperation from others in the next pandemic. Last month, the Biden administration said it would help 50 countries respond to new outbreaks and prevent global spread, giving the country leverage should it need critical information or materials in the future.
Yuanqiong Hu, a senior legal and policy adviser at Doctors without Borders, said it's unclear what might be different in the next pandemic, but hoped that focusing attention on some of the glaring errors that emerged in COVID-19 might help.
"We will mostly have to rely on countries to do better," she said. "That is worrisome."