Following civil society advocacy, an agreement on pandemic prevention, preparedness and response is being drafted. Another health crisis is certain to come, and the world needs to learn the lessons of the COVID-19 pandemic to be better prepared and act more effectively next time. A treaty is needed to improve international cooperation and avoid the narrow nationalist and top-down approaches that have characterised responses to the current pandemic. Civil society’s vital role in reacting to COVID-19, often doing the work governments failed to do, makes it a vital partner in treaty negotiations and implementation.

Civil society is increasingly asserting the need for a pandemic treaty as a way of ensuring the lessons of the COVID-19 pandemic are learned and the mistakes made are never repeated.

Along with the climate emergency and a string of humanitarian crises, the COVID-19 pandemic has made clear the tragic limitations of the current international system in addressing major global problems. As the virus crossed borders, there was little coordinated response. When progress was made in developing vaccines, those leading the advances prioritised their narrow self-interest and adopted policies of vaccine nationalism. This approach intensified global inequalities and harmed global south countries. It also backfired on powerful states as it allowed the virus to linger and mutate, unleashing fresh waves of infections.

The United Nations (UN) was largely sidelined. The World Health Organization (WHO) came in for civil society criticism, accused of acting too slowly at the start of the pandemic and of being deferential towards China instead of demanding transparency and accountability. The COVAX vaccine initiative it launched in partnership with other organisations fell far short of its initial targets to distribute vaccines in global south countries as donor countries and vaccine manufacturers dragged their feet.

Preparedness is key

For years scientists warned that in our increasingly hyper-connected world a pandemic of some kind was inevitable. But pandemic preparedness remained low, even among wealthy states, and there was little help available to enable global south states to prepare. Because governments weren’t prepared, nor was the public, and vital time was lost when the virus spread quickly around the world in early 2020. The price of this lack of preparedness was avoidably high, with many human lives lost that could have been saved.

Scientists and civil society working in the health arena had been advocating for pandemic preparedness even before COVID-19 struck. But since then, they have stepped up their efforts, focusing advocacy on the demand for a treaty to strengthen pandemic prevention, preparedness and response. As the pandemic’s effects have gone beyond those on people’s health, including economic shocks and restrictions introduced by many states on human rights, a wider circle of civil society has joined the call.

In response, the WHO agreed last December to launch a process to develop a pandemic treaty. In the first meeting, held in March, a team was set up to prepare a first draft, expected in August. The aim is to have a treaty ready for adoption by 2024. This would likely be in the form of a framework convention, a format that allows states to agree high-level commitments and subsequently negotiate mechanisms and bodies to implement them.

Voices from the frontline

Barbara Stocking is the chair of the Panel for a Global Public Health Convention, an advocacy coalition pushing for the development of an effective pandemic treaty.

 

The need for a convention became obvious to everybody as a result of COVID-19, but it is not just about COVID-19. For the last 20 years, every single report concluded that we were not ready to deal with a pandemic. COVID-19 just confirmed this in the most horrifying ways.

Preparedness is key. Governments have tried to be prepared, but they were clearly not. Why is that? For some countries it was a matter of resources, and in those cases we must ensure they get the resources to have health surveillance systems in place. However, many countries with abundant resources and excellent health systems were not ready either. One of the reasons for this is that very few countries practise preparedness.

The principles of equity, transparency and accountability must be built into this treaty. We need to think what needs sorting out or making right, because these are the things we will be held accountable for.

Civil society is clearly asking for more say in health issues and in the development of the pandemic treaty, and I think this is truly necessary.

When hearings were held, civil society participated actively and the scope of participating civil society organisations (CSOs) broadened to include human rights CSOs, not only because of the freedoms affected by lockdowns but also because governments were using the pandemic as an excuse to violate human rights. As a result, more and more human rights CSOs wanted to have a say in the treaty.

In terms of participation in the treaty process itself, the WHO has a category for civil society, as ‘official observers’. But civil society should have much more influence in the discussion.

One major problem I have seen is centralised pandemic management. We need to engage communities, and this includes civil society. When handling a pandemic, engagement of people and organisations at the local level must be built in. This can’t be done by central government alone.

States have already agreed to produce some sort of treaty or convention and are already working on it. But the question is, is it going to be the right one? If everything goes well, we will have an agreement by 2024, and then there needs to be some time for countries to ratify it – or not.

But we must not let the momentum pass because we really must be prepared. I see everyone relaxing a bit since COVID-19 seems to be somewhat under control. But we must not go to sleep on this. It is almost certain that this will happen again in the future. The one thing we don’t know is how soon.

 

This is an edited extract of our conversation with Barbara. Read the full interview here.

A crucial role for civil society

The COVID-19 pandemic has made abundantly clear the limitations of top-down approaches, which even when they have some success in keeping the virus at bay, can come at a huge cost in human rights. When governments failed to respond adequately, or acted without consulting communities and taking their needs into account, civil society’s efforts on all fronts, from service provision to human rights advocacy, made an immense difference to how people lived through the pandemic.

Any treaty must accordingly connect the global to the local by recognising the value of and making room for civil society. History shows that the best way to ensure a proper role for civil society in treaty implementation is to involve it extensively in the process of treaty development – and to ensure that a wide diversity of civil society is engaged.

Civil society is clearly asking for more say in health issues and in the development of the pandemic treaty, and I think this is truly necessary.

BARBARA STOCKING

Civil society’s experience also warns that the adoption of a treaty is no magic bullet. A global treaty is only the start, because it then needs to be domesticated and enforced, with civil society playing a key role in monitoring the adherence of states and demanding accountability. Voices from the global south must be particularly heard: the failures of the COVID-19 pandemic largely stemmed from global north states failing to act in the interests of the world. This has to change. Global north states must make serious commitments to finance global south preparedness and response – and if the inadequate response to climate financing is anything to go by, this will likely be a thorny issue.

A practical proposal from civil society is to develop a mechanism to assess preparedness, through strengthening and scaling up existing peer review systems, in which states have their preparedness periodically assessed by others, and establishing an independent body to conduct external reviews.

It’s easy to see this working on similar lines to the UN Human Rights Council’s Universal Periodic Review Process, where human rights performance is evaluated and recommendations made for improvement. Crucially, the UPR process makes room for civil society input, and one point of civil society advocacy might be to have a similar provision for civil society participation in pandemic preparedness reviews, enabling human rights issues to be raised.

While there is much left to be discussed and negotiated, the pandemic treaty process offers some hope that the world can meet the next pandemic better equipped to help save lives and uphold rights. Civil society will keep working to try to ensure the treaty is up to the task.

OUR CALLS FOR ACTION

  • The pandemic treaty should take a human-rights based approach and embed provisions that uphold and enhance rights.
  • The WHO should ensure wide and substantive involvement of civil society, particularly from the global south, in the process of developing the treaty.
  • Civil society groups should work together to engage with and influence treaty development.

Cover photo by REUTERS/Monicah Mwangi via Gallo Images