Workers transport the second shipment of the Johnson & Johnson COVID-19 vaccine upon its arrival at the O. R. Tambo International Airport in Johannesburg on Feb. 27, 2021.KIM LUDBROOK/Getty Images
When global leaders announced a bold plan in late 2021 to negotiate a pandemic treaty, they touted it as a historic decision to ensure fairness and equity in future health crises.
Never again, they said, would there be the stark injustices of the COVID-19 pandemic that left billions of people without vaccines in lower-income countries – causing an estimated 1.3 million deaths – while richer countries built huge stockpiles to safeguard themselves.
But more than two years later, with a deadline looming in just over a month, the treaty negotiations are badly stalled. Wealthy countries, including Canada, are pushing for weak language and vague aspirations on crucial issues such as vaccine-sharing mechanisms.
Governments are squabbling over almost every line in the latest 110-page draft of the proposed agreement. There are almost 5,000 brackets in the latest version, with each of the brackets signalling objections or caveats by various countries.
To worsen the situation, the treaty has been dogged by persistent conspiracy theories and disinformation campaigns on social media, including the false claim that it would create a global regime with the power to use military force to impose lockdowns and eliminate freedoms. This has eroded the political support that the treaty needs, analysts say.
The negotiations over the past 28 months have been tortuous. But after nine rounds of backroom talks by the World Health Organization’s member states, a deadline is approaching soon.
Under the official schedule, the WHO needs an agreement by May 27, the beginning of this year’s World Health Assembly in Geneva. If there is no deal by then, the treaty will be left in limbo.
A last-ditch round of negotiations, seeking to salvage a final deal, will begin on April 29. There are already reports that some key issues could be deferred to an unspecified future date because of the disputes.
“There are still some pretty fundamental disagreements unresolved in this,” said Adam Houston, a medical policy adviser at the Canadian office of Médecins sans frontières (Doctors Without Borders) who has followed the negotiations closely.
“Countries seem pretty entrenched in their positions, and there’s not a lot of willingness to drastically shift those positions,” he told The Globe and Mail.
The latest delays are undermining the idealistic rhetoric of the WHO’s member states when they announced the treaty plan in 2021. WHO Director-General Tedros Adhanom Ghebreyesus said the negotiations were “a once-in-a-generation opportunity” to strengthen the global health architecture and safeguard the world. He called it “a cause for celebration.”
The goal was to create a blueprint for complex issues in the next pandemic, including mechanisms for technology transfer and sharing vaccines and treatments with lower-income countries. Charles Michel, president of the European Council, said the treaty would ensure fairness. “We simply cannot allow the same inequality we have seen, and continue to see, to repeat itself in future pandemics.”
Since then, the text of the pandemic accord has been diluted, filled with platitudes. “Hundreds of hours and unknown costs have been spent, but the political impetus has died,” the British medical journal The Lancet said in an editorial last month.
In clauses of the treaty where action is promised, Western governments are seeking to add phrases such as “where appropriate” – making it impossible to enforce.
One clause in the drafts would set aside only 20 per cent of pandemic-related products for the WHO to distribute on the basis of public-health needs – allowing 80 per cent to go to the highest bidder. The Lancet called it “shameful.”
Recent events have made clear that the inequities seen at the worst of the COVID-19 pandemic are still persisting today. Moderna, for example, announced this month that it was suspending its plans to build a vaccine manufacturing centre in Kenya – a key element of its response to the widespread accusation that it favoured the rich countries in the pandemic.
The Africa Centres for Disease Control and Prevention said the Moderna announcement was proof that the company had no commitment to vaccine equity. The late delivery of vaccines to Africa during the height of COVID-19 was a significant factor in weakening African demand for vaccines and worsening the crisis, it noted in its response to Moderna’s decision.
Africa this year has again suffered from a severe shortage of vaccines – this time for the cholera and mpox outbreaks in several African countries. But tourists from Canada and other Western countries still have easy access to those same vaccines, which are marketed in wealthy countries for travellers to disease-prone countries.
South African health activist Fatima Hassan says the pandemic treaty negotiations have been hampered by “bullying and unreasonable demands” from Western governments and the pharmaceutical industry.
“The goodwill that was promised in these negotiations is not there,” she told The Globe. “I’m disappointed but I’m not surprised.”
When deaths from COVID-19 were escalating, it took nearly a year for South Africa to get the same level of vaccine access that wealthy countries enjoyed, even though the manufacturers had conducted clinical trials of their vaccines in Africa, and this could easily happen again if there is no strong treaty, Ms. Hassan said.
“If we can’t get agreement on this, what happens in the next pandemic? Again it’s a free-for-all. It’s survival of the fittest, and it’s survival of those who speak the loudest.”
Canada’s position in the negotiations is unclear, since the talks are held behind closed doors. But leaked documents show Canada seeking to weaken the language on vaccine sharing and technology transfer, sometimes by replacing the word “shall” with vague phrases such as “intends to” or “on voluntary and mutually agreed terms.”
“They’re pushing equitable language, but they’re actively opposing the tools to follow through,” Mr. Houston said.
Without stronger language or enforceable mechanisms, the treaty could be merely “aspirational,” allowing a repeat of the injustices of the COVID-19 pandemic, he said.
Mark Johnson, a spokesperson for Health Canada, said the government has a long-standing position that the transfer of technology should be a voluntary process, on mutually agreed terms, with the support of the technology’s holder.
“Technology transfer is a collaborative process between the technology developer and the recipient of a given technology and, as reflected in long-standing private sector practice, is best supported by mutual engagement,” Mr. Johnson said in reply to questions from The Globe.
The government wants a “successful consensus-based outcome” in the treaty negotiations to “prevent and minimize” the devastating effects of potential future pandemics, he said.
“The COVID-19 pandemic has demonstrated the need to take bold action to ensure the world is better prepared for the next pandemic,” he said.