Last month, the much-anticipated United Nations high-level meeting (HLM) on on pandemic prevention, preparedness and response (PPPR) resulted in a political declaration. This declaration outlines a call to action, ambitiously encompassing 36 points. However, it remains unclear how the wording of commitment and “strong resolve” to scale up efforts to strengthen PPPR will translate into actual actions. These actions should take place on local, national, regional, and international levels that would secure the necessary funding.
The declaration has received mixed reviews globally. The WHO Director-General hails it as historic. In contrast, some, such as the Pandemic Action Network and Médecins Sans Frontières, express disappointment. They believe the declaration lacks ambitious commitments, and this disappointment stems from much disagreement between countries over the wording of previous drafts in the summer.
Decoding the UN Pandemic Declaration: Ambitions and Realities
Without accountability mechanisms or an action plan, the declaration appears unrealistic and ironic regarding its call to action. The text repeatedly addresses PPPR financing, including the following wording:
…ensure sustainable and adequate financing to implement and evaluate high-impact policies to protect people from pandemics and other health emergencies…
Strengthen international cooperation and coordination and financial and investment commitments to support efforts to build, strengthen and sustain capacity… including through enhanced official development assistance and adequate surge financing for future responses, and other means of innovative financing while recognizing that all people should be able to receive high-quality health care without financial hardship
…to mobilize additional timely, reliable, flexible, equitable, predictable and sustainable funding for pandemic prevention, preparedness and response, as well as funding for rapid surge financing for responses in the event of a public health emergency of international concern, strengthening financing mechanisms for global health and other relevant sectors…
Global Health Funding Challenges: Bridging the Pandemic Prevention Gap
Mentioning financing and funding, a global PPPR funding gap of $10 billion per year exists. Countries haven’t committed to fill this gap with their budgets. Pandemic prevention is far less costly in both economic and human terms than another COVID-19-like pandemic. Yet, a global declaration was needed to state the obvious, despite no adequate investment in sight.
During an event on September 20th, hosted by the Elders and the Pandemic Action Network, Juan Manuel Santos, former President of Colombia and Nobel Peace Laureate, recalled African delegates during the formation of the World Trade Organization who said, “don’t put money over life.” He asked, “how do you show love through the budget? Where is the money?“
From Words to Deeds: Implementing the UN’s Pandemic Call to Action
One point in the call to action concerns universal access to sexual and reproductive health-care services by 2030. Achieving this relies on nations lifting conservative policies governing reproductive rights. Recent developments, such as the overturning of Roe v. Wade in the United States, now allowing U.S. states to ban abortion, cast doubt. In numerous countries, not only sexual and reproductive health care but overall healthcare faces significant challenges. These words can seem like a mere list of empty notions that governments pay lip service to.
Moving ahead, the declaration explicitly calls for a report by the UN-Secretary General. This report will offer implementation recommendations. It will be presented at another high-level meeting in 2026, initiating a comprehensive review of the declaration’s implementation. This meeting would commence “a comprehensive review of the implementation of the present declaration.”
International Pandemic Conventions and Negotiations
The declaration supports alignment with the Intergovernmental Negotiating Body (INB), currently drafting a pandemic convention. It also aligns with the Working Group on the 2005 International Health Regulations (IHR), negotiating revisions to the IHR. Both processes aim to conclude with consensus texts by May 2024. However, negotiations have proven challenging due to disagreements among countries, especially regarding equitable access to pandemic products and intellectual property.
On October 16th, an INB draft included the Pathogen Access and Benefit Sharing (PABS) system. This system facilitates sharing genetic material of pathogens in exchange for countries sharing emerging benefits. This includes at least 20% of pandemic products to be distributed by the World Health Organization. PABS sparks controversy between the Global South, where pathogenic outbreaks often originate, and the Global North, the primary producers of pandemic products developed from shared pathogens.
Navigating the Future: Pandemic Prevention in the Post-2023 Landscape
In the months leading to the May 2024 World Health Assembly and the years beyond, the world will witness whether countries honor their commitments. Global health law has limits in enforcing compliance, even with the proposed member states-led “implementation and compliance committee” linked to PPPR. All we can do is hope that countries genuinely grasp the lessons of COVID-19 and fulfill their promises.
