2/15/22, 12:05 AM What is the missing ingredient in global pandemic preparedness and response?

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What is the missing ingredient in global pandemic

preparedness and response?
September 16, 2021

There is an emerging global consensus for a political compact to prevent

future crises on the scale of the covid-19 pandemic, writes Tedros Adhanom
Ghebreyesus

The covid-19 pandemic is a lesson in humility for the world. It has shown us
what devastation a novel pathogen can wreak, especially if we fail to come
together in global solidarity. 

The health impacts of the pandemic have been traumatic and unprecedented
with more than 220 million reported cases worldwide, and more than 4.5
million deaths. Health systems have been overwhelmed and essential health
services disrupted. This will have implications for morbidity and mortality for
years to come. 

Equally painful has been the social and economic impact of the pandemic and
the great inequities that we have seen—especially in access to vaccines.

One of the biggest lessons is that we must revamp the world’s collective
response. This means improving how we collaborate, across all sectors, to
protect the global population from a global threat.

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In 2003, the SARS outbreak propelled the world to adopting what it thought
would be the answer to preventing and responding to disease outbreaks of
international concern: the International Health Regulations (IHR 2005).

This global playbook is still in place today. The IHR are designed to prevent,
detect, and respond to infectious disease events. They advise on the
introduction of safeguards to protect travelers’ rights and trade, and treat
personal data carefully. They contain many of the ingredients needed to keep
outbreaks and pandemics in check. 

Even today, there is broad consensus on the critical role of the IHR, and their
centrality to the global architecture for pandemic preparedness and response,
even if some adjustments are needed to ensure they remain fit for purpose. 

But certain elements have held the IHR back, in particular, the short supply of
broad, high level, political commitment and global collaboration needed to
fully implement their provisions for the common public good.

Earlier this year, dozens of world leaders reacted to this gap with a landmark
call for change, proposing a global, legally binding compact agreed at the
highest levels of government to prevent a crisis like covid-19 occurring again.

I, too, believe the time has come for such an accord between WHO’s Member
States. 

The call for such an instrument, rooted in the WHO Constitution, helped
initiate a process now playing out within the framework of the World Health
Assembly, which will meet from 29 November 2021 to 1 December 2021 for a
special session to consider the way forward for such a bold proposal.

The WHO Constitution was built for this purpose. It was designed in 1948 with
the knowledge that the attainment by all people of the highest possible level
of health was not a job for one ministry, or one sector, or one institution. 
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2/15/22, 12:05 AM What is the missing ingredient in global pandemic preparedness and response? - The BMJ

It also empowers WHO to engage with all relevant actors, including Heads of
State and non-health authorities. It enables countries to send Heads of State
as their representatives to the World Health Assembly and special sessions of
this body, such as the upcoming one considering an agreement on pandemic
preparedness and response.

The consideration of a global agreement, framework, or treaty—call it what

you want—on pandemic preparedness and response does not represent an
“either or” decision between a new accord and a stronger IHR.

In fact, a global agreement that secures the highest level of commitment to

ready the world for future pandemics will, in turn, provide the political muscle
and motivation needed to ensure tools, like the IHR, are properly
implemented.

A strong, durable agreement will increase compliance with the letter and spirit
of the IHR, renew commitment to the principles, objectives, and purpose of
the WHO Constitution, and support the need for sustained investment in
global health and keep people safe. 

Covid-19 has laid bare global shortcomings, including the grossly uneven
distribution of vaccines, oxygen, diagnostics and other tools, on the
background of fragile health systems, exacerbating already existing global
inequalities. 

What would this instrument look like? That would be up to Member States to
decide. But at its heart is a commitment to sharing data, information,
resources, knowledge, and tools; and strengthening global, regional, and
national health systems to make them ready to respond.

It will embrace a One Health approach that addresses the interface between
environmental, animal, and human health. 

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And it will foster improved trust and accountability—so sorely lacking in this
pandemic—and provide the solid foundation on which to build other
mechanisms to protect global health.

The pandemic has shown how some countries that invested too little in
outbreak prevention and response were badly caught short, but it has equally
highlighted how many nations responded rapidly due to their past experience
in fighting outbreaks.

This practiced preparedness must become the norm.

The pandemic has also shown that the mechanisms we have in place to
detect, prevent, and respond to an outbreak of potential pandemic threat are
inadequate, particularly in our digital world. 

We expect the new WHO Hub for Pandemic and Epidemic Intelligence,
supported by Germany and inaugurated in Berlin recently, to play a key role in
this regard.

But we need more. The world cannot afford to pay lip service to the need to
respond. We must seize the once-in-a-generation opportunity presented by
the pandemic to breathe life into a true global commitment to act. 

I believe this can be achieved through a legally binding instrument covering all
facets of pandemic prevention, preparation, and response, and addresses
itself to today’s leaders and future generations and to adapt to a rapidly
changing world. 

I look forward to supporting WHO’s Member States do all in our collective

power to prevent the next pandemic before it starts, to commit to take the
steps needed before the first cases are reported, and to invest in the measures
needed to stop an outbreak in its tracks.

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The world needs this—and now is the chance to make the need a reality.

Tedros Adhanom Ghebreyesus, Director-General, World Health Organization.

Competing interests: none declared. 

This is the first in a special collection of articles on a global pandemic treaty.

The collection is published in cooperation with, and with funding support
from, a research project at the Global Health Centre, Graduate Institute,
Geneva.

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