Pandemic Treaty

We have known for a long time that infectious diseases that occur in one place in one country can actually spread, even spread, to other countries. Therefore, since 2005, the world has had regulations to control it, namely the International Health Regulations (IHR).

Since it was officially implemented and widely used—including in Indonesia—the world has experienced many epidemics, and also two pandemics, namely the influenza pandemic (H1N1) in 2009 to 2011, and the Covid-19 pandemic. 19.

It is true that the world had hoped that the rules in the IHR would be able to handle the negative impacts of epidemics and pandemics. However, in reality, it is quite the opposite, the existing rules are still inadequate.

The world's experience of almost collapsing due to Covid-19 shows that the world is not ready to face a pandemic and there is a need for real improvements in the future. Especially considering that we know there will definitely be another pandemic in the future, we just do not know when it will happen and what disease will be the trigger.

Also read: Preventing Pandemics by Strengthening International Instruments

Due to the powerlessness of existing regulations, in the midst of the world facing Covid-19, the world health meeting, the World Health Assembly (WHA), on December 1 2021 agreed to launch a process to form a world historic activity (historic global accord ) to deal with the pandemic, both in terms of prevention, preparation and global response.

Therefore, rules will be formed in the form of conventions, agreements, or other international instruments by the World Health Organization (WHO) in this field.

In general, a kind of pandemic accord or pandemic agreement will be produced, or more broadly it would be good if a pandemic treaty or pandemic treaty, which is expected to protect the world and all of us in the face of future outbreaks and pandemics.

The world agreed that the results of this rulemaking will be reported to the WHA, May 2024.

Tough negotiations

To fulfill the pandemic treaty, the Intergovernmental Negotiating Body (INB) was formed to draft and conduct in-depth negotiations. The INB is attended by all WHO member countries, including Indonesia of course.

From 2021 to April 2024, INB has held nine meetings and is still in the process of negotiating, which has been quite challenging.

The international health journal Lancet in early March 2024 published an article with a very scathing title, "The Pandemic Treaty: Shameful and Unjust." The Lancet journal said that in more than two years of meetings, negotiations and international diplomacy regarding the pandemic treaty, the results have not been adequate.

However, this treaty is intended to make the world a safer place. To protect all inhabitants of the world, both in developed and developing countries, both rich and poor.

Moreover, in a pandemic we know the term "no one is safe until everyone is safe" (no one is safe until everyone is safe).

Basically, a pandemic treaty is really needed so that the world is ready to face outbreaks and pandemics that will definitely hit.

The ninth INB meeting in March 2024 was originally scheduled as the final discussion. However, in reality, there were still many issues that had not been agreed upon until the end of the event. Therefore, at the closing of the ninth meeting on March 28, it was finally decided that a follow-up meeting would be held from April 29 to May 10, 2024.

Of course, the hope is that there will be more conducive diplomatic negotiations. WHO Director General (Dirjen) Tedros Adhanom Ghebreyesus really hopes for this, and said that "WHO member countries are very aware of the importance of this pandemic agreement to protect future generations from the bad consequences that the world has experienced during the Covid pandemic. -19 hit.”

The WHO Director-General expresses gratitude to WHO member states for their commitment to finding consensus and being able to reach a historic pandemic agreement at the end of May during the WHA 2024. That is his hope, of course.

In line with the development of INB, countries around the world have agreed to amend the International Health Regulations (2005), an international rule signed by all countries to address the issue of cross-border disease transmission.

For this purpose, the Working Group on Amendments to the International Health Regulations/WGIHR (2005) was formed, and its seventh meeting was held on February 5-9, 2024. The attendees of this meeting were practically all WHO member countries, nearly 200 countries around the world.

The discussion and negotiation process is still very difficult, being discussed clause by clause, and sometimes even sentence by sentence. The eighth WGIHR meeting will be held again soon, and it is hoped that this meeting can produce a better agreement.

Apart from the respective INB and IHR meetings, a joint session (joint session) was also held between WGIHR and INB to draft and negotiate WHO conventions, agreements or other international instruments for prevention, preparedness and response. against future pandemics.

This meeting is very important because it can generally be said that the results of INB will certainly be a kind of "umbrella" and very important in the concept of philosophy and fundamental policies, in addition to the clause by clause contents of the IHR which will serve as a reference in daily activities in the field, including in our country.

Basic principles

Now we are truly in the final days of international diplomatic negotiations for this pandemic treaty, towards the end of May.

It must be admitted that there are those who still question this rule, as is the news inKompas.id, April 13 2024, entitled "Pandemic Treaty Polemic". Therefore, to guarantee the benefits of this treaty for the world, humanity and our nation, there are several principles that must be maintained and guaranteed to be in the treaty or in whatever form the regulations exist in the future.

Also read: Pandemic Treaty Polemic

The first principle is the main element in the regulation of global health that should be the guideline in discussions and negotiations at the WHO, namely honesty, equality, and transparency. This element must be accompanied by aspects of leadership, inclusivity, and accountability.

In facing various cross-border health issues, it is necessary to uphold principles of international coordination and cooperation, multilateralism, global solidarity, as well as regulation at the highest political and relevant cross-sectoral levels.

Meanwhile, it must be remembered that the goal of global health diplomacy should be to overcome the problem of inequality and also ensure the continuity of various types of health services that are affordable, effective, efficient and available at the time needed.

Another principle that must be ensured is that this new regulation is able to overcome gaps in international responses, clarity of roles, state and international organization responsibilities, and the establishment of clear rules and norms.

Then, what has been discussed a lot is the basic principle of fair distribution between access to pathogens that cause outbreaks/pandemics and the benefits that may be obtained in the form of drugs or vaccines, or known as pathogen access and benefit-sharing (P -ABS). This still feels unfair.

If there is a potential outbreak/pandemic of a disease in a country, that country is asked to send the pathogen causing the disease to the international community. However, if the pathogen is then turned into medicine or a vaccine, its distribution is considered unfair and does not guarantee the principle of equity or equality.

The article in the Lancet states that the existing draft still states that WHO only has access to 20 percent of the existing benefits to be distributed to countries that need them in accordance with public health principles.

Meanwhile, the remaining 80 percent, whether in the form of medicine, vaccines, or diagnostic tools, are left to the free market. This means that those with more money are the ones who can obtain them.

Basically, a pandemic treaty is really needed so that the world is ready to face outbreaks and pandemics that will definitely hit. However, of course this treaty, or whatever other form of regulation there will be, must uphold the basic principles that guarantee equality.

We must ensure that no country or organization is granted specific privileges, while others are not treated equally, resulting in some having to be sacrificed and the overall protection of public health failing to be achieved.

Hopefully, the world will become safer in the future and more capable of protecting humanity, both globally and of course, in our own country.

Tjandra Yoga Aditama, Postgraduate Director at Yarsi University, Professor at FKUI, Former Director of Infectious Diseases at WHO Southeast Asia