A Pandemic Agreement that Works for Africa
By guest contributors Fifa A Rahman and Benjamin Djoudalbaye The 77th World Health Assembly (WHA77) passed without having resolution on a Pandemic…
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By guest contributors Fifa A Rahman and Benjamin Djoudalbaye
The 77th World Health Assembly (WHA77) passed without having resolution on a Pandemic Treaty, with negotiations now expected to last until 2025. Parties could not agree on several issues, the most prominent of which are One Health and Pathogen Access and Benefit Sharing. It remains imperative for global health security to achieve a pandemic treaty that makes the world safer and fairer. This pandemic agreement must address fundamental inequalities in our power structures that resulted in the global COVID-19 pandemic.
Respectful Partnerships in One Health
There is no dispute on the fundamental idea of One Health. Various scholars have stated that One Health is a ‘scientifically undisputed idea that animal health, human health and the environment are integrally connected’ [2], and that One Health is a ‘bridge between different scientific disciplines’. Africa CDC’s own One Health framework document states that a One Health approach is ‘used to attain optimal health outcomes for people, animals, plants, and their shared environment’. Many African member states are actively working on One Health, whether identifying weaknesses in the implementation of One Health strategies (Tanzania), cross-sectoral partnerships to address zoonoses (Kenya), and training initiatives in Central Africa. However, as the abovementioned framework document states, One Health initiatives can be stymied as a result of, inter alia, a lack of effective coordination and appropriate budgeting.
The absence of concrete financing obligations in the Pandemic Agreement is one reason for resistance to far-reaching One Health obligations beyond national aspirations and fiscal capabilities. There continue to be robust One Health initiatives at the regional level, with Africa CDC’s One Health framework recommending countries, inter alia, formally constitute joint surveillance teams drawn from human, animal, and environmental sectors and for evaluations to be conducted to understand country-level capacity to detect priority zoonotic diseases. One Health initiatives continue to be implemented on the continent, in line with country capacities. Certainly, work to prevent zoonoses can be improved in many countries, but they must be guided by norms that are mutually agreed and consider varying levels of resources and domestic context.
A Fairer Bargain on Pathogen Sharing and Multilateral Benefits
Countries also could not agree on pathogen access and benefit sharing (PABS). As one scholar notes, Africa has ‘unprecedented genetic diversity’ and that African genetic material is ‘scarce, extremely valuable, and highly desirable’. This is evidenced also through U.S. foreign policy; the U.S. has signed 50 formal Global Health Security partnerships with countries including Nigeria and the Democratic Republic of Congo emphasizing, inter alia, the importance of sharing genetic material for the purposes of biodefence.
Inequity in access to pandemic products during the COVID-19 pandemic is well-documented. It is only fair that if pandemic products are developed from genetic material originating in the Global South, that there are multilateral benefits arising from the commercialisation of that product. The text as it stood at WHA77 was that manufacturers would provide 10% of the pandemic product in question free-of-charge to the WHO for distribution to countries in need, and (up to OR at least) 10% would be purchased at not-for-profit prices, or, that manufacturers transfer technology about that product to developing countries through the WHO. Some countries wanted key principles defined in the text. Others wanted details postponed to a separate additional protocol and process, and key disputes occurred around what percentages would be acceptable for equitable distribution. Some of these disputes were fuelled by disinformation, i.e. that ‘Britain would have to hand over 20pc of vaccines.’
A fairer bargain means that Africa must receive an equal share of pandemic products during the next pandemic. While regional and local manufacturing is a part of that, PABS is a crucial additional element Africa needs.
Quo Vadis, Intergovernmental Negotiation Body?
The Intergovernmental Negotiation Body (INB), the body constituting diplomats and technocrats from all WHO Member States, has a tough task ahead when negotiations resume in July or August 2024. Notably, these dates are after the French and United Kingdom general elections, meaning there may be new directives from new governments, notably before the United States elections.
African interests are rooted in more equitable access to pandemic products while ensuring that African resources are not being committed towards burdensome obligations that are not in line with the pace of development in some Member States and that may divert resources from other more pressing priorities. The INB must go towards pandemic norms that enshrine the interests of all, not a few. It is only with this sentiment that we can truly achieve a ‘grand global social bargain’ that we deserve for future pandemics.
About the authors:
Dr Fifa A Rahman is a global health consultant with over 15 years in qualitative research, health diplomacy, and legal and policy analysis in global health. As Pandemic Negotiations Consultant for Africa CDC, she has supported Africa Group negotiators with legal analyses and comparison texts during the negotiations. Externally to this role, she is Principal Consultant at Matahari Global Solutions, working on health workforce on the African continent, 95-95-95 targets in HIV, and diagnostics rapid assessments.
Dr Benjamin Djoudalbaye is a Senior Health Expert with over 22 years of experience in global health, with a particular focus on the African context. His extensive expertise in this area, coupled with his skills in designing, managing, and evaluating public health programs, make him a valuable asset. He has successfully managed significant programs, demonstrating his ability to set a clear vision, lead diverse teams, and mentor/inspire others toward accomplishing goals. His excellent negotiation skills and experience with complex, high-profile, or sensitive agreements further enhance.
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