A concrete suggestion that could save millions of lives in a future pandemic

It is not a question of if another pandemic will hit, but when. This is why, for more than two years, intense negotiations have been taking place at the World Health Organization (WHO) to create a Pandemic Accord outlining how the world can better prevent and prepare for pandemics and outbreaks — and respond when they happen.

Negotiators in Geneva this week are in the midst of the next-to-last “sprint” before the deadline. They aim to have a final agreement adopted during the World Health Assembly in May.

These negotiations are critically important. Communities around the world are still reeling from the Covid-19 pandemic. Families are mourning their loved ones, economies are still recovering, and people are still dying — at a rate of 10,000 deaths per month, according to WHO.

If one good thing could come out of this ongoing catastrophe and the profound inequities it has exposed, it would be a new set of rules to which all countries agree that will ensure the immediate detection of a pandemic threat; the rapid development of treatments, tests, and vaccines; and the implementation of critical policies that ensure those life-saving health tools are equitably accessible to all, with no exception.

But time is running out.

The WHO has only ever agreed to an accord once in its 75-year history — the Framework Convention for Tobacco Control in 2003 — and that took seven years to negotiate. In the race to find a pandemic agreement by May, there is a real risk that major divisions on substantive issues, geopolitical tensions, and increasing pressure to reach consensus could leave us with a ‘lowest common denominator’ accord that essentially fails to change the status quo in any meaningful way, and that will fail to protect and save lives in the next pandemic.

However, having followed the negotiations closely, we see several opportunities to help bridge the divides and ensure all the talk about equity is transformed into more than just a slogan. One such opportunity concerns an issue about which there is, ironically, near unanimous agreement: the need to accelerate and finance research and development (R&D) of new health tools for pandemics and outbreaks — while also guaranteeing equitable access to them globally.

But the sticking point is: how?

A diverse range of countries, from the Global South and the Global North, have been calling for a specific obligation in the Pandemic Accord to ensure that when public taxpayer money finances the R&D, the knowledge generated should be more openly shared in order to speed up the research needed. This provision should also ensure that health products — new, potentially lifesaving treatments, vaccines, or tests — resulting from publicly funded R&D should be equitably accessible and affordable, as a public return on those public investments.

There is a specific provision in the current draft of the Accord that obligates all countries to put these access conditions in place. This provision was removed in previous drafts, before being reinstated last week. While other obligations are needed, this provision is a key step. It is critical that it remains in the final Accord and all countries need to support it.

The Drugs for Neglected Diseases Initiative (DNDi) is an R&D organization that develops new, accessible medicines for a range of neglected infectious diseases. Part of our work (for which we were grateful to receive the Asturias International Cooperation Award last year) revolves about including knowledge-sharing and access provisions in our agreements with academic and industrial partners, so we know firsthand how such provisions can both accelerate research and ensure access to the resulting treatments.

And we are not alone. Global health funders and actors such as the Bill & Melinda Gates Foundation and CEPI, a foundation that develops vaccines against emerging infectious diseases, also require that the health tools developed by the projects they fund are accessible, and that the knowledge that is generated is broadly disseminated. During the pandemic accord negotiations, CEPI highlighted that, if there had been more funders putting in place clear access provisions in the early days of the COVID pandemic, the number of vaccine doses available to people in low- and middle-income countries could have been far greater, and delivered far quicker.

Only governments have the power and leverage to make this happen.

The U.S. government spent an estimated $31.9 billion over more than three decades on the groundbreaking research that led to the mRNA vaccines. Imagine if these public funds been tied to well-crafted equitable access conditions. The price of the vaccines in the U.S. may not have sky-rocketed after the emergency declaration was over — and the inequities in access to these vaccines around the world, which resulted in millions of lives lost, might also have been greatly reduced.

These conditions should include affordability; management of knowledge and licensing strategies that accelerate research and facilitate equitable access; and transfer of technologies and know-how, if needed, to allow manufacturing in different regions of the world.

My organization develops treatments for some of the most neglected communities on our planet. We see the current Pandemic Accord negotiations as pivotal — a crucial opportunity to ensure that everyone, regardless of where they live or how much money they have, will benefit from scientific progress and have access to the medical tools they need when the next pandemic hits. Governments have a historic chance to course-correct, and ensure they have all the legal and policy tools they need.

They must seize it.

Luis Pizarro is the executive director of the Drugs for Neglected Diseases initiative

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