Global health expert: three years on, world not ready for next pandemic

On 11 March 2020, Tedros Adhanom Ghebreyesus, director general of the World Health Organization (WHO) made a dramatic announcement: “In the past two weeks, the number of cases of Covid-19 outside China has increased 13-fold, and the number of affected countries has tripled. (…) We have therefore made the assessment that Covid-19 can be characterised as a pandemic.” 

Exactly three years on, where are we? Has progress been made in preparing for a probable future pandemic? The co-director of the Global Health Center at the Graduate Institute of International and Development Studies, Suerie Moon, takes stock.

Le Temps: Over the past three years, have we learned the lesson and made progress on how to respond to a future pandemic?

Suerie Moon: We have certainly made progress, but we are still not ready for the next pandemic. The risk is always there. The H5N1 avian flu is there to remind us that a new pandemic can occur at any time. Where a lot of progress has been made globally in terms of more political attention to global health. It is a very good thing. But I fear that we will lose the sense of urgency to act and find political compromises. Yes, states and health authorities are negotiating a legal instrument or a pandemic treaty. The Intergovernmental Negotiating Body (INB) has just completed two weeks of negotiations (in Geneva). But things are going very slowly and states are trying to protect their national interests. They remain very divided on the direction in which to go and the urgency of the action, and no one seems to be leading the process. There are still several precious months left to achieve a real result. But I’m concerned that the window of opportunity is closing.

Are there any other advances?

Several countries have not waited to see what is happening in Geneva and at the WHO to move forward. They took advantage of these three years to strengthen their national health system and to respond to a possible pandemic. In Indonesia, for example, a recently created institute has greatly increased its capacity to manufacture vaccines. The African Union and the Africa CDCs (Centers for Disease Control and Prevention) have multiplied initiatives in terms of funding, coordination power and diagnosis. I think that the advances made in these countries can help the WHO in Geneva to find a consensus.

Can a pandemic treaty or a binding legal instrument make a difference?

There is political space for an agreement to be found in Geneva. WHO member states share common interests in the fight against pandemics. Surprisingly, the geopolitical tensions of the moment between China and the United States in particular do not undermine the climate of negotiation. But you have to be aware of it. Everything can fall apart and the document could be insignificant in the end. But I remain optimistic. States no longer want to relive the same three years. And then on the multilateral level, we see that we can still obtain results despite everything. Last week, a treaty on the protection of the high seas was adopted in New York and in December a historic agreement was reached in Montreal on biological diversity.

Covid-19 has exposed an ever-widening divide between North and South. Three years after the start of the pandemic, what is the state of play?

Covid-19 has exposed North-South divisions in intellectual property. But after three years, the view is that this gap between the North and the South is no longer that wide. We are far from the considerable divisions of 20 years ago. Today, the situation is less black and white. Middle-income countries now have access to technology. Look at vaccines: China, India, Russia and Cuba are producing them. It's not just the West. Technology is still highly concentrated in the West, but less so than before. Today, it would appear more likely than before for a compromise to be found on the issue of intellectual property.

To reform global health following the pandemic, one of the major components has to be to strengthen the WHO, whose headquarters are in Geneva. Are we moving towards that?

This is undoubtedly one of the great benefits of the pandemic. States realised that the WHO needs to be strengthened. After thirty years, it is time for this to happen. Last year, members agreed to increase their assessed contributions to bolster WHO's weak financial footing. It is a very strong political signal even if all is not perfect. What also matters is how much power member states are willing to grant to the WHO. On this issue, they’re vaguer. Some do not want the WHO to get too involved in issues related to the declaration of the start of a pandemic, others do not want international teams to be sent to try to identify the origin of a virus or that we exchange too much information. It's definitely a hot potato.