Can pandemic pact avert COVID chaos in next crisis?

LONDON - Five years after COVID-19 swept the world, killing millions and overwhelming health systems, countries are set to adopt a landmark treaty aimed at bolstering the world's ability to fight future pandemics.

The proposed accord seeks to improve early detection of dangerous new diseases and ensure fairer access to tests, drugs, vaccines and other health supplies.

Negotiations for the World Health Organization (WHO) treaty took more than three years and involved more than 190 countries.

However, there are concerns the agreement could be weakened by U.S. President Donald Trump's decision to quit the U.N. agency.

The treaty is set to be adopted at the WHO's annual assembly beginning on May 19 in Geneva, Switzerland.

How will the treaty improve vaccine equity?

During the COVID-19 pandemic, wealthier nations were accused of hoarding vaccines, leaving poorer countries without.

One study estimated national stockpiling could have cost more than 1 million lives.

A new mechanism called the Pathogen Access and Benefit-Sharing (PABS) system will facilitate the rapid sharing of pathogen samples and genome sequences to help speed development of diagnostics, treatments and vaccines.

In return, drug makers developing products from such samples will provide 20% to WHO - at least half as a donation and the rest at affordable prices.

These will be distributed on the basis of need with a focus on developing countries.

Will poorer countries be helped to make their own vaccines?

The huge vaccine disparities seen during the pandemic were exacerbated by the limited ability of many countries to produce them - especially in Africa.

Countries ratifying the treaty will promote "technology transfer", whereby pharmaceutical companies enable manufacturers in developing nations to make their own drugs and vaccines by sharing their know-how.   

Health experts say African nations that could become producers include Egypt, South Africa, Kenya, Rwanda, Nigeria, Ghana and Senegal.

How will countries better protect frontline health workers?

Many health workers died during the COVID-19 pandemic because they lacked personal protective equipment (PPE) like masks and medical gowns, as well as vaccines and drugs.

The treaty calls for countries to invest in strengthening their health systems, and to prioritise access to health products for frontline healthcare workers during emergencies.

How will supplies get to those most in need?

For the first time the WHO will have a mechanism to coordinate global supply chains for PPE, diagnostics, drugs and vaccines.

The new Global Supply Chain and Logistics (GSCL) network aims to ensure health products reach those in greatest need, including people trapped in humanitarian crises.

Countries can still make bilateral deals with pharmaceutical companies outside this network, but should avoid excessive national stockpiling and consider setting aside a portion of their procurement for those facing challenges.

The GSCL can also be activated outside pandemics to help developing countries tackle global public health emergencies like Ebola and Mpox.

When will the next pandemic happen?

Scientists say there is a significant chance of another deadly pandemic within the next 25 years.

There is particular concern around the increase in zoonotic diseases like COVID-19 that jump from animals to people.

The treaty calls for countries to improve surveillance to detect pathogens early, and do more to prevent spillovers from animals to humans.

Does the treaty have teeth?

It is legally binding on countries that ratify it, and they will have to submit progress reports. However, the treaty does not stipulate penalties for non-compliance.

The treaty is only the second of its kind in the WHO's 77-year history, the first being a tobacco control pact in 2003.

Health experts have hailed it as a massive achievement, but critics say it is not tough enough to end the inequities exposed by COVID-19.

They are concerned about the lack of clarity on how PABS will work and say there is little to ensure states compel the pharmaceutical industry to share know-how.

The accord says technology-sharing will be "as mutually agreed", which critics fear could be used as a get-out clause.

There are also concerns the treaty is compromised by the withdrawal of the United States, given its dominance of the pharmaceutical sector.

Will the treaty be immediately effective?

WHO officials anticipate it will come into force in 2027.

Countries first have to thrash out the details of the PABS agreement, which will be added as an annex. This will take time due to concerns around intellectual property rights.

The treaty must then be ratified by at least 60 states to come into force.   

Contrary to persistent myths online, the treaty does not give WHO power to force individual states to impose vaccine mandates, border closures or lockdowns.

(Reporting by Emma Batha; Editing by Jon Hemming.)