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Significant differences between richer and poorer nations are threatening progress on a key pandemic treaty, with officials warning that the planned May deadline for delivery of the global accord may be missed.
“[The] biggest issue at the moment is whether we’ll be able to reach agreement in May and what the consequences are if we fail”, said one western diplomat with knowledge of the process. Member states received a new draft of the text from the World Health Organization late on Friday, with the last round of talks set to take place at the end of March.
The sharing of genomic data on pathogens and funding for health systems during emergencies were some of the biggest issues dividing negotiators, officials said.
“The new text is kind of a few steps forward and a few steps back,” the diplomat added. “It doesn’t bring us any closer to consensus.”
Missing the May deadline would increase the political risk of the treaty unravelling. “Any extension will not make things easier with election pressures increasing,” said another western diplomat, pointing to ballots in the US and other countries. The WHO’s annual assembly convenes in Geneva from May 27 to decide on the final text, the proposed last step before a signing of the global accord.
The need for better pandemic preparedness was underscored by a wide-ranging demographic study that showed the death toll during the peak of the Covid-19 outbreak reached almost 16mn people, temporarily reversing a 70-year trend in falling global mortality rates.
While age-standardised mortality rates fell 62.8 per cent globally between 1950 and 2019, they climbed an estimated 5.1 per cent during the 2020-21 period, said the paper published in The Lancet on Monday.
Child mortality continued to fall during the peak pandemic years, albeit at a lower rate than previously, reflecting the much lower vulnerability of younger people to Covid-19.
“Increases in mortality rates in populations aged 25 years and older were observed on a scale not seen in the previous 70 years,” the paper said
The research estimated excess mortality due to Covid-19 using censuses, surveys and other data from 204 countries and territories.
US Republican lawmakers have criticised the treaty, arguing that it would diminish American sovereignty, while former US President Donald Trump threatened the full withdrawal of Washington from the WHO.
“The spectre [of Trump’s re-election] looms and it’s quite helpful in focusing minds,” said another diplomat, adding “there’s a fairly good chance it’ll have to be shelved” if the May deadline were not met.
One of the key points of contention centres around Article 12, which would create a genomic repository. Poorer countries are pushing for the so-called Pathogen Access and Benefit-Sharing System, or Pabs, to be contained within WHO, but richer countries say this is unworkable, with a European diplomat saying there would be “no deal” under the article’s current wording. Other issues include concerns around financing for pandemics.
A last session of talks is scheduled for the second half of March, but the health body could decide to add an extra one at the end of April, said one of the people with knowledge of the discussions.
“The question on timing is also whether agreements are reached early enough to [polish] the text for the final agreement,” they added. “It’s in pretty poor shape from a legal and technical perspective.”
Jamie Love, head of health NGO Knowledge Ecology International, said that despite the attention on Article 12, countries “are closer to a deal than some think”.
He said richer countries including the US, Japan, the UK and some EU states had blocked equity measures concerning intellectual property and technology transfer in other parts of the agreement, “and so many developing countries see the Pabs as an area where they have leverage”.
“To the degree that [article] creates restrictions of access to knowledge about pathogens, the blame can be placed on those high-income countries that have blocked other equity provisions,” he said.
Ellen ‘t Hoen, of research group Medicines Law & Policy, said there had been progress on areas such as access to antiviral drugs and vaccines, a severe problem during the pandemic, but said the current text “only asks parties that they encourage or incentivise the sharing of knowhow . . . It includes no powers to guarantee that it will happen if the encouragement or incentive do not work.”
Monday marked the four-year anniversary of the WHO’s designation of the Covid-19 outbreak as a “pandemic”.
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