Implications of a 2024 World Health Assembly Decree Meeting on the Status and Future of the COVID-19 Pandemic

Although the decision-making body of the World Health Organization (WHO) failed to agree on the final wording for a pandemic treaty on 27 May, I am hopeful that differences between countries can soon be overcome. This would avoid repeating the issues associated with the COVID-19 pandemic, such as when wealthy nations prioritized their own access to vaccines at the expense of people in low- and middle-income countries (LMICs).

The agreement and treaty extension were both announced on 1 June, the final day of the 2024 World Health Assembly, the WHO’s annual decision-making meeting in Geneva, Switzerland.

“There was a great weariness setting in Geneva,” says Lawrence Gostin, a specialist in health law and policy at Georgetown University in Washington DC, who closely followed the negotiations. The new deadline was a good outcome. It showed that there still is a political will to try to get this accomplished and not walk away from the table”.

“One year is a good, reasonable time” to conclude the negotiations, says KM Gopakumar, a researcher with the Third World Network, a research and advocacy organization focused on development in low-income countries in Penang, Malaysia. He says that if talks were rushed to meet the original deadline, they would compromise the legitimacy of the process.

Governments should be considering how to implement a treaty for abatement of respiratory Tract Infections. As a legal scholar who has acted as a negotiator for the South Korean government in free-trade agreements and advised corporate clients on how to comply with international treaties, I know that signing up is just the start.

The delegates said the adoption of amendments would re-energize the efforts to forge a treaty. A minister of health from Ethiopia said that the meeting would create a crucial moment to speed up discussions in the agreement to address the outbreak of swine flu.

Observers don’t think the treaty’s future will be good. “They could eventually approve some sort of agreement,” says Nina Schwalbe, a public-health researcher and founder of the public-health think-tank Spark Street Advisors, in New York City. “But the question is whether it will represent a meaningful step change for equity or have any commitment to accountability.”

I have seen many countries conclude ambitious treaty negotiations, only to fail to comply with the obligations. For example, with regard to free trade, some nations that have promised to avoid subsidies still offer tax breaks to domestic companies; others take advantage of exemptions by delaying renegotiations.

That is a very large amount to ask. Can countries be made to follow the rules? International treaties, unlike domestic laws, have no mechanisms to enforce them. There are no penalties for breaching these laws.

Other treaties have included incentives. An independent committee would be ideal for nuclear or chemical weapons to monitor their compliance. Although not included in the current draft, such a clause could be added as an amendment in the future.

Sharing information about compliance transparently also increases the likelihood that a nation will do the right thing. Other treaties require member states to notify each other if domestic laws are relevant to the treaty. There is a requirement for reporting and sharing information in the draft of the treaty. It is not known if this will be enough.

Treaty compliance cannot be guaranteed by adding all these mechanisms. And, in my experience, most breaches happen for more mundane reasons.

What ministers in the same government do it want to collaborate on pandemic preparedness and for how health ministers can feel uncomfortable interacting with the public

Different ministries in the same government often struggle to collaborate. It is not the case that Pandemic Preparedness is a top priority for every ministry. Capacity building in LMICs or the hiring of extra health-care personnel in the event of a future Pandemic are both items the treasury might not want to spend money on.

Similarly, ministries supporting businesses and industry might find it hard to persuade private firms to comply with the treaty, especially if it involves the loss of royalties. Ministries of justice might be reluctant to provide reviews to health ministers after domestic laws are changed.