WHO member states can expect an update from an Intergovernmental Negotiating Body in August 2022 on an “initial draft” of a treaty to “break the pandemic cycle”. In July 2022, Drs Alexandra Phelan and Colin Carlson published a recommended 12 elements for this treaty.

According to Drs Phelan and Carlson, we are “trapped in a positive-feedback loop” of disease spillovers that become outbreaks, then pandemics. These then reduce resilience and promote the “socioecological drivers” of further spillovers. The consequences are social, political, environmental, and economic. Therefore, the development of a treaty will be difficult, as “stakeholders lobby for [it] to be all things for all interests”.  

The primary purpose of this treaty is: “preventing, preparing for, and responding to pandemics”. Drs Phelan and Carlson identify 12 elements that they believe would comprise a “cohesive, transformative, and evidence-based treaty”.  

Reduce Spillover Risk 

  • Planetary health solutions 
  • One health solutions 
  • Zoonotic risk assessment 

Reduce Pandemic Risk 

  • Surveillance and assessment 
  • Biomedical R&D and production 
  • Health systems strengthening 

Reduce Pandemic Impacts 

  • Equitable access to global goods 
  • Emergency legal preparedness 
  • Least restrictive measures 

Recovery and Resilience 

  • Adaptive governance 
  • Accountability and transparency 
  • Reduce inequalities and injustice 

If a treaty can balance these aims, it will “move global health governance beyond the limited scope of the International Health Regulations” offering “clarity and complementarity to other relevant international legal regimes”.

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