What is the proposed WHO Pandemic Preparedness Treaty?

The WHO Pandemic Preparedness Treaty

In March 2021, a group of world leaders, including UK Prime Minister Boris Johnson, announced an initiative for a new treaty on pandemic preparedness and response. This initiative was taken to the World Health Organization (WHO) and will be negotiated, drafted, and debated by a newly-established Intergovernmental Negotiation Body.

In March 2021, a group of world leaders announced an initiative for a new treaty on pandemic preparedness and response. This initiative was taken to the World Health Organization (WHO) and will be negotiated, drafted, and debated by a newly-established Intergovernmental Negotiation Body.

A petition on the UK Parliament website called for the Government “to commit to not signing any international treaty on pandemic prevention and preparedness established by the WHO, unless this is approved through a public referendum”. The petition closed in November 2022 with 156,086 signatures, and was debated in Parliament on 17 April 2023.

A further e-petition called on Parliament to “hold a parliamentary vote on whether to reject amendments to the IHR 2005”. The Parliamentary Petition will be debated on 18 December 2023. The Government responded to this petition on 5 May 2023, with an updated response on 4 July 2023, explaining that the UK supports strengthening the IHR and the amendment process

This briefing will give an overview of the key background, progress, and developments of the treaty as of 16 May 2024. It will also give an overview of the parallel amendments being made to the International Health Regulations.

What is being proposed?

In the March 2021 joint article, the group of leaders said:

The main goal of this treaty would be to foster an all of government and all of society approach, strengthening national, regional and global capacities and resilience to future pandemics. This includes greatly enhancing international co-operation to improve, for example, alert systems, data-sharing, research and local, regional and global production and distribution of medical and public health counter-measures such as vaccines, medicines, diagnostics and personal protective equipment.

The article acknowledges existing provision for a coordinated international response under the International Health Regulations, which would “underpin such a treaty”.

In October 2021, the Working Group on Strengthening WHO Preparedness for and Response to Health Emergencies (WGPR) published a ‘zero draft’ report outlining an assessment of the benefits of a new WHO convention, agreement or other international instrument on pandemic preparedness and response, for consideration by the World Health Assembly. This Report, among other things, suggested that such an initiative “could include promoting high-level political commitment and whole-of-government whole-of-society approaches, addressing equity, enhancing the One Health approach, and strengthening health systems and their resilience.”

On 29 November – 1 December 2021, the WHO’s World Health Assembly (WHA) met in a special session to discuss the proposal and the way forward. This was only the second ever special session of its kind in the history of the Assembly.

In this session, the WHA agreed to establish an Intergovernmental Negotiating Body to draft and negotiate “a WHO convention, agreement, or other international instrument on pandemic prevention, preparedness and response.”

Does the UK support the treaty?

Prime Minister Boris Johnson was a signatory to the article proposing the treaty initially. 

On 27 May 2022, the Government responded to the Parliamentary petition, stating that it supported a new legally-binding instrument “as part of a cooperative and comprehensive approach to pandemic prevention, preparedness and response.”

During an Urgent Question in the House of Commons on 14 May 2024, the UK Government indicated that it would not sign the treaty in its current form but did not explicitly state the reasons for this.

The UK’s final position on the exact substance of the treaty remains to be seen as negotiations continue.

What does the treaty say?

The Zero Draft of the treaty, known as the Zero Draft of WHO CA+, was published on 1 February 2023, and discussed at the Intergovernmental Negotiating Body’s fourth meeting between 27 February 2023 and 3 March 2023.

The latest public version (PDF) of the negotiating text was published on 22 April 2024.

Because the Zero Draft was the starting point for negotiations, the substantive provisions and content of the treaty continue to change. Currently, the parties are negotiating on issues such as:

• The definition, means, and procedure for declaring a pandemic, and what this actually means in practice for states.
• How the treaty would work alongside the International Health Regulations.
• Key international principles that will guide the treaty, such as human rights, sovereignty, equity, solidarity, transparency, accountability and more.
• How to achieve equity in the global supply chain for pandemic-related products, and access to relevant technologies.
• Strengthening the resilience and responsiveness of health systems.
• How states and the WHO should be coordinating and cooperating in pandemic preparedness and response.
• How to finance pandemic preparedness and response initiatives.
• Setting up a new Governing Body for the treaty – a COP or Conference of the Parties.
• Other general legal issues relating to the treaty, such as amendments, withdrawal, and dispute settlement.

Reports suggest that the main contentious issues in negotiations are over the sharing of pandemic-related health products via donations and affordable / not-for-profit pricing for developing states, and the corresponding sharing of pathogen data, known as the Pathogen Access and Benefit Sharing System.  This is contained in Article 12 of the April 2024 version of the negotiating text of the treaty.

Will the WHO be given powers to impose restrictive measures?

Neither the proposed treaty, nor the amendments to the International Health Regulations propose to cede powers of this kind or sovereignty to the WHO.

During an Urgent Question in the House of Commons on 14 May 2024, the Minister for Health and Secondary Care indicated that “under no circumstances will we allow the WHO to have the power to mandate lockdowns. That would be unthinkable and has never been proposed.”

In May 2024, a WHO spokesperson told The Guardian that:

Claims that the draft agreement will cede sovereignty to WHO and will give the WHO secretariat power to impose lockdowns or vaccine mandates on countries are false and have never been requested nor proposed. This agreement will not, and cannot, grant sovereignty to WHO.

This briefing further explains where these concerns may have originated from, and how negotiations have addressed potential confusion over some proposals.

How does this relate to the International Health Regulations?

Alongside the development of the pandemic preparedness treaty, the WHO is also undertaking a review of the International Health Regulations 2005 (IHR).

As part of this process, more than 300 amendments have been proposed by States Parties.

These amendments were subject to a review by the Review Committee regarding amendments to the International Health Regulations. The terms of reference (PDF) for this Review Committee detail the exact scope of the work and analysis that the Committee was expected to undertake on the proposed amendments.

The WHO has also produced a Reference Document (PDF) containing a list of the proposed amendments alongside the Review Committee’s technical recommendations to these.

Key dates and future progress

According to the WHO, the following are key recent developments and updates in the progress of the treaty.

• The INB hosted its fifth meeting in April 2023.
• The INB delivered a progress report to the 76^th World Health Assembly in May 2023.
• A INB Drafting Group met in June 2023.
• The INB hosted its sixth meeting in July 2023.
• Further meetings or drafting group sessions were held in September, November, and December 2023, leading to the publication of the proposed negotiating text of the WHO Pandemic Agreement.
• At its seventh full meeting in December 2023, the INB recommended the continuation of informal discussions with Member States. Member States would propose further textual amendments by 15 January 2024 for consideration at the eighth INB meeting (19 February–1 March 2024). The ninth would take place from 18–28 March 2024.
• At the time of writing, there were no further dates indicated officially by the WHO or INB, but UK Minister Andrew Stephenson indicated in Parliament on 14 May 2024 that a further round of negotiations will take place on 16 and 17 May and 20 to 25 May, leading up to the World Health Assembly taking place on 27 May to 1 June.
• The INB will submit its outcome for consideration by the 77^th World Health Assembly in May 2024.