The World Health Organization (WHO) is continuing discussions of an international treaty or framework for global cooperation during the next pandemic. This sounds good in principle, but the effort may have difficulty gaining traction in a divided, highly politicized environment currently holding sway in the United States.
At a May 30, 2022, WHO press conference, held jointly with WHO Director-General Tedros Adhanom Ghebreyesus and Eurpoean Council President Charles Michel, discussions centered on vaccine equity, transparency, and sharing information on the virus and the supply chain of personal protective equipment (PPE).
“This treaty would strengthen the implementation of international regulations,” Michel said. “Critically, it would also provide a framework for international cooperation and solidarity. It could build resilience to pandemics and other world health emergencies with robust national and global preparedness systems. This could ensure timely access to pandemic countermeasures, including vaccines, supporting sustainable funding, and capacity for prevention, detection, and response to outbreaks. Ultimately, of course, how such a treaty is developed, what it looks like, and whether it is ratified is a matter for our member states and nations of the world.”
Although nothing has been determined at this point, and the member states ultimately will decide what the treaty is comprised of, some media outlets are pushing the narrative that this is a power grab by the WHO. This goes so far as to claim that, under such a treaty, the WHO would be able to dictate public health policy in the United States in the next pandemic.
For the record, here is a comment emblematic of these views by Fox News pundit Tucker Carlson on a recent broadcast:
“The Biden administration is very close to handing the World Health Organization power over every aspect, the intimate aspects, of your life,” he said. “So, imagine the civil liberties abuses that you lived through during the COVID lockdowns, but permanent and administered from a foreign country.”1
The falseness of this claim was emphasized in an article by David P. Fidler, a senior fellow for global health and cybersecurity at the Council on Foreign Relations.
“The WHO has a budget smaller than what many U.S. hospitals collect and spend annually,” Fidler wrote.2 “For decades, WHO member states — including the United States — have refused to grant the WHO more general authority and resources, even in the wake of COVID-19. It would need to be one hell of a treaty to transform a small, neglected, and resource-starved international organization into something that could keep life, liberty, and the pursuit of happiness in the United States permanently under its thumb.”
We sought comment on this issue from Amanda McClelland, RN, MPH, who leads the Prevent Epidemics team at Resolve to Save Lives, a nonprofit in New York City founded by Tom Frieden, MD, former director of the Centers for Disease Control and Prevention (CDC).
“I have heard this theory, and it is completely overplayed,” she says. “The WHO relies on the votes of member states and can only go as far as the member states allow it. I think the challenge is, especially from the right, is that [they think] the WHO should have stormed into China immediately after the outbreak and demanded access. But they wouldn’t want that to happen here in the United States. They were much in favor of encroaching on China’s rights and demanding that the WHO do more. Now they are saying that’s OK for everyone else but not for us.”
The treaty primarily is about getting agreements on a political level on sharing basic public health data around new viruses, she adds. The most contentious issue likely will be discussions on equitable distribution of vaccines.
“We favor equitable access to vaccines,” McClelland says. “Our position is that a pandemic is a global issue, so just making sure you have vaccines doesn’t reduce your risk. If we’re really addressing risk, then yes, global access to vaccines is critical if we are going to effectively [stop it].”
Russia, China, and the United States did not sign off on an initial statement last year supporting the need for collaboration and scientific sharing for the next pandemic.3 Twenty-five other heads of state did, including those of France, Germany, Italy, and Spain.
Vaccine equity certainly will be a big part of the negotiations by member states in a process that is not expected to conclude until 2024.
The WHO already has asked for no more boosting in wealthy countries until poor nations get adequate vaccine supplies. This is an unresolved issue, but if it were logistically possible, the idea of vaccinating widely in the next pandemic makes epidemiological and infection control sense. If a pandemic virus is allowed to fester in poor, unvaccinated nations, more dangerous mutations may arise, as they have with SARS-CoV-2. Of particular concern is large, immunocompromised populations, such as the 12 million people with untreated human immunodeficiency virus/acquired immunodeficiency virus in sub-Saharan Africa.
Haves and Have-Nots
Look no further than the current global monkeypox outbreak to see that vaccines often come down to the haves and the have-nots.
“[Monkeypox] vaccine access has only been discussed when we had transmission in high income countries,” McClelland says. “There have been regular outbreaks in low-income countries in Africa for several years now. We don’t have a position on [the solution].”
Agreeing to produce and share a vaccine for the next pandemic will require “a mix of increased manufacturing capacity, technology transfer, and equitable visibility on vaccine amounts and distribution. We are in favor of the goal and the necessity for equal access to vaccines based on risk,” she says.
How that will be achieved will involve several devils in the details, since vaccines in general seem to be a lightning rod for misinformation.
“Sharing the vaccine supply will be a very complicated issue that involves location of manufacturing facilities, contracts, national pride, and other issues, says William Schaffner, MD, a professor of preventive medicine at Vanderbilt University.
Regarding the treaty allowing the WHO to dictate U.S. public health policy, we asked Schaffner point blank: Would the CDC cede authority over a U.S. pandemic response to the WHO?
“No, and neither would the ministry of health in any other country,” he says. “They might take advice and guidance and do some things in concert with the WHO. I certainly applaud the idea of bringing the international community together in an even more transparent and immediate fashion in the context of any pandemic.”
McClelland sees this fear of the WHO primarily as a communications issue, saying public health officials need to explain the organization’s role in global health and the limits of its authority. Beyond that, she is concerned that protracted discussions and controversy over a pandemic treaty will stall actions that need to be taken now.
“There is room to move in terms of preparing the world more effectively right now,” she says. “Getting money out to countries so they can build better now. The pandemic treaty shouldn’t suck all of the oxygen out of the room.”
REFERENCES
- Carlson T. Tucker: Biden administration is close to giving WHO power over every intimate aspect of your life. Fox News. Published May 19, 2022. https://www.foxnews.com/opinion/tucker-biden-who-power-health-policy
- Fidler DP. Tucker Carlson blasts the pandemic treaty as a threat to the American way of life. Think Global Health. Published May 27, 2022. https://www.thinkglobalhealth.org/article/tucker-carlson-blasts-pandemic-treaty-threat-american-way-life
- Bainimarama JV, Chan-o-cha P, Santos da Costa AL, et al. COVID-19 shows why united action is needed for more robust international health architecture. Published March 30, 2021. https://www.who.int/news-room/commentaries/detail/op-ed---covid-19-shows-why-united-action-is-needed-for-more-robust-international-health-architecture
The World Health Organization is continuing discussions of an international treaty or framework for global cooperation during the next pandemic, but the effort may struggle to gain traction in a divided, highly politicized environment currently holding sway in the United States.
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content