After more than two years of negotiations, a generational opportunity to strengthen prevention, preparation and response to future pandemics is on a knife’s edge. Discussions within the Intergovernmental Negotiating Body for the Pandemic Agreement are in their final days before the 77th World Health Assembly. Recent drafts of the Pandemic Agreement sit upon strong foundations. There are important references to equity, human rights and the right to health throughout the text. Negotiators are still working to turn these foundational principles into reality.  

At this critical moment, the co-chairs of the Global Council on Inequality, AIDS and Pandemics – Joseph Stiglitz, Monica Geingos and Michael Marmot – call on WHO Member States to pass a courageous Pandemic Agreement that:  

  • – guarantees equitable development, production and access to health technologies for prevention, diagnostics and treatment during pandemics;  
  • – mobilizes greater financing; 
  • – supports the full breadth of community-led and -based capacity to fight pandemics; and 
  • – addresses the social determinants of pandemics.  

In September, the Council co-chairs called for a bold agreement that would break the inequality-pandemic cycle that has intensified and prolonged the devastation of AIDS, COVID-19 and many other communicable diseases. A Pandemic Agreement is needed. 

Now, the co-chairs urge world leaders to make clear commitments that put the future of humanity ahead of narrow national and corporate interests.  A failure to produce an Agreement would be a failure to learn the lessons from today’s pandemics, including AIDS and COVID-19. Recognizing that some crucial, inequality-responsive issues have not yet been agreed, the co-chairs called on leaders to work during and after the World Health Assembly to secure binding commitments. 

Joseph E. Stiglitz, Nobel prize-winning economist and professor at Columbia University  

On equitable development, production and access to health technologies for prevention, diagnostics and treatment during pandemics 

Millions of additional lives were lost during the COVID-19 pandemic because of unequal access to life-saving vaccines.  The enormous unnecessary increased burden on hospitals and health care systems deprived resources from others needing care:  the total loss of life and health is far greater than the direct costs.  Lack of access to medicines in the Global South hurt people’s health, and the economy, globally. We cannot continue a negative sum game—increased profits of pharmaceutical companies are dwarfed by the losses of people in the Global South. World leaders took too long to learn the lesson that government action is needed to make medicines accessible in responding to the AIDS pandemic, and they did not apply these lessons to the COVID-19 response.  

The path to a better, safer, and more equitable pandemic prevention, preparedness and response is known: widespread local and regional production of vaccines, tests, and treatments, and the open sharing of the knowledge and technology behind them. Obligations for countries to rapidly share information on pathogens must be linked to a concurrent commitment to share in the benefits of science. To enable this, sufficient funding needs to be provided at the national and international levels, and barriers which prevent safe, capable manufacturers from joining the pandemic response need to be removed. Some countries have selectively implemented measures to mandate the sharing of technology and knowhow when voluntary actions are not enough. The Accord can and needs to ensure that all countries are committed to doing so in the event of a pandemic.  

Monica Geingos, former First Lady, Republic of Namibia 

On mobilizing greater financing for pandemic prevention, preparedness and response 

Financing pandemic preparedness and response is a key factor in a world where countries have highly unequal resources, whether for buying tests and vaccines, for upgrades in health infrastructure, or bold efforts to address social determinants of health. Efforts to channel desperately needed financial resources to developing countries during the peak of the COVID-19 foundered horribly, and the global AIDS response remains chronically under-funded. Post-COVID crisis efforts to fund pandemic preparedness are fragmented and ill-suited to emergency responses. The Pandemic Agreement requires concrete commitments to mobilize and distribute rapid-response funding as soon as an outbreak with pandemic potential is identified.   

On ensuring that affected communities are fully engaged in pandemic prevention, preparedness and response 

The global responses to AIDS and COVID-19 have shown how communities, community-led responses, and community-led organizations are central to responding to disease outbreaks and pandemics. Their role during pandemic preparedness and disease outbreaks should include involvement in pandemic decision-making and policy development, service delivery and participation in transparent accountability mechanisms. The Pandemic Agreement must guarantee the full participation of communities in efforts to prevent, detect and respond to outbreaks by obligating governments to finance people-centered, integrated, community responses, including community-based education and outreach.  

Michael G. Marmot, Professor of Epidemiology and Director of the Institute of Health Equity at University College London 

On addressing the social determinants of pandemics 

The pattern of health inequities during pandemics closely resembles that during non-pandemic states. Actions on social determinants of health equity are an important component of preparing for pandemics and reducing their health impact. This is because infectious diseases disproportionately impact the most vulnerable. Failure to address infection and ill health among these populations provides fuel to pandemics, prolonging their impact and increasing inequality and vulnerability. Interrupting this cycle requires addressing social determinants—the circumstances in which people are born, grow, live, learn, work and age—at a local, national, and international level. To make the world more pandemic resilient, the Pandemic Agreement must commit states to concrete action on social determinants. During pandemics, states must pursue social and economic policies that reduce exposure of vulnerable groups and protect them from harms of isolation and illness. This includes addressing the barriers to preventative, diagnostic and curative services particularly experienced by vulnerable groups.