The CGD Podcast: Pandemic Proof – Negotiating a Global Pandemic Agreement

Date: August 22, 2024
Host: Javier Guzman (Center for Global Development)
Guest: Precious Mazozzo – Director, Health Regulatory Science Platform, Wit Health Consortium; Honorary Lecturer, Univ. of Witwatersrand, South Africa; Former Director General of the South African National Department of Health

Overview

In this episode of Pandemic Proof, host Javier Guzman speaks with international health expert Precious Mazozzo about the challenges, lessons learned, and hopes for negotiating a global agreement to better prepare for and respond to pandemics. With the World Health Organization (WHO) member states having missed their 2024 deadline to finalize a Pandemic Agreement, the discussion delves into why reaching consensus has been difficult, what key issues remain, and how the negotiation process can improve to ensure greater equity, effectiveness, and cooperation in global health governance.

Key Discussion Points & Insights

1. The Urgency and Feasibility of a Pandemic Agreement

• International Interdependence:

  • Mazozzo underscores that no country can ensure lasting safety from pandemics alone.

    "One country cannot be isolated. If your population is safe, your citizens are safe. It doesn't mean they'll be safe forever because these borders, they are porous, but also viruses move." (00:02)

• Status of Negotiations:

  • Negotiations for a global pandemic agreement are halfway complete. Of the outstanding articles, many are partially agreed upon.

    "By my own calculation, we actually are 50% done in terms of the agreed texts and articles. But of course, the remaining articles, they are partially agreed." (03:52–04:04)

• Nature of the Issues:

  • Remaining debates are both technical and deeply political, requiring nuanced compromise and strong political will.

    "These are not just technical discussions, they are political discussions that require some nuance, that requires that we find a balance between opposing views." (04:19)

2. The Three Main Sticking Points

A. Pathogen Access and Benefit Sharing (PABS)

• Key Issue:

  • Should benefits from sharing biological materials (like viruses) be transactional? What safeguards and definitions are needed?

    "Access to pathogens and benefits must be on an equal footing. And for that to happen, there are certain elements that need to be in place. For instance, the benefits must be defined." (08:14)

• Debate:

  • Some oppose a purely transactional approach, preferring nuanced legal frameworks (protocols or annexes) to balance interests.
  • Details about risk minimization, development triggers for diagnostics/vaccines, and supporting legal architecture remain contested.

B. One Health

• Key Issue:

  • Integrates human, animal, and environmental health. Developing countries are wary of new, unfunded obligations.

    "For developing countries, they are of the view that they do not want new obligations imposed for which additional resources will be needed." (10:14)

• Debate:

  • How to ensure preventive measures and surveillance capacity without stretching limited resources or imposing inappropriate mandates.

C. Technology Transfer and Intellectual Property (IP)

• Key Issue:

  • During COVID-19, vaccines and solutions were hoarded by richer nations.

    "Some countries hoarded vaccines and diagnostics. Now, this time around... can they also ensure that there's tech transfer for others to produce?" (13:32)

• Debate:

  • Should tech transfer be mandatory, voluntary, or negotiated on mutually agreed terms?
  • References to existing frameworks (e.g., PIP Framework, Nagoya Protocol) and ongoing disputes over the TRIPS waiver remain.

3. Financing Pandemic Preparedness

• Progress:

  • Financing mechanisms have seen significant agreement relative to other negotiation elements.

    "We've made considerable progress on the financing... There's been some recognition that having new funding mechanism may not work..." (16:32)

• Consensus:

  • Focus should be on coordinating existing global funds (like the Pandemic Fund), not starting from scratch.
  • Emphasis on future-proofing: the agreement should recognize current funds without being so specific that it is outdated in future decades.

• Domestic vs. Global Financing:

  • Sustainability requires a balance between global investments and reinforced domestic funding efforts.

    "You want domestic financing, you want countries to also invest locally and ensure that they can sustain whatever initiatives that are necessary..." (17:45)

4. Lessons for Future Negotiations

• Process Challenges:

  • Attempting to reach consensus with 194 countries in plenary sessions is ineffective.

    "You can't negotiate in a plenary with 194 countries. It doesn't work." (20:50)

• Solution:

  • Emphasize informal, trust-building conversations outside of formal meetings; deals are often made "outside the room."
  • The trust deficit and geopolitical tensions (Ukraine, Gaza) have spilled into negotiations, complicating progress.

• Memorable Quote:

  "When there's no trust, it doesn't matter how many meetings we convene... have to find mechanisms of building trust, building confidence, promoting dialogue." (21:34)

5. The Primacy of Governance

• Main Priority for the Future:

  • Governance – at both global and national levels – is the critical factor for pandemic response and preparedness.

    "The one thing I would improve is governance. The global governance, I think has been identified as key..." (24:15)

• Leadership:

  • Heads of state must be more directly involved, with health being understood as a whole-of-government issue.
  • A strong call for new pandemic governance arrangements that reach beyond ministries of health.

Notable Quotes and Memorable Moments

• On why agreement is essential:

  "Can we really afford not to solve them, given what we've gone through? I mean, given the number of lives lost and the economic devastation... I don't think there's any country that was spared." (05:30)

• On inclusion and geopolitical hurdles:

  "They did not happen at the time when the geopolitical landscape was as is today... we've also seen with the Gaza issue, those issues have been brought into the room." (22:55)

• On global solidarity:

  "Viruses move, they don't need a visa, they hit any country. So it's in our best interest to ensure that we can solve this problem collectively, collaboratively, and also that there's cooperation." (14:32)

• On governance and political will:

  "When pandemics hit, they affect the whole of government. Every country must ensure that heads of states at national level take interest in these matters." (24:15)

Timestamps for Key Segments

• 00:02 – Precious Mazozzo on the impossibility of isolating countries from pandemics
• 03:52 – Status update on negotiations: halfway done and remaining challenges
• 08:14–14:32 – Deep dive into the three main sticking points: Pathogen Access, One Health, Technology Transfer
• 16:32–19:50 – Financing pandemic preparedness; balancing domestic and global roles
• 20:50–23:42 – Lessons for more effective negotiation; the importance of trust and informality
• 24:15–25:51 – Why improved governance at all levels should be the top reform

Conclusion

This episode illustrates both the promise and the complexities of forging a new global pandemic agreement. While much technical progress has been made, the political dimensions – trust, solidarity, shared financing, and governance – will ultimately shape success. Mazozzo’s optimism is grounded in a pragmatic understanding of international law and politics, and her call for strengthened governance, balanced financing, and informal diplomacy will resonate with listeners hoping for a safer post-pandemic world.