World's First Pandemic Treaty Is In A Deadlock And No One's Willing To Budge

Deadlines are rather morbid. In retrospect, when the member states of the World Health Organization agreed to start talks on the world's first pandemic treaty back in December 2021, it was audacious of them to assume that the negotiators would manage to deliver a final draft by May 2024.

To be fair, one would think that crafting a treaty aimed at helping governments sidestep the blunders of the Covid-19 crisis, which claimed some seven million lives, would unite the world in a common cause. Instead, it pitted low-income countries against big pharma. The main bone of contention has been access to pathogen data.

At the crux of the pandemic accord is the idea that to adequately prepare for future pandemics, which could prove more lethal than the one from which we've only recently emerged, nations must readily share samples and genetic sequencing of newly discovered pathogens, thereby facilitating the world (read: Big Pharma) to develop therapies and life-saving vaccines well in advance of crisis. 

There is just one problem. Low-income countries are demanding guaranteed benefits, including equal access to vaccines and collaborative efforts with local scientists. They also want drugmakers to compensate them for access to pathogen data.

And therein lies a deal-breaker for the world’s biggest pharmaceutical firms. 

The Pharma Logic 

In a recent statement, the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), the global industry body whose members include Pfizer, AstraZeneca and Johnson & Johnson, insisted that “achieving equitable access to medical countermeasures requires a comprehensive solution and should not be based on linking access to pathogen samples and sequence data to benefit-sharing obligations.”

In other words, big pharma has drawn a line: it won’t let go of intellectual property rights over vaccines, nor will it pay for pathogen data. “You will not see, at any point of time, Western drug makers ever compromise on intellectual property (IP), as it contradicts their business model,” Aparna Krishnan, a London-based healthcare consultant, told The Core. 

IP is key to the global pharmaceutical industry. Developing new drugs takes years of work and tons of cash poured into research that may not even result in consequential breakthroughs. Only one or two compounds out of a thousand, per the Association of the British Pharmaceutical Industry, make it through clinical trials to become marketable drugs. Making new therapies is a risky, pricey gamble. For example, AstraZeneca — facing heat in a UK court over its Covid-19 vaccine's side effects — spent a whopping $10.9 billion on R&D alone last year. "So if you're spending almost 12 years developing and commercialising a new drug, you only have around eight years to ensure it's profitable for the company and then reinvest in more research. Letting go of IP rights just isn't sustainable for the industry," Krishnan said.

Indian pharmaceutical companies, in comparison, don’t have deep pockets to splurge on developing new drugs. An analysis shows that Indian companies spend the equivalent of 4.4% of net sales on R&D as opposed to over 20% by the companies in the US. Viranchi Shah, president of the Indian Drug Manufacturers Association, told The Core that the sharing of pathogen data could still aid the Indian industry. "Of course, the big US and European companies can develop new products faster than us, but we shouldn't entirely dismiss our capabilities," he said. "With access to data, Indian pharma could consider repurposing older drugs for new pathogenic strains."

Indian companies have the capacity to make drugs and vaccines in bulk. It is the world’s biggest generics supplier with a 20 per market share by volume. Indian vaccine-making capacities came in handy during the pandemic when vaccine rollout faced manufacturing hiccups in Europe and distribution bottlenecks in America. That’s when India’s Serum Institute and Bharat Biotech ramped up production and exported the doses. 

Yet, engagement with the pandemic treaty negotiations has been minimal in India thus far. When The Core reached out to a senior executive at a vaccine-manufacturing firm, he candidly admitted being unaware of the negotiations. Questions sent to leading vaccine makers and the Indian Council of Medical Research remained unanswered at the time of publishing. We will update the story if and when they reply. 

This is to say that the world pretty much depends on global pharma giants to make drugs, more so when there’s a pandemic. Furthermore, their refusal to pay for access to pathogen data also stems from a similar rudimentary economic logic, Krishnan added. It’s a distinct possibility that an expected pandemic may never occur and therapies and vaccines developed in anticipation may not be required. 

The Global South demanding payment for pathogen sharing could even prove counterproductive. "With climate change, it's not just the global south at risk. Arctic melting could release pathogens in Switzerland. Should they sell those to pharma for access? No, those pathogens matter to the South, too," she remarked. 

So if not with obligations on drugmakers to share vaccines at the event of a global pandemic, how could the treaty ensure fair healthcare access? The industry proposes the good old model of voluntary collaboration. During a pandemic, drugmakers developing viable vaccines may share proprietary information with generic medicines manufacturers, such as India's Serum Institute, that possess the capacity for mass-producing the vaccines. 

But this offers little reassurance to developing countries. 

"I understand their mistrust after being last in line for COVID vaccines, despite providing data. That's the flip side," Krishnan said. 

Fears of South

The Global South's mistrust of Big Pharma, and by extension, the West, is far from misplaced.

According to a paper published in the journal Nature in October 2022, vaccine coverage had reached nearly 75% in some high-income countries by the end of 2021. In contrast, in many low-income countries of the Global South, less than 2% of the population had received two doses of Covid vaccines.

"The expectation of the Global South is to secure access to essential health products related to global health emergencies or pandemics,” KM Gopakumar, who’s stationed in Geneva observing the negotiations as legal advisor at the nonprofit Third World Network, told The Core. “If the treaty does not offer that, then what is the point of even signing the pandemic accord?" he added. 

Observers are also wary that in the absence of strict regulations, pathogen data can be misused. “The treaty is basically proposing to create an obligation on countries to have collaborative surveillance. This very data could potentially be co-opted for strategic purposes, such as the development of bioweapons. It could also be used as a deterrent in matters of international trade, leveraged to forestall agricultural exports from your country,” Gopakumar said. “Nothing in the instrument seemingly proposes any kind of discipline related to the use of this data,” he added.

This tussle between the Global South and North has derailed nine rounds of talks on what the WHO director-general Tedros Adhanom Ghebreyesus had described as a “once-in-a-generation opportunity” to strengthen the globe’s health architecture.

As the WHO’s negotiating body, having representatives of 194 countries, meets again in Geneva — for the 10th and final round of discussion — the question looms: who will emerge victorious in this tug of war? 

The Day of Judgement

Two possible outcomes lie ahead.

One portends a future in which the negotiating body fails to achieve consensus, leaving the world to simply march on with its myriad affairs without the pandemic accord. The second augurs an accord reached, the world's inaugural historic pandemic pact, but one that may not guarantee equitable access to all. 

If the last draft of the pandemic treaty released by the WHO is of any clue, the second scenario is likely. The draft obligates data sharing but only goes as far as recommending the sharing of vaccines and tech in the likelihood of a pandemic.

“One of the paragraphs in the draft reads ‘will take appropriate measures to support time-bound waivers of intellectual property rights’. But what does support mean? There is no clear-cut commitment, ” said Dr K Srinath Reddy, professor and former president of Public Health at the Public Health Foundation of India. 

"It's like you're in your boat, I'm in mine, and maybe I'll throw you some food if you're starving. That kind of deal," Reddy added.

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