How to stop Disease X, next pandemic

•Global leaders unite behind make-or-break Pandemic Treaty talks key to strengthening world’s ability to contain menace

An independent coalition of global leaders has made recommendations on how to prevent future outbreaks from becoming global pandemics or rather Disease X, the next pandemic.

Disease X is a placeholder name that was adopted by the World Health Organisation (WHO) in February 2018 on their shortlist of blueprint priority diseases to represent a hypothetical, unknown pathogen that could cause a future epidemic. The WHO adopted the placeholder name to ensure that their planning was sufficiently flexible to adapt to an unknown pathogen (for example, broader vaccines and manufacturing facilities).

The Panel for a Global Public Health Convention (GPHC), in a statement, yesterday, called for an accountable international system that enables countries at every income level to detect, alert and respond to health threats.

GPHC, through concrete solutions, accountability measures and governance structures, proposed a bold path forward to dramatically strengthen pandemic prevention, preparedness and response systems through a new Pandemic Treaty or Convention.

Worried that now in the third year of the COVID-19 pandemic, as new waves continue to rip through countries, the Panel warned that alarming deficits and gaps in compliance remain unaddressed along the continuum of what an effective epidemic and pandemic response could look like. It said, not only are countries no better prepared today to stop disease X, but the current international system has led to an unequal, two-tier response where one-third of the world’s population remains unvaccinated, which could yet undermine all the progress made to date.

Chair of GPHC, Barbara M. Stocking, said: “Countries need to wake up because global health security is only as strong as its weakest link. “Building a new Pandemic Treaty rooted in solidarity, transparency, accountability and equity is non-negotiable – it is in every country’s self-interest.”

The new set of recommendations calls for a positively incentivised system where compliance with agreed preparedness standards, alert protocols and response efforts are overseen by an independent monitoring and assessment body, covering both data and action.

To both publicly praise and criticise countries depending on their adherence to such requirements, the Panel proposes the body sit at arm’s length from the WHO. “WHO should be strengthened so that its role at the centre of the global health infrastructure is enhanced. This means it would set international standards in preparedness and response and support countries in achieving targets, but would also be supported by an independent body that has the mandate to call on and call out countries based on the performance of pandemic preparedness, detection and response,” it said.

Professor and Founding O’Neill Chair in Global Health Law, Georgetown University, Lawrence O. Gostin, said: “Whether we’re talking about the climate crisis, antimicrobial resistance, or the next global health security threat, we will not have an impact without compliance and full accountability.

“Currently, there are no incentives and accountability measures for countries to transparently report outbreaks and to contain them before they become pandemics. Many governments haven’t complied with the regulations we have. More than ever, we need a binding international treaty to reform our system. We can, and must, leave a safer world for our children.”

The Panel recognised that while agreed indicators for pandemic preparedness will vary based on a country’s current capacities and financial outlook, all targets must be ambitious and take a whole-of-government approach. All countries should be accountable to meet their targets, and an independent body should be responsible for tracking and monitoring progress or regression.

Former President of Ghana, John Dramani Mahama, said: “It is in everyone’s national interest to leave no one behind. Yet, the last two years have shown us that marginalised communities and those living in lower-income regions disproportionately bear the brunt of COVID-19’s debilitating effects on people and societies.

“We cannot ignore those who were forgotten the first time around. Thus, a new Pandemic Treaty must ensure life-saving tools and resources are available to people everywhere.”

The set of recommendations emphasised that sufficient funds will be needed to support a new international architecture for pandemic preparedness and response, namely, predictable, sustainable and timely funding. A multilateral facility would enable easy access to funds and ensure low- and middle-income countries are able to meet determined international requirements to detect, report and respond to health threats.

Former Secretary-General, the Organisation for Economic Co-operation and Development (OECD) and also former Minister of Foreign Affairs and Minister of Finance and Public Credit, Mexico, Angel Gurría, said: “It’s no good creating a new Pandemic Treaty if we don’t ensure countries can access the funds needed to comply with it.

“From the very beginning of the pandemic through to today, funding for the global response has been slow, unreliable and insufficient. We expect things to get better, but how can we hope for better results if we’re not willing to pay for them?”

Key to an effective Pandemic Treaty will be measures that secure mutual assurance along the timeline of events. The Panel argued that all agreements on who is required to take what action and when must be negotiated and determined to ensure actors can mobilise in time to contain outbreaks. This includes accountability for preparation; transparent and real-time reporting of health threats; implementation of evidence-based public health measures; information sharing, including genetic sequences, specimens and samples; equitable distribution of pandemic goods; as well as a fully-funded financing facility.

Former President of Costa Rica and Vice President of the World Leadership Alliance – Club de Madrid, Laura Chinchilla Miranda, said: “If we do not transform lessons from the last two years into an effective global system capable of stopping the next outbreak, future generations will look back in disbelief at our failure to stop preventable deaths.

“We have the lessons and tools to change the way the world responds next time – let’s now put them to work through a new Pandemic Treaty.”

The Panel noted that a transformed international system for pandemic preparedness and response to work, it must also be coherently governed. An overarching governance body overseen at the heads of state level would need to ensure equity and inclusion, coordination, trust between all parties and accountability. As global health leaders continue to negotiate a Pandemic Treaty this year, the Panel urged them to take bold action and ensure no person will ever have to endure a pandemic that could have been prevented.