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International negotiations for a pandemic treaty: A thematic evaluation of 43 member states

International negotiations for a pandemic treaty: A thematic evaluation of 43 member states PROGRESS IN TREATY DEVELOPMENTTo date, the Intergovernmental Negotiating Body have met on four occasions to discuss the development of a pandemic prevention, preparedness and response accord (Figure 1). The first INB meeting aimed to identify critical elements of the instrument and initiate the development of a working draft; these discussions were largely consumed by procedural and logistical deliberations. The second, more substantive INB meeting, was convened to appraise a working draft and specify preferences for the nature of the pact under the WHO Constitution. The intended legally‐binding nature of the instrument had been contended by some member states through predicted political resistance, with some favouring amendments to the International Health Regulations (2005) exclusively, or the development of alternative mechanisms and new regulations that do not rely on ratification by all states (Hannon et al., 2022). However, the third meeting concluded that a binding accord presenting a sufficiently compelling preventative and preparatory opportunity for pandemic prevention and preparedness, and for the scope of IHR – which fatalistically assumes that outbreaks cannot be prevented, only managed – to be transcended. The INB Bureau agreed the development of a ‘zero draft’ of the pandemic accord, advancing on the conceptual iteration, which was discussed at the fourth meeting in February 2023. Despite advances in this process, a poorly‐considered treaty could fail to fulfil its mission (Wenham et al., 2022). Hence, a thematic evaluation of interventions was conducted to provide comprehension of gaps in negotiations, areas of over‐ and under‐emphasis, and to identify opportunities to enhance subsequent negotiations and guide refinement in developing further iterations of the draft.1FIGURETimeline of key events in the development of a pandemic treatyMETHODS12 evidence‐based elements have been proposed for a successful and transformative treaty (Carlson & Phelan, 2022), spanning four domains: (i) spillover prevention; (ii) pandemic prevention; (iii) pandemic response and (iv) recovery and resilience (Table 1). To evaluate the themes of the negotiations at the second INB meeting, 21 indicators were developed corresponding with the objectives of the 12 elements (Table 1).1TABLESummary of indicators and the mean performance of elements and domains across member states.DescriptionMean (SD)Domain I: Spillover prevention0.20 (0.07)Element 1One Health0.26 (0.44)1.1Supportive of One Health0.44 (0.59)1.2Supportive of addressing antimicrobial resistance0.07 (0.40)Element 2Planetary Health0.22 (0.31)2.1Supportive of the need to address global environmental issues (eg, climate change, biodiversity loss, land degradation, wildlife trade and spillover events)0.26 (0.45)2.2Supportive of efforts to formalise this interface through other international law (eg, CBD, CITES and UNFCCC)0.19 (0.39)Element 3Zoonotic risk assessment0.12 (0.32)3.1Supportive of notification and data‐sharing obligations for animal disease outbreaks0.12 (0.32)Domain II: Pandemic prevention0.36 (0.08)Element 4Surveillance and assessment0.37 (0.38)4.1Supportive of obligations for improvements in infectious disease surveillance generally (eg, data sharing, capacity building, technology transfer and equitable sharing of benefits from the use of pathogen samples and genomic sequence data)0.47 (0.50)4.2Supportive of obligations for sharing pathogen samples0.28 (0.45)4.3Supportive of obligations for sharing genetic sequence data0.37 (0.49)Domain 5Biomedical R&D and production0.44 (0.50)5.1Supportive of obligations for biomedical research, development and manufacturing (eg, technology transfer and capacity building)0.44 (0.50)Element 6Health systems strengthening0.28 (0.33)6.1Supportive of a ‘right to health’ approach0.16 (0.37)6.2Supportive of universal health coverage and/or primary health care0.40 (0.49)Domain III: Pandemic response0.26 (0.11)Element 7Equitable access to global goods0.40 (0.35)7.1Supportive of the need for equitable sharing of vaccines, diagnostics and therapeutics0.60 (0.50)7.2Supportive access and benefit sharing consistent with the Nagoya Protocol0.21 (0.47)Element 8Emergency legal preparedness0.21 (0.47)8.1Supportive of improving public health authorities' powers0.21 (0.47)Element 9Least restrictive measures0.19 (0.24)9.1Supportive of obligations to respect, protect and fulfil human rights0.40 (0.49)9.2Supportive guidance or limits on the use of travel restrictions−0.02 (0.15)Domain IV: Recovery and resilience0.19 (0.39)Element 10Adaptive governance−0.27 (0.37)10.1Supportive of regular Conference of Parties0.19 (0.39)10.2Supportive of the principle of Common But Differentiated Responsibilities0.35 (0.53)Element 11Accountability and transparency0.37 (0.49)11.1Supportive of accountability and transparency mechanisms, including enforcement mechanisms or periodic review0.37 (0.49)Element 12Reduce inequities and injustice0.45 (0.28)12.1Supportive of equity and justice as preambular language0.79 (0.41)12.2Supportive of binding obligations for non‐discrimination in the implementation of prevention, preparedness and response measures.0.12 (0.39)Abbreviations: CBD, Convention on Biological Diversity; CITES, Convention on International Trade in Endangered Species; SD, standard deviation; UNFCCC, United Nations Framework Convention on Climate Change.For the purpose of this analysis, the indicators closely followed the outline of elements, to frame the objectives in an examinable way that would facilitate binary assessment. The second INB meeting was selected, as this represented the first instance where member states constructively exchanged views on the working draft of the instrument. The indicators allowed the broadly‐framed elements with multifaceted components, to be separated into individual items. The elements drew from the Pandemic Treaty Project led by researchers at Georgetown University. Interventions by member states between July 18 and 21, 2022, were analysed and qualitatively coded. JP independently reviewed transcripts – generated through artificial intelligence and machine learning, speech‐to‐text transcription service – and meeting recordings for the relevant sessions. The researcher inputted their findings into a single spreadsheet, mapped against the 12 elements (Appendix S1). The qualitatively coded responses were transformed into a simple numerical scale, where a response of “no” corresponded to a value of −1, “not mentioned” was equated to 0, and “yes” scored 1. Numerical representation of the coding enabled the aggregation of member states' responses across the elements and domains, in addition to the 21 individual indicators, enabling evaluation at different layers of granularity. Descriptive statistics were used to analyse and characterise the spatial trends. The aggregate results for the 12 elements and four domains across 43 member states were presented as a forest plot displaying the average element and domain scores.FINDINGSThe thematic evaluation showed member state's support for all four domains, where pandemic prevention was the most strongly supported, followed by the pandemic response, spillover prevention and recovery and resilience. Equity and justice followed by obligations that strengthen biomedical research, development and manufacturing, were the most commonly agreed ambition by member states (Figure 2). Efforts to enhance accountability and transparency – a key determinant of the success of international treaties (Hoffman et al., 2022) – through enforcement mechanisms and objective monitoring efforts were also well‐supported. The element concerning adaptive governance, scoping member states' encouragement for a regular Conference of Parties and the principle of Common But Differentiated Responsibilities (CBDR), was the least supported element.2FIGUREForest plot illustrating the degree to which the elements and domains were supported by member states.Spillover preventionThe framing of One Health and antimicrobial resistance was raised as a concern by some member states, at risk of detracting from the primary focus of the instrument, inspiring a mere tokenistic mention. With the development and implementation of many dedicated national action plans on antimicrobial resistance (Patel et al., 2023), this may disturb or duplicate objectives that member states have developed through separate processes. However, the ability for a One Health empowered treaty to aim for deep prevention and contribute to a global state shift (Carlson & Phelan, 2022; Vinuales et al., 2021), empowering the Quadripartite Collaboration for One Health – a consortium of the World Health Organisation, the World Organisation for Animal Health, the Food and Agriculture Organisation and the United Nations Environment Programme – was more widely acknowledged. Although the value of effective spillover prevention and monitoring were recognised for pandemic prevention, suggestions for international implementation mechanisms were lacking. Widespread agreement for global environmental issues as a central thematic feature for the new instrument, but only eight member states specified interest in formalising these synergies through existing legal obligations. The lack of recognition for the interlinkages between the new instrument and other legal frameworks could represent a missed opportunity for harnessing the relevant co‐benefits.Pandemic preventionThe need for improvements in the interoperability of surveillance and reporting systems was raised, with calls for greater clarity on the role of non‐governmental stakeholders, and how the WHO might seek to cooperate with its fellow agencies comprising the Quadripartite. Some member states were concerned that the language describing the preparatory role of health systems was highly focused on technological solutions, failing to account for a broader array of ‘building blocks’ required for equitable health systems strengthening (WHO, 2010). High levels of support for biomedical research and development, may have reflected an international consensus that science and technology ultimately deliver the tools to respond to pandemics effectively. A notable example of global collaboration for biomedical products was the Access to Covid‐19 Tools Accelerator (ACT‐A) partnership, launched by WHO, which raised over $24 billion to procure 2 billion vaccine doses, 245 million treatments and 500 million tests deemed necessary to end the COVID‐19 pandemic and enable global economic recovery (WHO, 2023).Pandemic responseWhile the inclusion of equity was widely championed, its operationalisation required greater clarity. Many countries suggested an independent or complementary international framework for access and benefit sharing, in accordance with existing instruments such as the Convention on Biological Diversity and its Nagoya Protocol, and providing low‐ and middle‐income countries with the capacity to expand local manufacturing hubs. Member states approved the central, coordinating role of a sustainably financed WHO in the global governance of pandemic response, to avoid fragmenting the global health architecture. China emphasised that the sovereignty of member states should be respected, with the right to manage and regulate their public health measures. Complementarity with the amended IHR was encouraged, with gaps that the IHR misses, addressed by the new instrument.Recovery and resilienceHigh‐income countries promoted transparent, monitoring and accountability mechanisms for the implementation and compliance with the agreement, acknowledging that additional support may be necessary to implement these activities in low‐ and middle‐income countries. Adaptive governance, scoping the support of member states for regular Conference of Parties (COP) and the CBDR principle, was the most contested element. Those in favour expressed support for the establishment of a dedicated COP, as a continuous monitoring tool, and to strengthen the leadership and governance oversight of the instrument. However, the European Union were not convinced that the importation of CBDR to the instrument would be appropriate, and Japan expressed the need for an oversight mechanism under the COP for full utility, while African nations did not state their position on either aspect.LIMITATIONSThis analysis is limited in the following ways: firstly, it reports on the second INB meeting, and does not consider the more recent interventions by member states at subsequent meetings. Secondly, the framework by Phelan and Carlson (2022) guides the assessment matrix, however, additional elements may be of relevance to governments and institutions that these elements do not consider. Thirdly, the indicators developed by the researcher may have a narrow scope or may have missed critical aspects of the elements. Future analyses may consider methods for a more comprehensive capture of indicators.CONCLUSIONIn summary, all domains and the majority of elements for an effective pandemic treaty were supported by member states. Support for an instrument that reduces inequities and injustice was the most commonly agreed ambition by member states However, future negotiations may benefit from the consolidation of elements susceptible to disagreement, to direct the development of a treaty with maximum utility across national and regional contexts. The value of reproducing this analysis for the INB meetings that followed the July 2022 deliberations would aid the development of a longitudinal comprehension of priorities raised by member states, including their consistencies and differences.ACKNOWLEDGEMENTsWith thanks to Kayla Zamanian and Alexandra Phelan.CONFLICT OF INTEREST STATEMENTI declare no competing interests. This Practitioner Commentary did not receive funding.DATA AVAILABILITY STATEMENTRecordings of the second INB meeting, used for this analysis, are available through the World Health Organisation https://inb.who.int/. All coded data informing this analysis are supplied in the Appendix S1.REFERENCESCarlson, C.J. & Phelan, A.L. (2022) International law reform for one health notifications. The Lancet, 400(10350), 462–468.Hannon, E., Hanbali, L., Lehtimaki, S. & Schwalbe, N. (2022) Why we still need a pandemic treaty. The Lancet Global Health, 10(9), e1232–e1233.Hoffman, S.J., Baral, P., Rogers van Katwyk, S., Sritharan, L., Hughsam, M., Randhawa, H. et al. (2022) International treaties have mostly failed to produce their intended effects. Proceedings of the National Academy of Sciences of the United States of America, 119(32), e2122854119.Patel, J., Harant, A., Fernandes, G., Mwamelo, A.J., Hein, W., Dekker, D. et al. (2023) Measuring the global response to antimicrobial resistance, 2020–21: a systematic governance analysis of 114 countries. The Lancet Infectious Diseases [Online] Available from: https://www.thelancet.com/journals/laninf/article/PIIS1473‐3099(22)00796‐4/fulltext [Accessed 23 March 2023]Phelan, A.L. & Carlson, C.J. (2022) A treaty to break the pandemic cycle. Science, 377(6605), 475–477.Vinuales, J., Moon, S., Le Moli, G. & Burci, G.L. (2021) A global pandemic treaty should aim for deep prevention. The Lancet, 397(10287), 1791–1792.Wenham, C., Eccleston‐Turner, M. & Voss, M. (2022) The futility of the pandemic treaty: caught between globalism and statism. International Affairs, 98, 837–852.World Health Organization. (2010) Monitoring the building blocks of health systems: a handbook of indicators and their measurement strategies. Geneva: World Health Organization.World Health Organization. (2023) Access to COVID‐19 tools funding commitment tracker [Online]. Available from: https://www.who.int/publications/m/item/access‐to‐covid‐19‐tools‐tracker http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Global Policy Wiley

International negotiations for a pandemic treaty: A thematic evaluation of 43 member states

Patel, Jay
Global Policy , Volume 14 (3) – Jun 1, 2023
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Abstract

PROGRESS IN TREATY DEVELOPMENTTo date, the Intergovernmental Negotiating Body have met on four occasions to discuss the development of a pandemic prevention, preparedness and response accord (Figure 1). The first INB meeting aimed to identify critical elements of the instrument and initiate the development of a working draft; these discussions were largely consumed by procedural and logistical deliberations. The second, more substantive INB meeting, was convened to appraise a working draft and specify preferences for the nature of the pact under the WHO Constitution. The intended legally‐binding nature of the instrument had been contended by some member states through predicted political resistance, with some favouring amendments to the International Health Regulations (2005) exclusively, or the development of alternative mechanisms and new regulations that do not rely on ratification by all states (Hannon et al., 2022). However, the third meeting concluded that a binding accord presenting a sufficiently compelling preventative and preparatory opportunity for pandemic prevention and preparedness, and for the scope of IHR – which fatalistically assumes that outbreaks cannot be prevented, only managed – to be transcended. The INB Bureau agreed the development of a ‘zero draft’ of the pandemic accord, advancing on the conceptual iteration, which was discussed at the fourth meeting in February 2023. Despite advances in this process, a poorly‐considered treaty could fail to fulfil its mission (Wenham et al., 2022). Hence, a thematic evaluation of interventions was conducted to provide comprehension of gaps in negotiations, areas of over‐ and under‐emphasis, and to identify opportunities to enhance subsequent negotiations and guide refinement in developing further iterations of the draft.1FIGURETimeline of key events in the development of a pandemic treatyMETHODS12 evidence‐based elements have been proposed for a successful and transformative treaty (Carlson & Phelan, 2022), spanning four domains: (i) spillover prevention; (ii) pandemic prevention; (iii) pandemic response and (iv) recovery and resilience (Table 1). To evaluate the themes of the negotiations at the second INB meeting, 21 indicators were developed corresponding with the objectives of the 12 elements (Table 1).1TABLESummary of indicators and the mean performance of elements and domains across member states.DescriptionMean (SD)Domain I: Spillover prevention0.20 (0.07)Element 1One Health0.26 (0.44)1.1Supportive of One Health0.44 (0.59)1.2Supportive of addressing antimicrobial resistance0.07 (0.40)Element 2Planetary Health0.22 (0.31)2.1Supportive of the need to address global environmental issues (eg, climate change, biodiversity loss, land degradation, wildlife trade and spillover events)0.26 (0.45)2.2Supportive of efforts to formalise this interface through other international law (eg, CBD, CITES and UNFCCC)0.19 (0.39)Element 3Zoonotic risk assessment0.12 (0.32)3.1Supportive of notification and data‐sharing obligations for animal disease outbreaks0.12 (0.32)Domain II: Pandemic prevention0.36 (0.08)Element 4Surveillance and assessment0.37 (0.38)4.1Supportive of obligations for improvements in infectious disease surveillance generally (eg, data sharing, capacity building, technology transfer and equitable sharing of benefits from the use of pathogen samples and genomic sequence data)0.47 (0.50)4.2Supportive of obligations for sharing pathogen samples0.28 (0.45)4.3Supportive of obligations for sharing genetic sequence data0.37 (0.49)Domain 5Biomedical R&D and production0.44 (0.50)5.1Supportive of obligations for biomedical research, development and manufacturing (eg, technology transfer and capacity building)0.44 (0.50)Element 6Health systems strengthening0.28 (0.33)6.1Supportive of a ‘right to health’ approach0.16 (0.37)6.2Supportive of universal health coverage and/or primary health care0.40 (0.49)Domain III: Pandemic response0.26 (0.11)Element 7Equitable access to global goods0.40 (0.35)7.1Supportive of the need for equitable sharing of vaccines, diagnostics and therapeutics0.60 (0.50)7.2Supportive access and benefit sharing consistent with the Nagoya Protocol0.21 (0.47)Element 8Emergency legal preparedness0.21 (0.47)8.1Supportive of improving public health authorities' powers0.21 (0.47)Element 9Least restrictive measures0.19 (0.24)9.1Supportive of obligations to respect, protect and fulfil human rights0.40 (0.49)9.2Supportive guidance or limits on the use of travel restrictions−0.02 (0.15)Domain IV: Recovery and resilience0.19 (0.39)Element 10Adaptive governance−0.27 (0.37)10.1Supportive of regular Conference of Parties0.19 (0.39)10.2Supportive of the principle of Common But Differentiated Responsibilities0.35 (0.53)Element 11Accountability and transparency0.37 (0.49)11.1Supportive of accountability and transparency mechanisms, including enforcement mechanisms or periodic review0.37 (0.49)Element 12Reduce inequities and injustice0.45 (0.28)12.1Supportive of equity and justice as preambular language0.79 (0.41)12.2Supportive of binding obligations for non‐discrimination in the implementation of prevention, preparedness and response measures.0.12 (0.39)Abbreviations: CBD, Convention on Biological Diversity; CITES, Convention on International Trade in Endangered Species; SD, standard deviation; UNFCCC, United Nations Framework Convention on Climate Change.For the purpose of this analysis, the indicators closely followed the outline of elements, to frame the objectives in an examinable way that would facilitate binary assessment. The second INB meeting was selected, as this represented the first instance where member states constructively exchanged views on the working draft of the instrument. The indicators allowed the broadly‐framed elements with multifaceted components, to be separated into individual items. The elements drew from the Pandemic Treaty Project led by researchers at Georgetown University. Interventions by member states between July 18 and 21, 2022, were analysed and qualitatively coded. JP independently reviewed transcripts – generated through artificial intelligence and machine learning, speech‐to‐text transcription service – and meeting recordings for the relevant sessions. The researcher inputted their findings into a single spreadsheet, mapped against the 12 elements (Appendix S1). The qualitatively coded responses were transformed into a simple numerical scale, where a response of “no” corresponded to a value of −1, “not mentioned” was equated to 0, and “yes” scored 1. Numerical representation of the coding enabled the aggregation of member states' responses across the elements and domains, in addition to the 21 individual indicators, enabling evaluation at different layers of granularity. Descriptive statistics were used to analyse and characterise the spatial trends. The aggregate results for the 12 elements and four domains across 43 member states were presented as a forest plot displaying the average element and domain scores.FINDINGSThe thematic evaluation showed member state's support for all four domains, where pandemic prevention was the most strongly supported, followed by the pandemic response, spillover prevention and recovery and resilience. Equity and justice followed by obligations that strengthen biomedical research, development and manufacturing, were the most commonly agreed ambition by member states (Figure 2). Efforts to enhance accountability and transparency – a key determinant of the success of international treaties (Hoffman et al., 2022) – through enforcement mechanisms and objective monitoring efforts were also well‐supported. The element concerning adaptive governance, scoping member states' encouragement for a regular Conference of Parties and the principle of Common But Differentiated Responsibilities (CBDR), was the least supported element.2FIGUREForest plot illustrating the degree to which the elements and domains were supported by member states.Spillover preventionThe framing of One Health and antimicrobial resistance was raised as a concern by some member states, at risk of detracting from the primary focus of the instrument, inspiring a mere tokenistic mention. With the development and implementation of many dedicated national action plans on antimicrobial resistance (Patel et al., 2023), this may disturb or duplicate objectives that member states have developed through separate processes. However, the ability for a One Health empowered treaty to aim for deep prevention and contribute to a global state shift (Carlson & Phelan, 2022; Vinuales et al., 2021), empowering the Quadripartite Collaboration for One Health – a consortium of the World Health Organisation, the World Organisation for Animal Health, the Food and Agriculture Organisation and the United Nations Environment Programme – was more widely acknowledged. Although the value of effective spillover prevention and monitoring were recognised for pandemic prevention, suggestions for international implementation mechanisms were lacking. Widespread agreement for global environmental issues as a central thematic feature for the new instrument, but only eight member states specified interest in formalising these synergies through existing legal obligations. The lack of recognition for the interlinkages between the new instrument and other legal frameworks could represent a missed opportunity for harnessing the relevant co‐benefits.Pandemic preventionThe need for improvements in the interoperability of surveillance and reporting systems was raised, with calls for greater clarity on the role of non‐governmental stakeholders, and how the WHO might seek to cooperate with its fellow agencies comprising the Quadripartite. Some member states were concerned that the language describing the preparatory role of health systems was highly focused on technological solutions, failing to account for a broader array of ‘building blocks’ required for equitable health systems strengthening (WHO, 2010). High levels of support for biomedical research and development, may have reflected an international consensus that science and technology ultimately deliver the tools to respond to pandemics effectively. A notable example of global collaboration for biomedical products was the Access to Covid‐19 Tools Accelerator (ACT‐A) partnership, launched by WHO, which raised over $24 billion to procure 2 billion vaccine doses, 245 million treatments and 500 million tests deemed necessary to end the COVID‐19 pandemic and enable global economic recovery (WHO, 2023).Pandemic responseWhile the inclusion of equity was widely championed, its operationalisation required greater clarity. Many countries suggested an independent or complementary international framework for access and benefit sharing, in accordance with existing instruments such as the Convention on Biological Diversity and its Nagoya Protocol, and providing low‐ and middle‐income countries with the capacity to expand local manufacturing hubs. Member states approved the central, coordinating role of a sustainably financed WHO in the global governance of pandemic response, to avoid fragmenting the global health architecture. China emphasised that the sovereignty of member states should be respected, with the right to manage and regulate their public health measures. Complementarity with the amended IHR was encouraged, with gaps that the IHR misses, addressed by the new instrument.Recovery and resilienceHigh‐income countries promoted transparent, monitoring and accountability mechanisms for the implementation and compliance with the agreement, acknowledging that additional support may be necessary to implement these activities in low‐ and middle‐income countries. Adaptive governance, scoping the support of member states for regular Conference of Parties (COP) and the CBDR principle, was the most contested element. Those in favour expressed support for the establishment of a dedicated COP, as a continuous monitoring tool, and to strengthen the leadership and governance oversight of the instrument. However, the European Union were not convinced that the importation of CBDR to the instrument would be appropriate, and Japan expressed the need for an oversight mechanism under the COP for full utility, while African nations did not state their position on either aspect.LIMITATIONSThis analysis is limited in the following ways: firstly, it reports on the second INB meeting, and does not consider the more recent interventions by member states at subsequent meetings. Secondly, the framework by Phelan and Carlson (2022) guides the assessment matrix, however, additional elements may be of relevance to governments and institutions that these elements do not consider. Thirdly, the indicators developed by the researcher may have a narrow scope or may have missed critical aspects of the elements. Future analyses may consider methods for a more comprehensive capture of indicators.CONCLUSIONIn summary, all domains and the majority of elements for an effective pandemic treaty were supported by member states. Support for an instrument that reduces inequities and injustice was the most commonly agreed ambition by member states However, future negotiations may benefit from the consolidation of elements susceptible to disagreement, to direct the development of a treaty with maximum utility across national and regional contexts. The value of reproducing this analysis for the INB meetings that followed the July 2022 deliberations would aid the development of a longitudinal comprehension of priorities raised by member states, including their consistencies and differences.ACKNOWLEDGEMENTsWith thanks to Kayla Zamanian and Alexandra Phelan.CONFLICT OF INTEREST STATEMENTI declare no competing interests. This Practitioner Commentary did not receive funding.DATA AVAILABILITY STATEMENTRecordings of the second INB meeting, used for this analysis, are available through the World Health Organisation https://inb.who.int/. All coded data informing this analysis are supplied in the Appendix S1.REFERENCESCarlson, C.J. & Phelan, A.L. (2022) International law reform for one health notifications. The Lancet, 400(10350), 462–468.Hannon, E., Hanbali, L., Lehtimaki, S. & Schwalbe, N. (2022) Why we still need a pandemic treaty. The Lancet Global Health, 10(9), e1232–e1233.Hoffman, S.J., Baral, P., Rogers van Katwyk, S., Sritharan, L., Hughsam, M., Randhawa, H. et al. (2022) International treaties have mostly failed to produce their intended effects. Proceedings of the National Academy of Sciences of the United States of America, 119(32), e2122854119.Patel, J., Harant, A., Fernandes, G., Mwamelo, A.J., Hein, W., Dekker, D. et al. (2023) Measuring the global response to antimicrobial resistance, 2020–21: a systematic governance analysis of 114 countries. The Lancet Infectious Diseases [Online] Available from: https://www.thelancet.com/journals/laninf/article/PIIS1473‐3099(22)00796‐4/fulltext [Accessed 23 March 2023]Phelan, A.L. & Carlson, C.J. (2022) A treaty to break the pandemic cycle. Science, 377(6605), 475–477.Vinuales, J., Moon, S., Le Moli, G. & Burci, G.L. (2021) A global pandemic treaty should aim for deep prevention. The Lancet, 397(10287), 1791–1792.Wenham, C., Eccleston‐Turner, M. & Voss, M. (2022) The futility of the pandemic treaty: caught between globalism and statism. International Affairs, 98, 837–852.World Health Organization. (2010) Monitoring the building blocks of health systems: a handbook of indicators and their measurement strategies. Geneva: World Health Organization.World Health Organization. (2023) Access to COVID‐19 tools funding commitment tracker [Online]. Available from: https://www.who.int/publications/m/item/access‐to‐covid‐19‐tools‐tracker

Journal

Global Policy – Wiley

Published: Jun 1, 2023

References

  • International law reform for one health notifications
    Carlson, C.J.; Phelan, A.L.
  • Why we still need a pandemic treaty
    Hannon, E.; Hanbali, L.; Lehtimaki, S.; Schwalbe, N.
  • International treaties have mostly failed to produce their intended effects
    Hoffman, S.J.; Baral, P.; Rogers van Katwyk, S.; Sritharan, L.; Hughsam, M.; Randhawa, H.
  • Measuring the global response to antimicrobial resistance, 2020–21: a systematic governance analysis of 114 countries
    Patel, J.; Harant, A.; Fernandes, G.; Mwamelo, A.J.; Hein, W.; Dekker, D.
  • A treaty to break the pandemic cycle
    Phelan, A.L.; Carlson, C.J.
  • A global pandemic treaty should aim for deep prevention
    Vinuales, J.; Moon, S.; Le Moli, G.; Burci, G.L.
  • The futility of the pandemic treaty: caught between globalism and statism
    Wenham, C.; Eccleston‐Turner, M.; Voss, M.
  • Monitoring the building blocks of health systems: a handbook of indicators and their measurement strategies