World Health Organization members' negotiations on a pandemic preparedness treaty remain rocky less than two months before the intended deadline, as industrialized and developing nations butt heads over technology access.
Talks began in December 2021 with countries hoping to apply lessons from the slow COVID-19 response to prepare for the next pandemic. After two years of negotiating the contents, the plan was to reach an accord at the negotiating body's meeting last month.
That meeting ended on March 28 with no agreement, after failing to bridge the gap between India and African countries pushing for greater fairness in areas such as drug distribution, and the U.S., Japan and European countries seeking to avoid heavy financial burdens and transfers of valuable technology.
Global interest in the issue is also ebbing as countries focus on new crises such as the wars in Ukraine and the Middle East.
"If we miss this opportunity, we risk losing momentum," WHO Director-General Tedros Adhanom Ghebreyesus said on the first day of the meeting.
A major point of contention is how to handle technologies developed by drugmakers.
During the COVID-19 pandemic, limited vaccine supplies left poorer nations lagging on inoculating their populations. Emerging countries called for the pandemic treaty to include provisions ensuring technology transfers and waivers of intellectual property rights by drugmakers to enable local production of vaccines and treatments when needed.
An Indian representative argued at the meeting that tech transfers are a necessity to resolve supply constraints. The goal of the negotiations should be "to ensure that the fruits of this treaty reach the poorest and most vulnerable of the world," he said.
Other proposals included a system for countries to provide data on pathogens in exchange for sharing in the benefits when drugmakers use this the information, and financial support to help emerging economies develop disease control measures.
Advanced economies balked at the tech-sharing provision, arguing that it could end up hindering the response to pandemics if the prospect of heavy losses from forced technology transfers leaves pharmaceutical companies less willing to take risks on research and development.
"We do want a pandemic accord," Thomas Cueni, director-general of the International Federation of Pharmaceutical Manufacturers & Associations, said at the meeting. "Companies are willing to accept mandatory commitments to delivering equitable access to essential medical countermeasures, provided that the system is workable."
Amendments proposed by WHO members swelled the draft treaty's length to 110 pages, around four times the size of the negotiating text prepared before the meeting.
An analysis of the section on technology transfer by U.S. nongovernmental organization Knowledge Ecology International found that the U.S., the U.K. and European countries proposed numerous amendments that would favor pharmaceutical companies. Bangladesh, Iran and Brazil pushed for broader technology access.
The negotiating body is set to meet again on April 29. If WHO members cannot find common ground, the treaty may not be ready for adoption at the organization's annual World Health Assembly in late May, likely sapping much of the effort's momentum.
Misconceptions about the treaty, such as the idea that it would give the WHO broad powers to take steps such as imposing lockdowns, have been spreading on social media. The longer the negotiations drag on, the harder it will be to get the public behind the agreement, said Jaume Vidal at Dutch NGO Health Action International.