 For more videos on people's struggles, please subscribe to our YouTube channel. Hello everyone and welcome to the new issue of People's Health Dispatch, the health publication by People's Dispatch and People's Health Movement dedicated to the struggles in health and struggles of health workers. Recently governments from around the world met at the WHO and agreed to move ahead with plans for a new binding treaty to address future pandemics. Countries will now meet over the next two years to decide the details of this treaty. Right now we're still very much in the middle of the COVID-19 pandemic for which the global response has been extremely inadequate. In this discussion we're going to reflect on utility of a binding treaty at this time and the global dynamics that we're seeing playing out in these discussions. Here today with me I have Preeti Patnaik who is the founding editor of Geneva Health Files. Preeti thank you so much for giving your time and being home with us. So I wanted to start off by asking you to just outline for us what is the pandemic treaty, why are we discussing it and who has been driving it. Thanks so much for the invite and I'm happy to be a part of this conversation also based on our recent reporting on these issues. So essentially the term pandemic treaty has become a shorthand for something wider which is that there is expectation that WHO member states feel the need to come up with new rules to govern health emergencies. And there are a bunch of different motivations of who's driving this conversation and where we are today. This week we saw that WHO member states adopted a decision to actually start negotiations for new rules to govern health emergencies. Given the kind of inequities we have faced not just in the access of vaccines but also other medical products disruption and supply chains and so on and so forth. I think many different sectors of society feel the need to not lose the momentum and use this crisis to actually redraw how some of these existing rules function and now it is clear that we need something more than what we already have. So I think the genesis of the idea that we should have some kind of international agreement to govern health emergencies was first let's say incubated in the West particularly the European Union and over time this happened sometime in late 2020 and earlier this year about 25 to 30 countries came together and started talking about formalizing the conversation around the pandemic treaty and earlier in the year at the World Health Assembly in May member states agreed to actually set up a working group that will work on WHO strengthening and preparedness and response to health emergencies and one of the tasks of this working group actually was to also prioritize and assess the need for a new instrument. So that's where we are and following the May Assembly it was also decided that a special session of the World Health Assembly should be convened in November. This was convened this month this week and where it was decided that yes there is a need to launch negotiations for new rules. The thing you must keep in mind is that during the summer between August and November a lot of progress was made by countries there were a lot of divergences between countries but they arrived at a somewhat difficult consensus that this is the way to go. Having said that I will you know it is still too early to conclude the shape and the form that any new rules that's going to come up we will dig. I think I'll leave it there for now. Thank you. So then moving on as you mentioned about that the meeting we saw will happen this week. Member states, governments came together and made this decision to move forward on the treaty. I want to encourage you just outline a bit more for us anybody who mentioned the decision but sort of what happened at this meeting and whether there was any particular moments or particular interventions or things that happened over this week that you think are worth highlighting? Yeah I think this week was a reflection of all the discussions and dynamics that we witnessed over the last few months and weeks. So like I mentioned earlier initially they were only about 25-30 countries let's say early endorsers for the idea of a treaty or an agreement. Eventually as the weeks and months passed the decision that was adopted by the World Health Assembly this week was endorsed. The decision text was endorsed by more than 100 countries and eventually of course all the 194 member states adopted the decision. So all member states stand by this decision as it worked. So some of the dynamics that we witnessed was over the last few months leading up to this week was you know these were highly contentious and highly political discussions and there was a lot of unease among not only many developing countries who had yet to sort of formulate national positions on these issues because they're busy fighting the pandemic but also other developed countries who were some of whom were not comfortable with signing with already committing binding nature of these rules and so on. Having said that I think there were a lot of discussions on equity on the strength of existing rules. Do we actually need new rules or can we rework existing rules? So all those dynamics came to the fore even at the World Health Assembly and what was you know the couple of things were striking. One is that as we reported earlier as well that a lot of developing countries are interested in taking this conversation forward in committing to these negotiations because they truly believe that these negotiations are a unique opportunity to address concerns on equity. They see that any new rules will have to have binding commitments on equity whether it's access to medicines, intellectual property issues, you know addressing long-standing issues in research and development and a whole host of other issues related to equity and I think country after country at the World Health Assembly this week you know presented equity as a central goal and motivation for their involvement and commitment to these negotiations so that was striking and what also sort of came to the fore is the importance of existing rules and these you know there are a range of rules that actually govern health emergencies among them central to this process are international health regulations and in the lead up to these discussions countries were divided over whether they must trend in these existing rules or whether they need you know they need a completely new approach and it appeared to me that for a number of countries the international health regulations or the IHRs as they are called you know they continue to be important you know from Brazil, China and many others who sort of made statements that there has to be a coherent coherence and you know and there has to be a complementarity in the process of how we address these you know different approaches to tackle health emergencies in the future. I think although there was a lot of heat and dust on the specific legal routes that that new rules should take but frankly there was some mention some countries did mention that we must take a particular route you know on how these rules should be framed but not so many and this actually also goes to show that you know some of these discussions are sort of premature something that some countries were insisting on meaning that let's talk about what these rules should be and not so much about how they should be framed and you know specific instruments that should be used and so on. I think overall this is a very significant moment and as the decision stands now there is still a lot of latitude for countries to actually you know draft these new rules according to their own needs and as I told you these needs are very diverse the motivations of different countries are very different for developing countries equity is a major issue for some of the countries in the north you know they want to see new rules on sharing information on pathogens for example just to give you an example and also you must understand that the special session of the assembly is you know took place in the backdrop of a new variant and in the midst of a raft of new travel restrictions for affected countries that also contributed to the you know overall climate at these discussions and some southern countries also suggested that maybe we should have binding commitments on addressing unfair travel restrictions for example so these were some of the you know elements that came up repeatedly during this week. Thank you that was really interesting and I wanted to focus particularly on sort of elements that you raised for example about several countries highlighted the need for stronger equity and I was just wondering then how could we make that a reality in terms of how can we go forward what sort of things do we see do we need to see what sort of commitments do we need to see to try and make these themes become a reality moving forward that both perhaps in the way that discussions are being had and in terms of what commitments do we want from countries. Right I think that this is going to be you know the the million dollar question as it were and the way I see it is that this is an opportunity and maybe it's going to be the ultimate fight to actually code norms on equity and it's going to be very difficult because of the kind of entrenched interest that we have seen which has resulted in the inequities that we are witnessing today. I think before answering your question on equity you just take a step back on the motivations for these new rules and as I mentioned earlier I think you know developed countries have certain expectations of these new rules you have the industry as you know civil society organizations and other scholars that have certain expectations of these rules and then of course we already discussed that equity is central to all developing countries. You have to keep that in mind that we have a whole diverse group of actors wanting a treaty but a treaty that will address you know different concerns as it were. A number of proposals on equity have been discussed and have been put forward by different countries but notably South Africa that actually proposed that you know equity is something that has to be seen across the board not just about vaccines but about you know access to treatments access to diagnostics and equity in the way we think about trade and travel measures in the way we share information and the benefits that arise from sharing this information. So I think that there are a number of sort of concomitant legal regimes that already determine various aspects of equity but the expectation is that one new international agreement on future health emergencies will govern you know across all of these components and that hasn't really happened before so to that extent it's a significant and a real opportunity and therefore this has been seen as a legitimate moment as it were. For some of the civil society organizations and the very strong and influential access to medicines movement for instance sees this that this is the moment to create norms on access you know have rules on financing and licensing of R&D on technology transfer on regulatory standards on governance and transparency so on and so forth. So I think you know there are a lot of these blue sky approaches as to what will be a risk under the overarching theme of equity but it really depends what kind of deep concessions are some of the players willing to make you know whether countries in the north are willing to actually consider you know very deep-seated beliefs about let's say protection of intellectual property and we see this fight currently sort of unraveling at the World Trade Organization in the context of the chips waiver so there are some indications on how difficult this fight you know to ensure provisions and equity could be. So having said that I think at the end of this week I believe that this is the moment for optimism for many countries and we do hope that developing countries will actually be able to use all the right bargaining chips as it were to ensure that their interests are actually eventually interest and you know are made legally binding as it were for the industry, for other countries and so on. Thank you and I saw reaching to an end so I wonder if you had any final remarks or any final thoughts or perhaps particular global dynamics that we all need to be kept aware of and to be really lucid about the linkages between certain dynamics and the processes that we're going to see in sort of the discussions and you already mentioned sort of about these deep-seated ideologies certain countries have around intellectual property restrictions for example and I know you spoke earlier on about how it's particularly in the EU who are pushing your need for a treaty and now we're having the convergence around this from different countries so I just want to round in that general topic is something that you'd like to share as we brought to a close. Sure I think it is important to recognise the legitimate need of developing countries that they do feel that this is the moment of opportunity for them but having said that you know what the last few months have shown is that in all of these discussions there is a perception that there is a kind of a forced multilateralism and there was a perception that you know this is like this was like a straight jacketed consensus on like this is the way we have to go forward despite the fact that you know many many countries especially developing countries with smaller delegations find it very hard to negotiate you know rules and treaties across different platforms and now we will see a number of different parallel discussions and negotiations happening. We have to keep in mind that there are very serious capacity issues especially for smaller delegations and these are very very contentious and difficult negotiations going forward we can expect them to be really difficult and the fact that many of the countries are still fighting the pandemic and may not have the kind of capacities and resources to really ensure that their interests will be protected. I think this is something that must be kept in mind there is a very real risk that if you know if it's quite possible that they might end up committing more than they should as far as protecting their own interests as far as developing countries go and I think that this is something we have to keep in mind but this is how it has been you know a playing field that is not that is not level and I think that the pandemic actually exacerbates these inequalities even in decision making and the kind of latitude that that member states have at the international level. Perfect thank you so much Preeti so yeah thank you so much for your time and sharing your thoughts with us. Yeah I think it's very clear from the discussions and what you shared with us today that there's a lot to reflect on what we've seen in negotiations and the drivers of it so far in which the dynamics are of course going to persist as they do in the whole sort of global health governance and international society so I think you've highlighted some really key points that we can also keep in mind as we continue to watch these negotiations. Yeah so thank you so much. Thanks so much.