The Pandemic Agreement: A Springboard for Urgent Progress or a Safety Net for Basic Commitments? BRIEFING DOCUMENT & STATEMENT ON THE WHA PANDEMIC AGREEMENT DRAFT

Executive Summary
The Association of Schools of Public Health in the European Region (ASPHER) has contributed to discussions surrounding the pandemic treaty coming forward to the WHO World Health Assembly 2024. ASPHER is the key independent European educational body dedicated to improving and protecting Public Health by strengthening the education and training of public health professionals for both practice and research. ASPHER recognizes the critical importance of a robust and comprehensive global framework to address future
health emergencies. We view this agreement as a potentially very positive development, with ample space for countries to go further in their commitments and actions.
Key Points of the ASPHER Statement:
Rapid progress in global pandemic preparedness:
Ensuring rapid progress in global pandemic preparedness is crucial. The constant global dialogue since the COVID19 pandemic and recent discussions at the World Health Assembly (WHA) in May 2024 are leading to a proposal for a Pandemic Agreement, which aims to provide a framework for significant advancements by October 2026.
ASPHER advocates for strengthening national and global health systems to enhance preparedness, response, and resilience against future pandemics. This involves substantial investment in healthcare infrastructure, workforce training and resilience, and public health research. Timely implementation of measures is crucial to prevent and mitigate the impacts of future pandemics. Building and maintaining public trust through transparent communication and community engagement is fundamental. ASPHER underscores the role of public health
institutions in fostering trust and compliance with health measures.
The agreement needs to be backed up by concrete Action. Complementarity with International Health Regulations and other WHO treaties is needed, for a cohesive approach to health emergencies. Countries may prioritize pandemic responses based on their needs. WHO provides support but does not override national laws. Member states must ensure their legislation supports pandemic efforts. Member states need to enhance equity and balance human rights in their pandemic response measures. The Pandemic Agreement could facilitate
collaborative efforts during global health crises. Setting expectations and minimum standards is crucial to address lessons from COVID-19 and other outbreaks.
ASPHER advocates for the strengths of the Pandemic Agreement to address governance, prevention, and response deficits observed during COVID-19, aiming for higher global standards.
ASPHER collaborates with partners to improve future pandemic preparedness, based on lessons learned from
COVID-19.
ASPHER supports building community trust and transparency to counteract misconceptions and misinformation.
ASPHER advocates for a well-staffed public health workforce focused on equity and the precautionary principle.
ASPHER is ready to collaborate with international partners to ensure the Pandemic Agreement incorporates these essential elements.
One Health Approach as a Foundation:
ASPHER recognises the need to learn from history, noting that most pandemics and public health emergencies of international concerns in the past two decades have been of zoonotic origin, including SARS CoV-1, swine flu, MERS, COVID-19, Mpox, Ebola, Zika virus, and now H5N1. Experts continue to identify potential candidates for the next pandemic, with the 'Disease X' scenario advocating for a flexible and resilient approach to unknown pathogens.
ASPHER advocates for a One Health approach in transforming agri-food systems, highlighting the interconnectedness of human, animal, and environmental health. This approach is essential for ensuring food safety, security, sustainable and equitable production and distribution. Public health measures underscore the importance of achieving global food safety and security, conserving natural resources, and improving health and health equity.
One Health also seeks to address the threats posed by disasters and transboundary diseases.
ASPHER promotes One Health approaches, emphasizing a multisectoral understanding of vulnerabilities and fostering information exchange among One Health partners. This collaborative and multidisciplinary strategy is essential for strategic coordination, research, capacity building, stakeholder engagement, and joint interagency activities. It supports high levels of health protection in all policies, enhances Health in All Policies (HiAP), and promotes a well-being-based economy. This approach aims to address social, environmental, and commercial determinants of health and health equity, fostering cross-sector collaboration to improve health and well-being within and across societies. Integrating human, animal, and environmental health should be a critical foundation for the Pandemic Agreement. This holistic perspective is crucial for effective prevention and response strategies.
Universal Health Coverage (UHC) for Resilience:
Promoting Universal Health Coverage (UHC) should remain a central strategy for enhancing population resilience and the ability to respond to future pandemics. Access to quality health services for all is fundamental to global health security.
ASPHER stresses the importance of addressing inequities that have been exacerbated by the COVID-19 pandemic. The divide between universal healthcare and selective social care leads to avoidable harm and fosters distrust, especially during pandemics.The agreement should ensure that vulnerable populations receive adequate protection and support during health
crises.
Learning from COVID-19: To avoid the unpreparedness seen during COVID-19, particularly the race for PPE and diagnostics, ASPHER emphasizes the need for resilient primary care. Strengthening primary care systems builds sustainable, community-embedded services essential for managing acute and chronic conditions, early health risk detection, ongoing surveillance, and sustainable health financing.
ASPHER highlights the vital role of primary healthcare in pandemic prevention, preparedness, and control. Trusted relationships with patients and local populations are fundamental for effective healthcare management.
ASPHER advocates for policies that achieve UHC, addressing inequalities in access and outcomes of health care and serving socio-economically disadvantaged and vulnerable groups. Capacity building, education, and training are essential components of resilient health systems. Public health actions must align with UHC, supported by public investment and financing. Efforts are needed to sustain investment to build vaccine confidence and trust and restore high immunization coverage for routine immunisation programs. Development of new vaccines is vital for health security in response to new infectious diseases
Multisectoral Pandemic Prevention and National Plans:
ASPHER emphasizes the importance of learning from past experiences to build more resilient public health systems. The association advocates for the inclusion of academic experts and community leaders in the process, encouraging them to provide independent advice and critically evaluate the adequacy of these national plans.
To better prepare for future health threats, ASPHER supports efforts to expand surveillance expertise and threat assessment capacities across countries. This enhancement is crucial for the timely identification and effective response to emerging pathogens and increased transmission rates. ASPHER also highlights the need for National Pandemic Plans to include commitments for an extended follow-up period beyond the acute phases of pandemics. This longer-term approach is essential for:
Comprehensive multisectoral pandemic prevention and public health surveillance national plans are needed.
Collaboration across sectors is vital to address the complex challenges posed by pandemics.
Recognizing Overlaps with Wider Emergencies:
It is essential to acknowledge the overlaps between pandemics and other emergencies, such as conflicts, adverse weather events, and climate change; the so-called ‘all risks approach’ to emergency preparedness and planning.
ASPHER foresees a rise in disasters and emergencies in the coming years, particularly as the impacts of climate change escalate. This includes adverse weather events like floods and heatwaves, which may facilitate the survival and spread of pathogens, potentially establishing vectors in previously non-endemic areas. Deforestation and desertification also play a role by altering habitats and extending vector presence to densely populated areas, increasing contact between humans and wild species and disease transmission. The interconnected nature of pandemics and other significant disasters highlights the importance of enhancing
resilience and preparedness. These interdependencies also illuminate the evolving skill sets needed in the public health workforce.
Equitable Access to Pandemic-Related Health Products:
It is imperative to ensure equitable and globally affordable access to pandemic-related health products, including Personal Protective Equipment (PPE), vaccines, drugs and medical equipment and information. No country should be left behind in accessing critical resources. Access to essential pandemic-related health products has crucial relevance for the control of pandemics. Emergency access and R&D for pandemic products will require cooperative action and ensuring equitable access over and above commercial rights. Pandemic agreements and negotiations could ensure that inevitable government measures would predictably take place and use the leverage of public financing effectively. Furthermore, pandemic preparedness must include measures including and beyond addressing trade secrets and sustainable global production and business continuity practices to address the fragility of critical supply chains
for essential pandemic products, such as diagnostics, vaccines, medicines, and PPE.
ASPHER supports further negotiations on pathogen access and benefit-sharing and calls for upholding equity at the core in institutionalising PABS to ensure fast control, response, and trust on pandemic measures, recognising the need for rules-based governance in contrast to market-based negotiations. Negotiations on access and R&D on pandemic-related products can use the leverage of public financing.
Global and Rapid Public Health Surveillance Systems:
The establishment of global and rapid public health surveillance systems is vital for early detection and response to health threats. Robust surveillance mechanisms for emerging pathogens and infectious diseases are key to safeguarding public health. Collaborative efforts are essential, bringing together diverse stakeholders to improve public health intelligence
and evidence-informed decision-making.
ASPHER recommends establishing integrated national and international surveillance systems with defined standards and procedures, enhancing reporting mechanisms, utilizing modern technology, and promoting data sharing to ensure rapid and comprehensive surveillance information globally. Legislative and regulatory support is also vital for the establishment and exchange of infectious disease surveillance data.
ASPHER calls for increased transparency and timely data sharing between nations. A standardized approach to data collection and dissemination is crucial for accurate surveillance, swift response, and informed decision making.
Updating International Health Regulations:
The ongoing process to update the International Health Regulations (IHR) aligns with efforts to strengthen global health security, running parallel to the development of the pandemic agreement. The updated IHR will introduce essential safeguards to protect travellers' rights and personal data. These measures ensure that standards of confidentiality and data protection align with best practices. They also require prior informed consent and a non-discriminatory approach to the application of health measures such as medical
examination and vaccination. It will also enable WHO to establish an early warning system and issue public health alerts for events that may constitute public health emergencies of international concern, further enhancing global health security.
ASPHER stresses the need to update the International Health Regulations (IHR) promptly. Modernizing these regulations is crucial to reflect current realities and improve global health security.
Effective Global Governance and Accountability:
ASPHER emphasizes the necessity for unprecedented global cooperation and solidarity to effectively respond to and mitigate the impacts of pandemics. This includes equitable access to resources, vaccines, and treatments for all countries, regardless of economic status. It is important that the current negotiations are considered not as the end, but as a potential beginning for a framework agreement allowing a pandemic agreement, which can become adjusted on the ground of emerging needs, crises, and challenges.
Pandemic negotiations need to support and strengthen wider commitments concerning other international agreements striving towards the same goal as well as provide policy space for governments for effective pandemic control and response, which may be against commercial policy priorities. Pandemic negotiations under the WHO provide close linkage concerning IHR, which needs to be seen as complementary to the pandemic agreement. Effective global cooperation requires trust and accountability, which are at the core of pandemic negotiations.
WHO oversight will also ensure a professional understanding of public health challenges, including commercialization and spread of disinformation.
ASPHER stands ready to collaborate with international partners to ensure that the WHO pandemic agreement incorporates these essential elements. Our commitment to advancing public health education and practice will continue to drive our efforts in contributing to a safer, healthier world for all.