Inching Closer to Global Pandemic Treaty

This editorial is based on “The outline of an essential global pandemic treaty” which was published in The Hindu on 10/09/2022. It talks about the rising widespread health inequity and the need for a Global Pandemic Treaty.

For Prelims: International Health Regulations, Public Health Emergency of International Concern (PHIEC), Bioterrorism, Antimicrobial Resistance, Doha Declaration of World Trade Organisation, Zoonotic diseases, Genetic surveillance, Monkeypox

For Mains: Existing Framework for Global Health Cooperation, Challenges Posing Risk to the Health Sector, One Health Approach, Global Pandemic Treaty

In contrast to the earlier scenario where infectious disease outbreaks were confined to a few countries, the world has now become more prone to witness pandemics.

COVID-19 would count as one of the most severe pandemics the world has seen in the last 100 years. It has highlighted the flaws in global health protection and pandemic governance and provided a better understanding of the fact that nobody is safe until everybody is safe.

More recently, Monkey Pox which was endemic to Africa was declared a Public Health Emergency of International Concern (PHIEC). The frequency of such threats call for increased cooperation among countries for sharing information and resources needed for a concerted global response.

What is the Difference Between Pandemic and Epidemic?

• As defined by the World Health Organisation, a pandemic occurs when a new disease for which people do not have immunity spreads around the world beyond expectations.
  • However, an epidemic occurs when an outbreak occurs among a population or region, and is less severe than a pandemic because it affects a limited area.
• Example:
  • Pandemic: Spanish Flu, Covid Pandemic
  • Epidemic: Yellow fever, Polio

What is the Existing Framework for Global Health Cooperation?

• The International Health Regulations (adopted in 1969 and last revised in 2005), is an instrument of international law that is legally-binding on 196 countries including India.
• It aims for international collaboration to prevent, protect against, control, and provide a public health response to the international spread of disease.
  • It provides an overarching legal framework that defines countries’ rights and obligations in handling public health events and emergencies that have the potential to cross borders.
• IHR empowers the World Health Organisation (WHO) to act as the main global surveillance system.
• The Regulations also outline the criteria to determine whether or not a particular event constitutes a PHEIC.

What are the Challenges Posing Risk to the Health Sector Globally?

• Inefficient Health Infrastructure: Public health data and infrastructure are fragmented and lacking any global standard causing a major concern regarding quality and reliability of existing healthcare systems.
  • Besides that, a large part of hospital expenditures are used to correct preventable medical mistakes or infections that people catch in hospitals. Additionally, medical staff are in short supply.
  • India has 1 government doctor per 10,189 people (the WHO recommends a ratio of 1:1,000), indicating a shortage of 6,00,000 doctors.
• Climate Change Hazard: Climate change threatens the essential ingredients of good health - clean air, safe drinking water, nutritious food supply and safe shelter.
  • Climate change exacerbates extreme weather events like drought and floods, which increase food insecurity, malnutrition rates, and help spread infectious diseases.
• Rising Commercialisation: Though commercialization of healthcare promises better infrastructure, medical facilities, and technological advancement, due to high profit motive charges, poor and middle-class people cannot afford it. This contradicts the very purpose of having a better healthcare system.
  • Further, doctors collaborate with pharmaceutical companies with a profit motive to prescribe branded medicines that are more expensive than generic versions despite the same formula, which hampers access to timely healthcare.
• Risk of Bioweapons: Technological advancement has increased the threat of biological weapons being used for bioterrorism or biological warfare.
  • According to WHO, biological and toxin weapons are either microorganisms like viruses, bacteria or fungi, or toxic substances produced by living organisms that are produced and released deliberately to cause disease and death in humans, animals or plants.
• Antimicrobial Resistance (AMR): Antimicrobial Resistance is reducing the effectiveness of medicines, making infections and diseases difficult or impossible to treat.
  • WHO has declared that AMR is one of the top 10 global public health threats facing humanity.
• Lack of Global Solidarity: A glimpse of weakened global solidarity was observed when high income countries were not sharing vaccines, drugs and diagnostics in an equitable manner at the time of pandemic.
  • The consequences of such inequities were evident in the emergence of virus variants.
  • A large portion of the globe lagged behind in vaccine development because of patent rights.
    • The Doha Declaration of World Trade Organisation provides for relaxation of patent rights in case of a public health emergency.
    • However, the WTO has not yet agreed to a proposal from South Africa and India to waive patent rights on Covid-related technologies.

What Should be the Way Forward?

• A Global Pandemic Treaty: In recognition of the need to further strengthen international cooperation, WHO has now commenced the process for the development and adoption of a new international treaty with an aim to ensure better preparedness and equitable response for future pandemics, and to advance the principles of equity, solidarity and health for all.
  • This treaty would be developed through the deliberations of an International Negotiating Body (INB), with the stated intention of concluding the process by May 2024.
• One Health Approach: There is a need for coordinated, collaborative, multidisciplinary and cross-sectoral approach to address potential or existing risks that originate at the animal-human-ecosystems interface.
  • By optimising the health of people, animals and the environment to effectively detect the outbreaks of zoonotic diseases and rising environmental hazards, they can be prevented to a greater extent.
  • There is also a need to regulate the use of antibiotics, to reduce the danger of antimicrobial resistance.
• Genetic Surveillance: Genetic surveillance can be a way forward to understand the evolution of different disease carriers across the globe, specially viruses.
  • Genetic surveillance of pathogens provides insights by following a molecular approach for contact tracing and understanding the transmission of the pathogen across the globe.
• Supply Chain Resilience: There is a need to optimise the highly fragmented healthcare supply chain across the globe to ensure that adequate supplies exist at the local, regional and national levels during times of crisis.
  • Also, there is a greater need for effective utilisation data among health care providers, manufacturers and distributors across the globe.

Drishti Mains Question

How has the Covid-19 Pandemic highlighted the flaws in global health protection and pandemic governance? Suggest measures to improve global health management.

UPSC Civil Services Examination, Previous Year Question (PYQ)

Prelims

Q.1 H1N1 virus is sometimes mentioned in the news with reference to which one of the following diseases? (2015)

(a) AIDS
(b) Bird flu
(c) Dengue 
(d) Swine flu

Ans: (d)

Q.2 ‘Doctors Without Borders (Médecins Sans Frontières)’, often in the news, is (2016)

(a) a division of World Health Organisation
(b) a non-governmental international organisation
(c) an inter-governmental agency sponsored by European Union
(d) a specialised agency of the United Nations

Ans: (b)

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Mains

Q.1 Appropriate local community level healthcare intervention is a prerequisite to achieve ‘Health for All’ in India. Explain (2018)

Q.2 Public health system has limitations in providing universal health coverage. Do you think that the private sector could help in bridging the gap? What other viable alternatives would you suggest? (2015)