Pandemic response requires early and robust verification – The Lancet

This report proposes the creation of an international treaty on pandemics, to be negotiated under the auspices of WHO, and a Global Health Threats Council to serve as an independent authority at the head of state and government level, endorsed by the UN General Assembly.

These instruments alone are inadequate. Effective compliance requires robust and independent mechanisms for reviewing progress and doing investigations that are empowered at the highest political level and armed with both incentives and consequences. On the basis of a review of institutional mechanisms and a mandate to enforce compliance with international agreements,

we propose several aspects to complement the proposal.

First, the Universal Health and Preparedness Review, currently planned as voluntary, should be obligatory. Using independent experts, similar to what is done for human rights treaties, would mitigate political pressure inherent to state-led processes and promote independence and transparency. Independent experts should be used to identify issues with compliance and to help countries by providing necessary support in preparedness.
Second, state parties to the treaty should not be able to block on-site investigations. Such investigations are crucial for identifying the origin of disease outbreaks and assessing preparedness and response. The model by the Committee on Prevention of Torture could lend itself to treaty monitoring and outbreak investigations on short notice or unannounced. Investigations should be stipulated as part of the treaty with a clear protocol, definitions, and assigned authority for the process to justify invoking an extraordinary power. Visits without state-specific consent should be done by an independent expert group reporting to the UN to help mitigate political pressure on any individual UN agency.
Third, any new mechanism should include incentives such as technical support and political stimulus. WHO can play a key role in this area by providing countries with technical assistance, normative guidelines, and tools to strengthen preparedness and response capacities.
Finally, the treaty needs to be based on several core principles: compliance to encourage state adherence to the agreement; accountability to trigger a high political response in cases of concern; independence to reduce financial and political dependencies; transparency and data sharing to ensure prompt access to information; speed to activate an investigation; assessment of capabilities including political factors and leadership; and incentives to motivate states to comply.

Source: Pandemic response requires early and robust verification – The Lancet