The COVID-19 pandemic has exposed the frailty and disparities of global health systems, especially in Africa, highlighting the inadequacy of the response and the need for reform. Vaccine nationalism and lack of inclusivity characterized early responses, raising concerns about the effectiveness of global health security frameworks like the International Health Regulations (IHR). In response, the WHO formed an Intergovernmental Negotiating Body to draft a new Pandemic Agreement aimed at ensuring equity and addressing policy gaps. While progress has been made on governance, compliance, and R&D, consensus on critical issues like pathogen access, benefit sharing, and pandemic financing remains elusive.

Researchers and agencies from low- and middle-income countries often contribute significantly to public health data but lack adequate compensation. Incentivizing data sharing is crucial for effective pandemic response, yet current legal frameworks have limitations. We explore adapting FIFA's benefit-sharing model, which rewards grassroots contributions and redistributes benefits, to global health. Despite challenges like integrating with existing frameworks and ensuring international buy-in, this model offers a promising approach to more equitable data sharing and benefit distribution.

The WHO Pandemic Agreement draft lacks sufficient accountability measures. While it introduces a Conference of the Parties (COP) for governance, crucial details such as review scope and consequences for non-compliance remain unclear. Ambiguities persist, including provisions allowing parties to opt out of reporting obligations, and softened language regarding commitment. Without a clear accountability mechanism, relying solely on good faith, as evidenced by past treaties, may not ensure effective implementation, as seen in the COVID-19 response.

The UN General Assembly High-Level Meeting (HLM) on pandemic prevention, preparedness, and response (PPR) failed to garner significant high-level commitment and momentum for global health emergency governance. Despite its aim to highlight a pressing policy issue slipping down the international agenda, diplomatic tensions among member states, lack of consensus on crucial matters, and a weak UN Political Declaration in New York indicate challenges ahead for negotiations at the World Health Organization in Geneva. This column explores the UN's evolving role in global health governance, analyzes the diplomatic process leading to the UN HLM on pandemic PPR, and evaluates the contributions and shortcomings of its resulting Political Declaration.

WHO Member States are nearing the end of negotiations for a proposed Pandemic Agreement, considering whether to adopt it under Article 19 or Article 21 of the WHO Constitution. Over the last two years of negotiations, the form of the treaty seemed settled on Article 19. However, the possibility of adopting the Pandemic Agreement under Article 21 has substantively re-emerged. While this may seem to many a simple question of an “opt in” or “opt out” approach, the legal and normative realities are somewhat more nuanced and require careful consideration by negotiators. Member States must carefully consider these factors, which will have critical implications for the future of global health and global health law-making.

The latest draft of the pandemic treaty falls short of expectations with governance revisions that lack accountability measures, leaving oversight to Member States through a World Health Assembly (WHA) committee. The proposed Implementation and Compliance Committee, now subordinate to the WHA, lacks independence and access to crucial information, raising concerns about effective monitoring and enforcement. Without robust compliance mechanisms and independent oversight, the treaty risks being ineffective in addressing the multisectoral challenges of pandemic preparedness and response, highlighting the need for urgent revisions before final negotiations conclude.

An independent monitoring mechanism is essential for the Pandemic Accord. Negotiators must remember to keep Member States accountable. It's feasible, viable, achievable and vital for preparing for the inevitable next pandemic.

On Oct 16, the world got its first glimpse of the complete draft negotiating text of the proposed pandemic agreement aimed at improving collective pandemic prevention, preparedness, and response. In our analysis of the pandemic preliminary draft, we found gaps in crucial areas such as health system resilience and equal access, while noticing the lack of an independent accountability mechanism. Understanding the limitations of relying solely on self-reporting and peer review from previous frameworks, we assert the necessity of establishing a dedicated, independently mandated monitoring committee to ensure compliance.

Negotiations are ongoing at the WHO for a binding pandemic prevention agreement, but past agreements haven't guaranteed effective implementation. We found that while enforcement mechanisms are crucial, they're inconsistently applied and often rely on softer political approaches rather than strict legal measures. To address this, we propose an independent monitoring mechanism to assess and report on countries' adherence to the pandemic agreement, utilizing various data sources and reporting to a higher political body for enhanced compliance.

Nearly two years after countries agreed to develop a new pandemic treaty, the prospect of achieving a bold new global agreement to prepare and respond to future disease threats is slipping away. Perhaps the last chance is the UN General Assembly’s High-Level Meeting on Pandemics in September. The meeting is a major opportunity for political leaders to show the sustained commitment that will be necessary to prevent and respond to future pandemics.

The COVID-19 pandemic has exposed the need for a coordinated global response to pandemics. In response, the Intergovernmental Negotiating Body for a pandemic accord will discuss a zero draft in February 2023, with the aim of presenting an accord for implementation in 2024. We conducted a comprehensive literature review of 11 monitoring mechanisms and consulted with experts from around the world. Based on our research, we propose the establishment of an independent monitoring committee to assess state parties' compliance with and reporting of the pandemic accord.

The 2022 World Health Assembly saw Member States discussing amendments to the International Health Regulations. Despite meeting in person for the first time since COVID-19, little progress was made on solutions for future pandemics due to procedural focus. In this article, we highlight the historical background and limitations of the IHR, exposed during the pandemic, as well as how data and evidence currently play too small a role in decision making. We propose committing to a pandemic treaty to be prepared for when the next pandemic hits.