The WHO Pandemic Treaty

Many people don’t know that the World Health Organization has been working on a legally binding international treaty designed to prepare the world for the next pandemic. There has been very little media coverage and public discussion around this monumental treaty which, once ratified, would direct the public health decisions and responses of all signatory countries. It’s vital that Canadians are aware of these global negotiations and the potential far-reaching implications for our own domestic health care responses in the future.

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What is the WHO?

The World Health Organization (WHO) is a UN agency that was formed in 1948 for “the attainment by all peoples of the highest possible level of health” with 55 member states initially coming together and pooling their resources to combat epidemics such as malaria, Ebola, smallpox, and other serious infectious diseases harming those largely in the developing world.  

The WHO has 194 member states today and its stated aim is to “coordinate the world’s response to health emergencies, promote well-being, prevent disease and expand access to health care. By connecting nations, people and partners to scientific evidence they can rely on, we strive to give everyone an equal chance at a safe and healthy life.”

Governance of the WHO is through the World Health Assembly (WHA), which is composed of all member states and meets yearly to approve policies, the budget and elect the director-general, who serves for a five-year term.

What is the WHO Pandemic Treaty?

The WHO currently calls its process to create a pandemic treaty a “convention, agreement, or other international instrument on pandemic prevention, preparedness and response.” The WHO initiated the process in December 2021, and at that time called it a proposed “International Treaty on Pandemic Prevention, Preparedness, and Response (Pandemic Treaty).” In either case, it constitutes the WHO’s efforts to change the international rules to prevent and manage future pandemics.

From November 29 to December 1, 2021, the WHA convened a special session to discuss a proposed treaty and begin the drafting process. This was only the second special session since the WHO’s founding in 1948.

What is the status of the Pandemic Treaty?

The Pandemic Treaty is nearing the end of the negotiation and drafting phase, ultimately due to be signed by May 2024. The WHO established the Intergovernmental Negotiating Body (INB) in December 2021 to spearhead the negotiations, drafting and input into the proposed treaty. Since then, the INB has held several meetings to gather input and discuss proposals for the treaty. 

The INB has gone over several iterations of proposals and considered member-state submissions. They are currently finalizing the text for a proposed accord to be presented at the 2024 WHA meeting.  

Notably, the change in referring to the pandemic instrument as an accord and not a treaty might signal that there may be a lower threshold of national scrutiny required than that which a formal treaty process would require. A treaty would require that each member state ratify the treaty, should it be legally binding in international law. The precise obligations and compliance measures to be adopted are yet to be determined.

What would the treaty do?

The WHO has stated that the treaty could “ensure better preparedness and equitable response for future pandemics, and to advance the principles of equity, solidarity and health for all.”  

It “could take the lessons learned from the COVID-19 pandemic and use them to build back better. Equity is one of the key principles being discussed as part of the work on the new accord.

“A new accord could promote political commitment at the highest level, through ensuring an all-of-government and whole-of-society approach within countries, and sustained and sufficient political and financial investment within and among countries.”[1] 

As proposed, a legally binding treaty would see power given to the WHO to direct the global health management of pandemics. The treaty will define and classify what is to be considered a pandemic. Once a pandemic is declared, the WHO would require countries to adopt specific response measures. The working draft of the treaty also proposes a reporting requirement to the WHO and advises that there should be a “global peer review mechanism to assess national, regional and global preparedness capacities and gaps.”

Does the Canadian government support the treaty?

The government released the following statement regarding the development of a Pandemic Treaty:

“Canada is working closely with other countries and international partners to strengthen global pandemic prevention, preparedness and response. This includes the development of a new World Health Organization (WHO) convention, agreement or international instrument.”

As one of the WHO’s 194 member states, Canada has the opportunity to provide direct input to the treaty drafting process and will vote on the final document at the World Health Assembly (WHA) meeting in May 2024.

When MP Lewis questioned the Prime Minister on the government’s engagement with the WHO on controversial amendments to the International Health Regulations, which would have provided the WHO with expanded powers, Prime Minister Justin Trudeau responded as follows:

“As an active member of the WHO, Canada has always been there to push for better science and to push for better impacts in the way we collaborate around the world. Canada is a leading voice on ensuring not only that we make it through this pandemic, which is continuing to be ongoing, but also that we prepare for future pandemics, which, unfortunately, may well be the reality for decades and generations to come. We will continue to be active, strong participants in international fora around health while always respecting and protecting Canada’s sovereignty and choices to make the right decisions for its own citizens.”

The government has stated its support for at least a partially legally binding treaty. In official comments provided to the WHO on the Working Draft in September 2022, the government stated that the treaty should “contain both legally binding as well as non-legally binding elements.” Among the input provided, the government has advocated for the new instrument to be “inclusive and defined by an all-hazards approach in alignment with the IHR,” and that “other global health threats” should be included in the new instrument, including “climate change impacts, air pollution, chemical contamination.”

In an Inquiry of Ministry response received by MP Lewis on December 11, 2023, the government further stated that the accord should “be based on science and evidence, aim to enhance health equity and gender equality, respect national contexts, and compliment [sic] existing tools. It should advance a One Health approach, strengthen health systems, data and information sharing, and enhance accountability for pandemic prevention, preparedness and response.”

What are the International Health Regulations (IHR) and how do they relate to the Pandemic Treaty?

Happening alongside the drafting of this treaty is a process to propose amendments to the International Health Regulations (IHR), which govern the conduct of countries and provide the legal framework for the WHO to exercise its powers. The IHR were established through the WHO constitution “to prevent, protect against, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade.”

The WHA met the week of May 22, 2022 to discuss the Pandemic Treaty and to vote on controversial amendments to these regulations, which would have given more power to the WHO over member states – essentially a pre-cursor to the kind of powers the proposed treaty would authorize.

MP Lewis had publicly urged the Prime Minister and Minister of Health not to agree to these amendments. Thanks in large part to mounting scrutiny and pressure from civil society, there was no consensus on the amendments, and they did not pass during the May 2022 meeting. However, there were other changes to the IHRs adopted at that meeting that limit the amount of time countries have to reject amendments. This could have adverse consequences on the ability of countries like Canada to be able to sufficiently respond and to go through the parliamentary and consultation processes before agreeing to new amendments. MP Lewis sent a letter to the Minister of Health in December 2023 to warn him of these risks after sponsoring a petition signed by thousands of Canadians expressing their concern about Canada’s adoption of recent amendments.

In addition, there is an ongoing “targeted” amendment process to the IHR with more than 300 amendments on the table for consideration in advance of the May 2024 meeting. They are being reviewed by a WHO committee, which has produced a reference document containing the proposed amendments, along with technical recommendations.

We must remain vigilant as amendments are considered and proposed alongside a pandemic treaty to ensure that there are not major ramifications for Canadian healthcare sovereignty or other unintended negative impacts.

What public consultations have taken place?

The WHO has conducted some informal regional consultations and consultations with experts on key issues, and they conducted two public hearings in 2022 in which they called for video submissions from the public to inform the drafting process. As an example, here is a link to one of the public hearings in which the WHO asked: Based on your experience with the COVID-19 pandemic, what do you believe should be addressed at the international level to better protect against future pandemics?”

Here in Canada, up until very recently, there has been very little public knowledge of the government’s work on this treaty or on the adoption of amendments to the IHRs, and no parliamentary debate. That is why MP Lewis since her election has been following the issue closely, sharing updates with Canadians, and sponsoring petitions. In the spring of 2022, MP Lewis sponsored a petition that collected almost 20,000 signatures calling for the government to give opportunity for parliamentary debate and approval of any changes to the international health rules before they are adopted. MP Lewis presented that petition in the House of Commons in September 2023.

The government has, however, engaged in targeted consultations and roundtables with stakeholder groups. The government launched a “Stakeholder Engagement Forum” on March 21-22, 2023 in which they invited over 100 participants from NGOs, academia, the private sector, among others, and published a report several months later in August 2023. Yet some experts and NGOs who have participated in the government’s consultations have called into question the rigour of the government’s consultations. The government has also promised to launch additional regional and stakeholder consultations in early 2024.

To date, there has still been no parliamentary review or discussion of Canada’s position or commitments to an international pandemic treaty. 

Isn’t more global cooperation a good thing? Why do I need to be concerned about this treaty?

It’s important for countries to work together to address global public health priorities, including responding to pandemics; however, there are strong reasons why this treaty should be concerning to Canadians.

Of greatest concern, the treaty could give the WHO the legal ability to direct Canada’s future pandemic response, including mandating any range of measures from lockdowns to social distancing to specific vaccines approved for distribution within Canada. The treaty will define and classify what is to be considered a pandemic, and this could consist of very broad classifications.  

The WHO has acknowledged that “any new agreement […] is drafted and negotiated by governments themselves, who will take any action in line with their sovereignty.” In the working draft of the treaty, they have listed “sovereignty” as one of 12 principles to guide the implementation. However, it is uncertain how this principle will be respected in the context of a comprehensive accord that the INB has already concluded should be legally binding on signatory nations, and would necessarily include compliance measures. Dr. Tedros Adhanom Ghebreyesus, WHO’s Director-General said, “The importance of a legally binding instrument cannot be overstated: it will be our collective legacy for future generations.”

Canada must be careful to not sign anything that could give away our sovereignty on health care, even if there is tremendous international pressure to do so for the sake of pandemic preparedness. It also does not make sense for this government to sign onto a legally binding treaty governing future pandemic response when Canada still has not had a national inquiry into our pandemic policies and outcomes. In essence, we can’t prepare for the future when we haven’t learned the lessons from the past.

Furthermore, if the government fails to be transparent with Canadians as it ratifies a far-reaching expansion to WHO jurisdiction and powers, it will undermine the democratic rights of Canadians to determine their own governance. While there has been some stakeholder consultation to date, there has been very little public awareness and engagement regarding this unprecedented treaty, and no parliamentary scrutiny.

What comes next?

The final treaty will be presented and signed at the 77^th World Health Assembly meeting in May 2024. Should it be adopted under Article 19 of the WHO Constitution, the final agreement would require the ratification of two-thirds of WHO member states. If ratified, it will be legally binding according to international law.

Timeline of Events

Below is a timeline of key events that tracks the developments under two parallel WHO processes: the IHR amendment process and the formal pandemic accord negotiations. Notable Canadian actions are also listed.

March 21 to 22, 2023:

Government Launches Stakeholder Engagement Forum

Attendees:

• non-governmental organizations and not-for-profits (28%)
• academics, experts and researchers (27%)
• health and allied health services (14%)
• the private sector (13%)
• provincial, territorial, and Indigenous departments of health and health authorities (12%)
• youth (6%)

November 20, 2023:

Canadian Delegation Meets with WHO Representatives.

The delegation, consisting of Global Affairs Canada and representatives to the UN in Geneva, discusses, among other topics, the International Health Regulations and the work of the Intergovernmental Negotiating Body.

Early 2024:

The Canadian government hosts domestic regional and stakeholder consultations on the pandemic instrument.

How can I keep informed and engaged in the process?

MP Lewis will continue to provide updates on the WHO pandemic treaty and IHR process. Follow her on social media to get her updates. We encourage you to write to MP Lewis with your views on the pandemic treaty and Canada’s response so she can advocate on your behalf to the Minister of Health.

For more information:

• Follow the latest updates on the Pandemic Treaty on the WHO’s website
• Review the latest working draft of the treaty

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[1] Pandemic prevention, preparedness and response accord (who.int)