Operationalizing “One Health” through a Pandemic Treaty
The World Health Assembly has recently started a negotiation process for a convention or other international instrument on pandemic prevention, preparedness and response. In support of this initiative, the International Centre for Comparative Environmental Law (CIDCE) has developed a draft convention on pandemics. Conceptually underpinned by the “One Health” approach, the CIDCE proposed text is aimed to serve as a tool for reference and inspiration for all actors involved in the diplomatic process leading to the conclusion, hopefully promptly, of a convention on pandemics. A bold call for a rapid conclusion of the pandemic treaty should clearly feature in the outcome documents of UNEP@50 and Stockholm+50, so as to promote progress in health law and environmental law globally, in harmony with nature, through a specific convention to combat pandemics.
The pressing need for a pandemic treaty
The COVID-19 pandemic has claimed the lives of millions of people around the globe. Continuing its growth, this dizzying toll challenges us all the more urgently as the deep bruises inflicted by the coronavirus on humanity and the planet are as multiple as they are immeasurable.
As the pandemic-induced shocks continue to unfold worldwide, extreme poverty is rising, economic recovery is marking time, the labour market is being damaged, natural resources are being depleted, essential health services have been interrupted, access to energy, water and sanitation is hampered, plastic pollution is proliferating, and biodiversity is declining. With the combined effects of heightened climate change, agri-food systems are further disrupted, exacerbating malnutrition globally. Thus, the UN-set 2030 horizon for the achievement of the Sustainable Development Goals risks slipping away inexorably.
The disastrous planetary toll of COVID-19 has revealed the common vulnerability of nations in the face of a global pandemic, the devastating human and environmental fallout of which has spared no single country. No individual State has been able to overcome, without pitfalls, the multifaceted crisis that has been unleashed. Clearly, the community of nations was not adequately equipped to manage the pandemic crisis quickly and effectively, both individually and collectively.
One of the factors limiting the capacity for joint international response to acute epidemic outbreaks is the lack of a global treaty dealing specifically with pandemics. While the 2005 International Health Regulations represent a major tool for epidemic control, they do not fully meet the specific requisites of the urgent and coordinated response that a widespread pandemic entails. Hence the need for an international convention that mobilizes the entire international community in fighting against pandemics.
Being a global threat, a pandemic calls for global solidarity and a global solution, through a global convention. The well-being of humankind and the viability of the planet are at stake.
The International Centre for Comparative Environmental Law (CIDCE), as an international NGO in special consultative status with the United Nations, has a natural vocation to protect human and animal health in times of pandemic. Thus, in August 2021, CIDCE set up a team of legal experts to develop a drat convention on pandemics, in partnership with the Normandy Chair for Peace and the Global Pandemic Network. The drafting process was completed in late November 2021 and the draft convention was published in English, French and Spanish in early December 2021 on the CIDCE website, with a rationale in favour of its adoption.
The draft convention drawn up by CIDCE is intended to support a related WHO initiative. The World Health Assembly (WHA), at a special session held in December 2021, decided to establish an intergovernmental body mandated to draft and negotiate a convention or other international instruments on pandemics.
It is scientifically recognized that the resurgence of pandemics is caused by anthropogenic interference in natural ecosystems. The complex interconnection that exists between living species is often the root cause of zoonoses, the occurrence of which is linked to the close interdependence between human health, animal health, environmental quality and climate change. Therefore, the “One Health” approach is at the heart of the CIDCE draft convention. Being at the crossroads of all disciplines relating to the human-animal-environment interface, it makes it possible to anticipate, prevent, detect and control diseases that are transmitted from animals to humans. It stems from a planetary health vision that intimately integrates the well-being of humanity and safeguards all other forms of life.
“One Health” comprehensively conceptualized
One Health is an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems.
It recognizes the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and inter-dependent.
The approach mobilizes multiple sectors, disciplines and communities at varying levels of society to work together to foster well-being and tackle threats to health and ecosystems, while addressing the collective need for clean water, energy and air, safe and nutritious food, taking action on climate change, and contributing to sustainable development.
In a joint statement issued on 1 December 2021, the Food and Agriculture Organization of the United Nations, the World Organisation for Animal Health, the United Nations Environment Programme and the World Health Organization welcomed this newly formed operational definition as a basis for their collaborative efforts to mainstream “One Health” as they advance their work to prevent, predict, detect and respond to global health threats and to promote sustainable development. Linking humans, animals and the environment, “One Health” addresses the full spectrum of disease control, from prevention to detection, passing by preparedness, response and management, with a view to promoting and improving health and sustainability. Such connections are graphically illustrated as follows:
In this spirit, the 10th Global Conference on Health Promotion adopted in mid-December 2021 the Geneva Charter for Well-being. To achieve “equitable health now and for future generations without breaching ecological limits”, the Charter calls for coordinated action to “value, respect and nurture planet Earth and its ecosystems”, including “just transition to a low-carbon economy to keep temperature rises below 1.5°C”, as well as “strong links to ‘One Health’ and planetary health to enhance pandemic preparedness and improve health and equity for the future”.
CIDCE’s draft convention in a nutshell
Centred as it is on “One Health”, the draft convention on pandemics is underpinned by the human right to a healthy life in harmony with nature, in an environment conducive to the achievement of the highest possible level of health and well-being, for the benefit of present and future generations. On this basis, the proposed convention aims broadly to prevent, anticipate, contain, manage and eradicate pandemics in a rapid, efficient, equitable, united and inclusive manner, while respecting human rights and staying mindful of the planetary boundaries.
Regarding pandemic preparedness, the draft convention urges States to put in place coordinated national strategies involving health, veterinary and environmental authorities; to develop scientific research on zoonotic risks; to have the necessary specialized medical and health personnel and the infrastructure needed; to strengthen epidemiological surveillance through early detection and warning systems, etc.
To respond to pandemics, States are required to alert the population when a pandemic outbreak is detected and to protect them effectively by means of an emergency plan, while transparently notifying potentially affected States. Enshrining vaccine equity, the draft convention recognizes that large-scale vaccination and universal access to vaccines are a global public good. The same goes for medicines, means of screening and medical equipment, the availability of which must be universal. In this spirit, States Parties cooperate in providing and receiving all necessary assistance, bearing in mind the special needs of developing countries.
Strengthening scientific and technical cooperation on pandemics is an essential part of the draft convention, which aims to promote the transfer of technologies and skills. In view of this, an Intergovernmental Panel of Experts on Pandemics is to be set up to collect and assess relevant data on the origins, prevention and management of pandemics and to impartially provide scientific, technical, socio-economic and legal advice.
To facilitate effective implementation of the convention, increased coordination of actions carried out by the international agencies concerned with pandemics is crucial, especially between the World Health Organization, the Food and Agriculture Organization of the United Nations, the World Organization for Animal Health, the United Nations Environment Programme, the World Trade Organization and the World Bank. Moreover, States commit to allocating adequate, predictable and sustainable financial resources for pandemic preparedness and response programmes.
Such a convention would therefore help to enhance engagement of all stakeholders and consolidate multisectoral partnerships, offering a dialogue and convergence framework for the coherence of approaches, the coordination of actions and the synergy of interventions.
Calling for a pandemic treaty at UNEP@50 and Stockholm+50
The important decision made by the WHA on 1 December 2021 to set up an intergovernmental negotiating body (INB) is most welcome. However, the INB work schedule, spread over three years, is far too long. Indeed, it is planned that: (i) the first meeting of the INB will be held in March 2022 to elect its officers and outline its programme; (ii) its second meeting will take place in August 2022 to identify the provision of the WHO Constitution under which the instrument should be adopted; (iii) the INB will then submit a progress report to WHA76 in May 2023; (iv) finally, it will present its outcome to WHA77, that is: not before May 2024!
In view of the devastating effects of the pandemic, a much more diligent stance is needed. A tighter timeline remains conceivable, should WHO Member States agree to it. To this end, a new WHA special session could be held in late 2022, with the sole purpose of considering and adopting the draft convention on pandemics, which would have been previously developed and negotiated by the INB. Thus, when it meets in May 2022, WHA75 could reschedule the INB meetings and decide to convene a WHA special session in December 2022. A condensed calendar for the negotiations, with intensified meetings of the INB, would make it possible to conclude the convention before the end of 2022.
Such a scenario is not utopian. By way of comparison, an exemplary precedent of an accelerated negotiation process can be recalled. After the explosion of a reactor at the Chernobyl nuclear power plant in 1986, two conventions were negotiated and adopted, in just five months, under the International Atomic Energy Agency: one on early notification of a nuclear accident, the other on assistance in the case of a nuclear accident or radiological emergency. Nowadays, in the face of an infinitely more deadly global pandemic, such a feat is replicable within WHO.
In a pandemic emergency, there is also a legal emergency. As professor Robinson warned, “the next pandemic is here”. And it could even “come soon and be deadlier”, as prospects of predictable outbreaks suggest. Hence the urgency to act: “We are now faced with the fact that tomorrow is today. We are confronted with the fierce urgency of now”. This prophetic phrase, although crafted by Martin Luther King, Jr. in a different context, could be paraphrased today as the world is at serious risk of severe future pandemics.
We would therefore argue that the 2022 Declaration emerging from the celebration of UNEP’s 50th anniversary should urge a prompt adoption of the proposed convention on pandemics, while also acknowledging its conceptual underpinning, the “One Health” approach, as already advocated by Rahel Zimmermann and Nicholas Robinson. Calling boldly for a rapid conclusion of the pandemic treaty in the outcome documents of both UNEP@50 and Stockholm+50 would help to promote progress in health law and environmental law globally, in harmony with nature, through a specific convention to combat pandemics.