The COVID-19 pandemic highlighted the urgent need for a more coordinated global response to health emergencies, leading to the ongoing negotiations of the World Health Organization (WHO) Pandemic Treaty. A cornerstone of the proposed treaty is the integration of the One Health approach, which recognizes the interconnectedness of human, animal, and environmental health in pandemic prevention, preparedness, and response (PPPR). The institutionalization of One Health within the treaty framework is seen as a vital step toward addressing the multifaceted drivers of pandemics. However, operationalizing this approach poses several challenges, as evidenced by the evolving nature of the treaty negotiations.
What is the Pandemic Treaty?
The WHO Pandemic Treaty is an ambitious international accord currently under negotiation, aimed at improving global cooperation and preparedness for future pandemics. Following the unprecedented impact of COVID-19, WHO’s 194 Member States initiated discussions in 2021 to draft and negotiate this new convention or agreement. The primary objective is to ensure that governments, sectors, and communities are better equipped to prevent and respond to future health emergencies.
Initial discussions considered housing the treaty under organizations like the WTO or WIPO, but ultimately WHO was chosen due to its global mandate on health. The Intergovernmental Negotiating Body (INB), tasked with drafting the treaty, has held numerous sessions since February 2022, with the goal of finalizing an agreement by May 2025. While considerable progress has been made, several key issues remain contentious, including pathogen access and benefit sharing, intellectual property rights, local manufacturing, technology transfers, and the incorporation of the One Health approach.
The pandemic treaty represents the first attempt to integrate One Health into a binding international legal instrument, acknowledging the critical linkages between the health of people, animals, and ecosystems in addressing global health threats.
One Health Provisions in the Pandemic Treaty
The One Health approach is embedded within various articles of the treaty. The preamble of the 27 May 2024 draft reaffirms the importance of multisectoral collaboration at all levels to safeguard human health, with a specific mention of the One Health approach, although the language is still under negotiation. While preamble clauses are not legally binding, they provide essential guidance for the interpretation and implementation of the treaty’s provisions.
Article 4: Pandemic Prevention and Surveillance
Article 4 outlines the treaty’s provisions for pandemic prevention and surveillance, emphasizing multisectoral national pandemic prevention plans aligned with the One Health approach. The draft specifies that member states should implement measures to prevent infectious disease transmission between animals and humans, conduct vector-borne disease surveillance, and address antimicrobial resistance (AMR). In addition, it introduces the idea that environmental, climatic, and anthropogenic factors must be considered in pandemic prevention strategies.
Article 5: One Health Approach for Pandemic Prevention, Preparedness, and Response
Article 5 is a dedicated provision for operationalizing the One Health approach in the context of pandemic prevention, preparedness, and response:
- The article mandates that Parties promote a coordinated and collaborative One Health approach, recognizing the interconnection between the health of people, animals, and the environment. This is to be done in accordance with national and international law, taking into account national circumstances.
- It calls for measures to address the drivers of pandemics at the human-animal-environment interface, with these interventions integrated into national pandemic plans, subject to the availability of resources.
- Article 5(3) encourages Parties to develop and review policies reflecting the One Health approach and to build relevant capacities through joint training and education programs at the human-animal-environment interface.
However, a critical change was made during the 11th INB negotiations: Article 5(4), which previously proposed a separate legally binding instrument to fully operationalize One Health, was removed. Instead, Article 4(3) was expanded to include a provision for a separate annex or instrument developed by the Conference of the Parties (COP) to address the operational dimensions of One Health. This is a significant shift in strategy.
Contentious Issues in the One Health Approach
While the inclusion of One Health in the proposed pandemic treaty is a landmark development, several contentious issues remain unresolved, particularly around the implementation and operationalization of this approach.
Challenges in Implementation: Ministry of Health Mandate
One critical issue is the limited scope of the WHO’s mandate, which focuses primarily on ministries of health (MoH). Effective implementation of the One Health approach requires collaboration across multiple sectors, including agriculture, environment, and trade, which often fall outside the purview of health ministries. The OH Obligations in the Accord must be conscious of the WHO’s mandate and limitations of MoHs to collaborate with other ministries and intergovernmental organizations to address the cross-sectoral challenges of pandemic prevention.
Community Engagement: An Omitted Element
A notable omission in the most recent negotiations is the removal of the community engagement requirement from Article 5(3)(b). Originally, the article included provisions for promoting community involvement in developing and implementing One Health policies. This is a concerning development, as community engagement is crucial for the success of One Health initiatives, particularly in addressing local drivers of pandemics and ensuring sustainable interventions. The lack of explicit reference to community involvement may hinder the effective operationalization of the One Health approach.
Annex vs. Separate Legal Instrument
The ongoing debate over whether One Health provisions should be included in an annex to the pandemic treaty or be developed as a separate legal instrument has significant legal implications. An annex would provide more flexibility and easier amendment processes, whereas a separate instrument could create stronger commitments but may complicate coordination with other intergovernmental organizations (IGOs) beyond WHO. Given the intersectoral nature of One Health, the involvement of IGOs like the World Organisation for Animal Health (WOAH) and the UN Environment Programme (UNEP) is critical, and their role needs further clarification in the final agreement.
Fear of Compartmentalization
There is also a growing concern that the One Health approach may become compartmentalized within the narrow scope of PPPR, limiting its broader application in addressing the drivers of pandemics. Once the treaty comes into force, One Health may find an international legal mandate restricted to pandemic-related issues, thereby neglecting its relevance in broader health and environmental governance. This could undermine the transformative potential of One Health as a holistic framework for global health security.
Funding and Resources: A Major Concern for LMICs
For low- and middle-income countries (LMICs), the financial and logistical burden of implementing One Health provisions is a significant concern. Many LMICs have expressed reservations about the costs and regulatory requirements associated with the One Health approach, particularly as it relates to agricultural trade and rural livelihoods. The operationalization of One Health will require substantial investments in capacity-building, surveillance systems, and cross-sectoral collaboration, all of which may be challenging for resource-constrained nations. The treaty must include mechanisms for financial and technical support to ensure that LMICs can fully participate in and benefit from One Health initiatives.
The Future of One Health in the Pandemic Accord
The proposed WHO Pandemic Accord represents a pivotal moment in global health governance, with the potential to embed the One Health approach into international law. However, the success of this integration will depend on the commitment of state parties to operationalize the approach, allocate sufficient resources, and ensure cross-sectoral collaboration. While the treaty’s One Health provisions mark a significant step forward, the remaining challenges—particularly around community engagement, funding, and the scope of One Health’s legal mandate—must be addressed in the final stages of negotiation.
Ultimately, the pandemic treaty presents a unique opportunity to institutionalize One Health as a guiding principle for pandemic prevention and preparedness. As negotiations progress, stakeholders must push for clear commitments and mechanisms for implementation, ensuring that One Health becomes more than just a conceptual framework and evolves into a practical tool for preventing the next global health crisis.
