Roojin Habibi is a research fellow at the Global Strategy Lab and a PhD student at Osgoode Hall Law School. Dr. Clare Wenham is an associate professor of global health policy at the London School of Economics.
Member countries of the World Health Organization are currently negotiating a new pandemic treaty in an effort to prevent a global health crisis like COVID-19 from ever happening again. But after the global mayhem and injustices of the pandemic, these negotiations are fast becoming a battleground for broader political tensions.
Nearly everyone would agree that egregious global inequalities were laid bare by COVID-19. While wealthy countries enjoyed timely access to quality vaccines, diagnostics and treatment, poorer ones were largely left to fend for themselves, even at the height of the global health crisis. To prevent another pandemic, countries need a new blueprint for global co-ordination and collaboration. The verdict is still out, however, on what that blueprint should look like.
Pandemic injustices have not only spurred demands for equity and solidarity in the WHO’s draft treaty, but also for countries with varying levels of development to accept “common but differentiated responsibilities,” or CBDR. While some entities see CBDR as the key to achieving health equity among the world’s nations, others, including Canada, view it as a divisive and unworkable concept in global health law. This impasse, reflected in the recently leaked version of the WHO’s pandemic accord, should not be an excuse for inaction. The stakes are too high and the need for solidarity is too urgent.
To be sure, the principle of common but differentiated responsibilities is longstanding in international environmental law. It rests on four key ideas: First, that the world faces a common danger (i.e., climate change) that must be thwarted by collective efforts; second, that some countries have less capacity than others to fend off this danger; third, that some countries are more vulnerable than others to the effects of the danger; and finally, that some countries have a greater historical responsibility for the problem, mainly due to greenhouse gas emissions.
In a nutshell, the principle holds that those with greater culpability, capability, and less vulnerability must step up and take a more significant role in addressing the shared threat of climate change.
These same ideas may apply to pandemic prevention, preparedness, and response. New and emerging pathogens pose a common danger to the world. Poorer countries with weaker health systems are less capable of detecting these pathogens or mitigating their spread. These same countries, which often do not have robust health systems, are also more vulnerable to the impact of an epidemic or pandemic, as was evident during COVID-19. Their disproportionate outbreak vulnerability is, moreover, a product of historical trajectories, such as colonialism, and global neoliberal policies, such as structural adjustment programs (used, for example, by the International Monetary Fund as requirements for loans to developing countries) which eroded long-term investments in health systems. It seems only fair, then, that the countries that carved out these legacies should bear greater responsibility for their outcomes.
The current draft of the pandemic treaty references common but differentiated responsibilities in its preamble, guiding principles, and Article 4. For many countries in the Global South still reeling from the impact of COVID-19, these references do not go far enough, and further mainstreaming of the concept is needed. Conversely, for many high-income countries, it goes too far, as they argue that pandemics pose a universal threat to all countries, and all countries should bear equal responsibility for it.
Whilst wholly applicable to the global health space, tensions over the principle of CBDR could presage the unravelling of negotiations, which are already running behind schedule (the WHO first began considering this type of treaty in December, 2021). Perhaps countries are trying to force a circle into a square peg. Perhaps what they need instead are bespoke solutions and bespoke language adapted to the domain of global health.
The tenets of CBDR are not all that foreign to global health diplomacy. Seventy-five years ago, the world came together, with common aims, to address the differential challenges of achieving global health equity. In that spirit, they established the World Health Organization and recognized in its constitution that “unequal development … in the promotion of health and control of disease, especially communicable disease,” poses a “common danger.”
Today, as countries negotiate a new pandemic treaty, they must channel that same historical will to collective action. With just one year left to negotiate the agreement (a timeline stipulated by the World Health Assembly when first embarking on the treaty), it’s time for countries to say yes to working together with the greater aim of capacity-building for developing countries, and collective financing for pandemic prevention, preparedness and response.
Let us not squander this opportunity to build a shared understanding of principles that can guide us toward a safer, healthier, and fairer future.
(This article was originally published in The Globe and Mail on April 24, 2023.)