Pandemic prevention, preparedness and response accord

In light of the impact of the COVID-19 pandemic, WHO’s 194 Member States established a process to draft and negotiate a new convention, agreement, or other international instrument (referred to in the rest of this FAQ, generally, as an “accord”) on pandemic preparedness and response. This was driven by the need to ensure communities, governments, and all sectors of society – within countries and globally – are better prepared and protected, in order to prevent and respond to future pandemics. The great loss of human life, disruption to households and societies at large, and impact on development are among the factors cited by governments to support the need for lasting action to prevent a repeat of such crises.

At the heart of the proposed accord is the need to ensure equity in both access to the tools needed to prevent pandemics (including technologies like vaccines, personal protective equipment, information and expertise) and access to health care for all people.

WHO Member States have developed multiple global legally-binding agreements, conventions, accords, and other types of international instruments to protect and promote people’s health, including the WHO Constitution itself, the WHO Framework Convention on Tobacco Control, and the International Health Regulations.

Such instruments were created by Member States to secure and foster further collaboration in multiple areas that impact on the health and well-being of people in communities, countries and globally.

These international instruments represent a commitment by countries of the world to address the health needs of their citizens to advance their health status and strengthen the socio-economic status of their communities at large.

The process to consider such an international accord for pandemic prevention, preparedness and response is being led fully by WHO’s Member States.

In December 2021, at a special session of the World Health Assembly – WHO’s highest decision-making body, comprising of all of its 194 sovereign member countries – WHO’s Member States decided to establish an intergovernmental negotiating body (INB), representing all regions of the world, to draft and negotiate a WHO convention, agreement, or other international instrument on pandemic prevention, preparedness and response, with a view to adoption under Article 19 of the WHO Constitution, other provisions of the Constitution as may be deemed appropriate by the INB.

Article 19 gives the 194 Member States forming the Health Assembly the authority to adopt conventions or agreements on any matter within WHO’s competence. The sole instrument established under Article 19 to date is the WHO Framework Convention on Tobacco Control, which has made a significant and rapid contribution to protecting people from tobacco since its entry into force in 2005.

The World Health Assembly decision establishing the Intergovernmental Negotiating Body (INB) and its work on this new international accord stressed that WHO’s Member States, who will be working in their sovereign capacity, should guide their efforts by the principle of solidarity with all people and countries, and that the accord should frame practical actions to deal with both causes and consequences of pandemics and other health emergencies.

The INB process has allowed various constituencies to be actively engaged through:

• written and oral inputs from Member States and relevant stakeholders on the successive iterations of the work, including the Substantive Elements, the Working Draft, the Conceptual Zero Draft and the Zero Draft;
• regional consultations during the WHO Regional Committees of 2022 and 2023, as appropriate;
• informal, focused consultations on selected key issues, including with experts, in the second half of 2022 and in March 2023;
• public hearings (two rounds, in April and September 2022), for interested parties and stakeholders to express their views; and
• regular information briefings.

In December 2021, WHO’s Member States requested the WHO Director-General to convene the meetings of the Intergovernmental Negotiating Body and support its work, including by facilitating the participation of other United Nations system bodies, non-state actors, and other relevant stakeholders in the process to the extent decided by the 194 Member States forming part of the negotiations.

The WHO Secretariat’s job is to support countries – its Member States – as they negotiate and agree on the new international accord. The WHO Secretariat does not determine the contents of any possible international accord.

Besides WHO Member States, the process for developing a possible new accord is providing extensive opportunities for engagement with relevant stakeholders, including other United Nations system bodies, and a wide range of other non-State actors in official relations with the WHO, to ensure robust and inclusive participation in the proceedings of the Intergovernmental Negotiating Body. Furthermore, WHO is seeking complementary inputs through public hearings with stakeholders including: international organizations; civil society; the private sector; philanthropic organizations; scientific, medical, public policy and academic institutions and other entities with relevant knowledge, experience and/or expertise.

Member States meet virtually and in person on a regular basis as part of the Intergovernmental Negotiating Body (INB), according to the timeline of the INB, which is set out in document A/INB/3/4.

Member States convening as part of the INB conducted a first phase of their work between February and June 2022 with the aim of agreeing on the way they would work, and defining how best to engage various stakeholders in an inclusive manner. The INB shared the report of this first phase of its work through a global public live webcast.

Member States started the second phase of their work as part of the INB in July 2022 by initiating discussions on elements that could become part of a future accord.

The INB took several important steps by discussing a Conceptual Zero Draft (CZD) of the accord at INB3 in December 2022 and agreed that the INB Bureau should move forward with producing a Zero Draft of the accord.

As part of this, the INB has taken several important steps, including:

• discussing a Conceptual Zero Draft (CZD) of the accord at INB3 in December 2022 and agreeing that the INB Bureau moves forward with producing a Zero Draft of the accord;
• agreeing at the fourth meeting of the INB, held on 27 February – 3 March 2023, that the Zero Draft (ZD) becomes the basis for negotiations by Member States on a pandemic accord;
• continuing to provide textual proposals for the ZD at the fourth and fifth meetings of the INB, held on 27 February – 3 March 2023 and on 3–6 April 2023 respectively, which form an integrated set of meetings focusing on reviewing the ZD, and agreeing that the INB Bureau should compile the textual proposals received, and provide a Bureau’s text, showing options where feasible, for consideration of the Member States;
• presenting a progress report to the Seventy-sixth World Health Assembly in 2023, which was discussed at the fifth meeting of the INB and was of a procedural nature;
• deepening the work on selected articles of the Bureau’s text at the resumed session of the fifth meeting of the INB, and agreeing to continue consideration of several of these articles through informal meetings of the Drafting Group in preparation for and during the sixth meeting of the INB, which was held on 17–21 July 2023, as well as ahead, and during the Drafting Group meeting on 4-6 September 2023. This work, which continues in September 2023 allows WHO Member States to bridge their understanding of each other’s proposals, and helps further the work. The INB Drafting Group will resume its work on 22 September 2023 to take stock of progress achieved through these informal meetings; and
• planning to consider a proposal for negotiating text of the WHO CA+ at the seventh meeting of the INB to be held on 6-10 November and resumed on 4-6 December 2023. This proposal will be shared by the INB Bureau by 16 October 2023, based on the discussions of the INB from its fourth, fifth, and sixth meetings, as well as the meeting of the Drafting Group, including its informal meetings, and the reports of the co-facilitators of those informal meetings.

It was agreed by Member States at the fourth meeting of the INB, beginning on 27 February 2023, that the Zero Draft becomes the basis for negotiations by Member States on a pandemic accord.

The fourth and fifth meetings of the INB, held on 27 February – 3 March 2023 and on 3–6 April 2023, respectively, formed an integrated set of meetings focusing on reviewing the ZD. The INB reviewed in detail the ZD and provided additional textual proposals.

The INB agreed that the INB Bureau should compile the textual proposals received, and provide a Bureau’s text, showing options where feasible, for consideration of the Member States. The INB presented a progress report to the Seventy-sixth World Health Assembly in 2023. The Bureau’s text was made available to Member States shortly after in early June 2023 in all UN Official Languages.

At the resumed session of the fifth meeting of the INB, the INB exchanged views on selected articles of the Bureau’s text and agreed to continue consideration of several of these articles through informal meetings of the Drafting Group.

The INB also agreed to a series of intersessional informal meetings for Drafting Group participants in advance of the sixth meeting of the INB, to be held on 17–21 July 2023.

A joint plenary session of the INB and the Working Group on Amendments to the International Health Regulations (WGIHR) was held on the afternoon of 21 July and morning of 24 July 2023.

The World Health Assembly mandated the INB to submit its final outcome to the Seventy-seventh World Health Assembly in May 2024.

After laying the foundations for its work in the first half of 2022, the INB has focused its attention on consecutive iterations of working documents, including the following: 

• The Conceptual Zero Draft (CZD), presented at the third meeting of the INB, in December 2022, was intended as a bridge for reflection by Member States, between the Working Draft presented at the Second meeting of the INB and the Zero Draft.
• After reviewing the CZD at the third meeting of the INB in December 2022, Member States agreed that the INB Bureau should move ahead with developing a Zero Draft (ZD) of a potential pandemic accord based on inputs received.
• The Zero Draft, which is available on the INB website in all six official UN languages was considered at the fourth and fifth meeting of the INB, working in a drafting group reserved for Member States, held in February and April 2023, respectively.
• At the fifth meeting of the INB, the INB agreed that the INB Bureau provides a compilation reflecting all the inputs received during INB4 and INB5, as well as additional written textual proposals.
• The INB Bureau was asked to provide, for consideration of the drafting group, a Bureau’s text. It should include options where feasible, based on all submissions received and included in the compilation document, to facilitate the work of the drafting group, on the continued understanding that nothing is agreed until everything is agreed.
• The INB completed a review of the Bureau’s text at the resumed session of the fifth meeting and at the sixth meeting of the INB, agreeing to deepen its examination of specific articles through informal meetings, including at and following the 4–6 September 2023 meeting of the Drafting Group.
• The INB Bureau will develop and circulate to the INB for its consideration a proposal for negotiating text of the WHO CA+ by 16 October 2023, based on the discussions of the INB from its fourth, fifth, and sixth meetings, as well as the meeting of the Drafting Group, including its informal meetings, and the reports of the co-facilitators of those informal meetings. The seventh meeting of the INB will take place from 6-10 November and will resume from 4-6 December 2023, to allow the presentation and consideration of the negotiating text of the WHO CA+. The Bureau will continue to consult with the co-facilitators, as appropriate. It was agreed that the proposal for negotiating text would be without prejudice to the right of any Member State to present textual proposals and to the status of the compilation document.

The Intergovernmental Negotiating Body is, per the World Health Assembly decision, operating based on the principles of inclusiveness, transparency, efficiency, Member State leadership and consensus. Public updates are provided at all relevant steps of the process. The INB website is the main source of information. The INB Bureau also regularly releases its Newsletter, which can be accessed from the INB webpage.

A report was submitted to the World Health Assembly in 2023. The final decision on whatever pandemic accord is agreed will happen in open plenary in the World Health Assembly in 2024.

More information on the INB

As the process of the Intergovernmental Negotiating Body is solely the decision of WHO’s 194 sovereign Member States, WHO’s Member States will ultimately determine the form and content of the new accord, including its objectives, principle(s), and scope.

The new accord could represent a global commitment to work together, as an international community, to help prevent disease outbreaks from impacting individuals, communities, countries and the world in the same way as the COVID-19 pandemic did.

Importantly, any new accord would be expected to establish principles, priorities and targets for pandemic preparedness and response, with the aim to:

• build resilience to pandemics;
• support prevention, detection, and responses to outbreaks with pandemic potential;
• ensure equitable access to pandemic countermeasures; and
• support global coordination through a stronger and more accountable WHO.

The new accord could complement other initiatives, actions and measures aimed at making the world safer from pandemics, including the International Health Regulations and global institutions and systems working to equitably share health technologies, information and expertise.

The proposed accord 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. 

Among other things, the new accord could, if WHO’s Member States so decide, address gaps that have been highlighted by the COVID-19 pandemic, including the following key areas for action:

• global preparedness and response arrangements – including at the human-animal interface – to help anticipate and prevent future pandemics and address them more effectively when they do arise;
• sustained, predictable funding for health emergency preparedness and response, including from domestic budgets to support preparedness measures and help ensure that the world is prepared and can respond to the emergence of dangerous pathogens; and
• governance and oversight mechanisms to increase trust, ensure accountability and foster transparency.

The International Health Regulations (2005) (the “IHR”) is a key international instrument on international health, rooted in the WHO Constitution. The IHR was established 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 work on the new accord on pandemic prevention, preparedness and response would aim to be coherent with, and complement, the IHR. The Health Assembly decision SSA2(5) establishing the INB noted the “need for coherence and complementarity between the process of developing the new instrument and the ongoing work […] regard to implementation and strengthening of the IHR (2005)”.

A process agreed on by the World Health Assembly at its meeting in May 2022 is underway to consider potential “targeted” amendments to the IHR. This work is being conducted through a dedicated Member-State led working group process (the Working Group on Amendments to the IHR (2005)) which held its first meeting on 14-15 November 2022.

The World Health Assembly decision establishing the above-mentioned Working Group requested the Working Group “to coordinate with the process of the [INB], by means that include regular coordination between the two respective Bureaux and alignment of meeting schedules and workplans, as both the International Health Regulations (2005) and the new instrument are expected to play central roles in pandemic prevention, preparedness and response in the future.”

It could be anticipated that a new accord could define the term “pandemic” as part of its terms, to ensure clarity with respect to its scope of application, if Member States so decide. It is also possible that the new accord could include a provision on its relationship with other international instruments, including clarifying that the new accord could be complementary to the IHR. Article 57 of the IHR also states that its Parties may conclude special treaties or arrangements in order to facilitate the implementation of the IHR.

The Zero Draft presented by the INB Bureau based on progress achieved and input received at the third meeting of the Intergovernmental Negotiating Body (INB) refers to a number of potential guiding principles and rights for the new accord, including the importance of national sovereign rights and full respect for the dignity, human rights and fundamental freedoms of persons.

As with all international instruments, any new accord, if and when agreed by Member States, would be determined by governments themselves, who would take any action while considering their own national laws and regulations.

Member States will decide the terms of the accord, including whether any of its provisions will be legally binding on Member States as a matter of international law.

It is expected that such an accord would aim to help prevent future disease outbreaks from impinging on people’s freedom to travel, work, seek education and, above all, lead a healthy life free of avoidable disease, as called for by another global accord, the WHO Constitution.

This would be a decision of WHO’s Member States, working through the intergovernmental negotiating body. It would be expected that a new accord would be open to the participation of all countries, who would be able to participate if they so wished. In line with the example provided by the WHO Framework Convention on Tobacco Control, the new accord could, possibly, be open to regional economic integration organizations.

It would be up to Member States to decide if and what compliance mechanisms would be included in the new accord on pandemic preparedness and response. It is a general principle of international law that once an international law instrument is in force, it would be binding on the parties to it, and would have to be performed by those parties in “good faith.”