Independent monitoring of the WHO pandemic agreement is non-negotiable, experts say

An accountability framework, including independent monitoring of state compliance, is critical for the pandemic agreement's success, according to researchers at Columbia University Mailman School of Public Health and affiliates at Spark Street Advisors. The paper and findings are published in BMJ Global Health.

"Countries signing up to a pandemic agreement is no guarantee of its effective implementation," said Nina Schwalbe, adjunct assistant professor in the Department of Population and Family Health and principal visiting fellow at Columbia Mailman School. "Countries' lack of compliance with the International Health Regulations have contributed to several failures to contain outbreaks, including COVID-19."

To assess how the pandemic agreement could best incorporate monitoring to promote compliance, the researchers did a comprehensive literature review of the governance of 11 existing global monitoring mechanisms and conducted over 40 interviews with stakeholders and experts. This included broad consultation with academics, advocates, activists, and officials from governments, international organizations, and foundations from around the world.

According to the researchers, an independent mechanism to monitor states' compliance with and reporting on the pandemic agreement can promote compliance with the agreement.

Schwalbe and colleagues identified key features for successful compliance monitoring of the pandemic agreement:

• Independent monitoring should be politically, financially, technically, and operationally independent of member states, the WHO, and donors to increase its reliability.
• The monitor should report to a high-level political body to be effective.
• Independent monitoring should review states' self-reporting to the Conference of the Parties, the main governing body of the agreement.
• It should triangulate state reports with shadow reports by civil society and UN agencies, confidential reports from the public, country visits, and inquiries to state parties.
• It should share reports transparently into the public domain, highlighting best practices and promoting mutual learning.
• In addition to self- and peer reviews, the pandemic agreement should have independent accountability mechanisms built into it from the start.

Currently, the Intergovernmental Negotiating Body, tasked with negotiating a pandemic agreement, is aiming to present it for the states to adopt at the World Health Assembly in May 2024. While a precursor to this agreement provided important provisions for equity, intellectual property rights, and benefit sharing, it contained little on holding countries accountable.

It suggested instead that the governing body should agree to accountability measures after the agreement is adopted. At an Intergovernmental Negotiating Body (INB) meeting held in December 2022, several WHO member states emphasized that accountability mechanisms should be negotiated into the agreement from the start.

On the basis of the findings, the researchers propose establishing an independent committee to monitor the state parties' compliance by assessing the timeliness, completeness, and accuracy of state reporting. The committee would report to a heads of state-level body, have the capacity to collect information, and share their findings publicly. The INB is meeting this week and again in December in Geneva.

Co-authors are Layth Hanbali, Elliot Hannon, and Susanna Lehtimaki, Spark Street Advisors; and Christine McNab of Toronto, Canada. Nina Schwalbe is also affiliated with United Nations University International Institute for Global Health.