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International Institutional Architecture To Combat Pandemics

COVID19 aka Novel Coronavirus has made us realize how fragile our health systems are, even with the significant advancement in medical science, we have yet to develop a system where we could respond immediately to a pandemic which is highly contagious and has a mortality rate which would be at least 20 times higher than the common flu.[1]

Coronavirus has shaken the very roots of the system in which we lived in, things which once seemed pretty ordinary/normal are today a luxury. Businesses throughout the world have been reinventing themselves to create some value amidst the lockdown.

We are now dependent hugely on the virtual world which again has its downsides. Coronavirus has had a two-fold impact on the countries throughout the world. First of course on the health and second is on the economy. We are losing billions of dollars every day because of the stringent nature of the lockdowns. The IMF has termed this crisis even worse than the Great Economic Depression [2] and on the economic front, we are still ascending that slope, unlike the corona case growth slope which is actually flattening for a lot of countries.

This is the biggest challenge the mankind has ever faced but there is still hope that we might come out of his crisis as a more resilient society, one which values things around them rather than taking them for granted, one which now has a greater sense of responsibility not just for themselves but for those around them and the environment. As the great British Historian, Arnold J Toynbee says “Those living in an age of crisis must become pioneers of a better age, striving to find positive solutions and thereby turning the age into one of achievement.” [3]

To ensure that we can prevent such a situation in the future, what we need is a Global Action Task Force for Prevention of Pandemics (GATFPP).

But before that let us look at the architecture of the present global organizations which are working in this sector to ascertain that why exactly do, we require such a specialized global organization.

The first such organization which comes to our mind is probably the World Health Organization (WHO) and rightly so as it has been the forerunner in the fight against COVID19. After the formation of the United Nations in 1945, the world leaders felt a need to set up an organization which could take care of the health of the people around the world. An organization which could act as an umbrella organization to coordinate with and assist the countries throughout the world with regards to supplementing their healthcare systems and practices.

Thus, with this goal in mind, WHO began when its Constitution came into force on 7 April 1948. Its primary role is to direct and coordinate international health within the United Nations system and the main areas of work are health systems; health through the life-course; noncommunicable and communicable diseases; preparedness, surveillance and response; and corporate services.[4]

The World Health Assembly is the decision-making body of WHO. It is attended by delegations from all WHO Member States and focuses on a specific health agenda prepared by the Executive Board. The main functions of the World Health Assembly are to determine the policies of the Organization, appoint the Director-General, supervise financial policies, and review and approve the proposed programme budget. The Health Assembly is held annually in Geneva, Switzerland.[5] The Executive Board is composed of members technically qualified in health and gives effect to the decisions and policies of the Health Assembly. The upcoming session of the World Health Assembly is scheduled to be held from 17th – 21st May 2020. The Executive Board is composed of 34 technically qualified members elected for three-year terms. [6] WHO also works with non-state actors to ensure that its network penetrates the grassroots.

Apart from WHO, we have organizations at the regional level such as the Pan American Health Organization (PAHO) which serves as the regional office for WHO in the Americas and, since it predates WHO it also carries on some additional activities. The European Public Health Association (EUPHA) is an umbrella organisation for public health associations and institutes in Europe. EUPHA was founded in 1992 by 15 members (12 countries). EUPHA now has 86 members from 47 countries. [7]

The Global Health Crises Task Force was another organization which was established by the United Nations Secretary-General Ban Ki-moon for a period of one year, beginning on 1 July 2016.[8]

The Global Health Crises Task Force was established to support and monitor the implementation of the recommendations of the High-level Panel on the Global Response to Health Crises, issued in its report on “Protecting humanity from future health crises”.[9] The Task Force sought to ensure that the implementation of the Panels recommendations was aligned with the observations of the Secretary-General as set out in his report on “Strengthening the global health architecture”.[10] But this organizations mandate ended in 2017 itself and it was largely led by the bureaucrats within the UN system.

Other agencies working within with health or related sectors are United Nations Childrens Fund (UNICEF), United Nations Development Program (UNDP), World Bank (WB), Joint United Nations Programme on HIV and AIDS (UNAIDS), the Food and Agriculture Organization (FAO), the United Nations Fund for Population Activities (UNFPA), the Office of the UN High Commissioner for Refugees (UNHCR), and the UN Fund for Drug Abuse Control (UNFDAC).

Some Intercontinental Non-Government Organizations working in the sector are International Red Cross, Oxford Famine Relief (OXFAM), CARE International, Save the Children International Alliance, World Vision and Medecins Sans Frontieres (MSF, Doctors Without Borders).

These again are not exhaustive lists but despite the plethora of organizations, the real problem is that there mandate does not entail them to pre-empt a global health crisis but only to provide insights to manage it when its out there and sometimes its too late and is out already out of hand as in the case of COVID19 because of its contagious nature.

Global Action Task Force for Prevention of Pandemics can be an organization which does not only manage pandemics and health crisis but prevents them from happening in the first place. The mandate of the organization as from its name would be simple to prevent pandemics which is a mammoth task because even if you fail once then it would mean that the countries throughout the world would raise questions to either junk/revamp the organization itself.

The organization has to work on a war footing to stop pandemics from happening come what may, to enable this, we have to ensure that the organization has wide powers and it works closely with all its member countries.

The Executive Body of the organization can comprise of Health Secretaries of its member countries heading them and should meet quarterly with a term of two years. Each continent can have at least 10% of its member countries on the executive body with at least 2 seats for each continent. All the member countries together should meet at least once a year as a whole for the General Body Meeting.

In case there is an outbreak of a new disease which according to initial estimates by the Technical Committee of the organization has the potential to develop into a pandemic, then the Executive Body should convene a meeting within 7 days of submission of such a report and then the body should come out with its binding guidelines for its member countries.

Alternatively, if a member state feels that a particular disease has the potential to develop into a full-blown pandemic, then it can request the Secretariat to convene an Executive Body meeting within 7 days and a General Body meeting within a month of submission of its application.

Having the health secretaries will ensure that there is a contact with the governments of the member states so as to ensure that the guidelines issued are implemented within time and the severity of the issue is conveyed and understood by the member states.

If any member country is aggrieved by the binding guidelines set out by the executive body, then it can request the Secretariat to call for a General Body meeting within a month of issuing of the guidelines, the guidelines can be discussed as well as voted upon if need be during the proceedings of the body which may get passed on a vote of a simple majority. The General Body on its own can issue guidelines as well if the member states pass a resolution towards the same.

The organization can have wide powers to enforce its mandate, it can make it mandatory for a member state to let the Technical Committee investigate within its territory with regards to the epicentre of the disease if the Executive Body so issues. Economic, as well as Travel Sanctions against the defaulting member states can be used as a tool to deter countries which may endeavour to flout rules and guidelines of the organization.

The Technical Committee of the organization should have experts from all member states which can be headed by a person who has already had an experience in heading such a global Technical Committee.

The Technical Committee should come out with suggestive guidelines concerning how each member state should conduct itself when there is an outbreak of a new disease and the kind of data which mandatorily needs to be shared with the Technical Committee and once endorsed by the Executive Body these will have binding effects.

The Technical Committee, as well as the GATFPP, can work in sync with the WHO and its technical committee and thus reduce the considerable burden from the shoulders of WHO in this sector.

This is only a set of suggestive idea of how the organization can look like, the time is ripe that we start discussing about the formation of such an organization. In Public International Law, each country is given absolute freedom to negotiate its side of bargain which will further its national interest and based on such negotiations, we embark upon binding treaties. It has been argued that negotiated agreements, rather than attempts to advance new rules of customary international law offer critically important advantages.[11] These treaties help to alleviate unnecessary competition by preventing states from trying to achieve a destabilizing advantage in certain kinds of systems.[12] Thus, they help in reducing trust deficits and kind of confrontation and blame naming[13] that we are seeing right now and therefore promote world peace.

The formation of such an organization I believe will be in the interest of each and every country because everyone has faced the brunt of this pandemic and will do absolutely everything to make sure that next one does not happen. It was only the second world war I believe which made the countries come together and create an organization like the United Nations with its entire system, which was given wide powers with the hope that a third world war does not happen and despite the criticisms levelled against it, it has lived up to its original fundamental mandate.

As Mark Twain once said History doesnt repeat itself but it often rhymes [14], no doubt the humanity will encounter another Force Majeure which we wont have an immediate answer to but to ensure that its not a pandemic next time, we need an organization like the Global Action Task Force for Prevention of Pandemics taking form with the kind of stringent measures and safeguards which have been proposed. The best time to negotiate such a treaty would be the present moment itself when the nation-states would be in favour of binding themselves into a stringent treaty such as this because the horrors of the pandemic are fresh and ongoing.


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