FINALLY, THE PANDEMIC AGREEMENT!!!
…… Many missed opportunities, but a beginning made.
Conversation with Prof. Biswajit Dhar(BD) and Prof. T. Sundararaman(TS)
TS – The Pandemic Agreement seems to have finally come through. But few seem to be celebrating. It is happening without the USA, and it is happening at a time when tariffs are being unilaterally imposed and a trade war is looming. And while there are many positive features in the agreement, there is the concern this agreement is just not good enough to avert another pandemic catastrophe, nor good enough to ensure equity. We have invited Prof. Biswajit Dhar who has been part of earlier global trade negotiations on behalf of the government of India, and who is a senior academic with extensive policy experience to take us through this issue. I’d like you to start, Dr. Biswajit, with a brief introduction of your engagement with this issue.
BD – Thank you, Sundar. It’s a pleasure to be here and thank you very much for inviting me to this conversation. The Agreement deals with issues that I have been dealing with for a long time. In fact, this whole issue of Pathogen Access and Benefit Sharing (PABS) has its origins in the Convention on Biological Diversity (CBD), and subsequently in the adoption of the Nagoya Protocol on Access and Benefit Sharing, in the legal disputations in the courts and now in the Pandemic treaty discussions as well. Within the WHO, one of the first attempts to discuss this issue was the Intergovernmental Meeting (IGM) on Pandemic Influenza Preparedness. The IGM called on the WHO Director-General (DG) to establish an Advisory Mechanism to monitor, provide guidance to strengthen the functioning of the trust-based system needed to protect public health and undertake necessary assessment of that system. I was member of this Advisory Mechanism on “Pandemic Influenza Preparedness: Sharing of influenza viruses and access to vaccines and other benefits” established in 2008. . To give you a background, after an epidemic outbreak of avian flu in Indonesia, this country shared virus with an Australian lab to develop the vaccine. Under CBD, whichever country is a provider of genetic resources, has a right to get access to the technology and the products that have been developed on the basis of the genetic material made available by the provider country. But the Australian lab refused to provide the vaccine to Indonesia. And that was the first time that this issue came up in the WHO. Since then, there have been many similar engagements. Now it is not just the genetic material in the physical form that has to be shared but the virus in digitized format, meaning the digital genetic sequence information as well.
TS – So coming to the pandemic agreement itself, I think it is called an agreement now rather than treaty. Can you take us through the process?
BD – This Agreement has been almost five years in the making and has been a very tough process. In the midst of the COVID pandemic itself, the WHO DG, on the directions of the 23rd World Health Assembly (WHA) of May 2020, had set up an independent panel for pandemic preparedness and response. That independent panel, headed by Helen Clark, called for a pandemic framework convention to be in addition and complementary to the International Health Regulations. The WHA of 2021 established the Member-States’ Working Group on strengthening WHO preparedness and response to health emergencies, and this working group actually set the stage for the next set of negotiations in the Intergovernmental Negotiating Body (INB), established in March 2022. The INB met over 13 times in the subsequent three years and arrived at a consensus draft in April 2025. It has, thus, been a very long drawn and arduous process.
Please note, that there were two parallel processes were put in place. The first was the INB which led to the pandemic agreement. The second was review of the International Health Regulations (IHR). The IHR amendments that were adopted in WHA 2024, created an enabling environment for dealing with a broad sweep of issues relating to pandemic preparedness. The Pandemic agreement is more focused on the issues thrown up by the bitter experience of the COVID-19 pandemic. During the pandemic, developing countries led by India and South Africa, had brought a proposal in the World Trade Organization (WTO), arguing that “intellectual property rights such as patents, industrial designs, copyright and protection of undisclosed information [should] not create barriers to the timely access to affordable medical products technologies relating to medical products including vaccines and medicines”. They further argued that the WTO members should agree to grant a waiver from the implementation, application and enforcement of the relevant sections TRIPS Agreement in relation to prevention, containment or treatment of COVID-19. The “waiver should continue until widespread vaccination is in place globally, and the majority of the world’s population has developed immunity”. The rationale for the waiver proposal was that the technologies can be widely used by developing countries, which could, in turn, produce affordable vaccines and other medical equipment.
All these issues have now come together in the Pandemic Agreement. What this agreement is expected to do is to address all those problems that we saw earlier both in terms of response and preparedness to pandemic. If you consider the basic principles of the pandemic agreement, it emphasises the need to ensure equity as a goal, principle and outcome of pandemic prevention, preparedness and response. And the second set of principles are inclusivity, transparency, and accountability to achieve the common interests of more equitable and a better prepared world to prevent, respond and to recover from pandemics.
This really, in my view, comes directly from the experience we had during the COVID-pandemic because inequity in the availability of vaccines, and medical equipment was staring in our face. The pandemic agreement now, and ultimately a pandemic treaty has the potential to unlock all these using the objectives and the principles included in the finalized text.
TS -With regard to the process, there was this big discussion about should it be adopted under Article 21 or 19, what was it finally adopted under and what is the implication of that now?
BD – It still seems quite open ended. Let me explain. Articles 19 and 21 are two articles of the WHO constitution. Any agreement concluded under Article 19 is adopted by the World Health Assembly through a two- thirds majority. It can also be adopted by consensus. It comes into force for each member-state after the ratification process. In other words, it is an opt-in process. Once ratified, it is legally binding. The WHO Framework Convention on Tobacco Control was adopted under Article 19.
Under article 21, a simple majority of the World Health Assembly is adequate to adopt an agreement, and it comes into force for all members of WHO, after due notice. It would be binding on all countries, but if countries find that certain protocols are not to their advantage then they can refuse to implement it. So, it is an “opt-out” option. However, Article 21 is primarily meant for sanitary and quarantine requirements or other procedures designed to prevent international spread of disease. The International Health Regulations are adopted under article 21. But since Pandemic Agreement has a much wider ambit, and includes issues regarding standards on procedures and products and much more, it will be a stretch to use Article 21 for Pandemic Agreement.
Other commentators have actually argued that neither Article19 nor Article 21 is appropriate for addressing pandemic preparedness and response. They suggest that the Pandemic Treaty should be negotiated as a single undertaking, like the Agreements under the World Trade Organization, where nothing is agreed till everything is agreed. I feel the third option is problematic, because the disagreements may persist until the very end, and an outcome can still be elusive. This option can prevent harvesting the “low hanging fruits”, meaning participating countries can agree to close issues on which there is broad unanimity and can then move on to the more challenging issues. However, in the agreement we are discussing today, it cannot be said for sure that the hanging fronts have been plucked. There is broad agreement on all the articles, but precise agreement on several articles have not yet been reached. Even articles where disagreements persist are included, implying that a final decision has been pushed to a later date, especially on One Health and on Pathogen Access and Benefit Sharing (PABS).
TS – Coming to the content, what would you say are the main gains from this Agreement? Are we celebrating? Or what should we celebrate? What has been the achievement and what are the lost opportunities?
BD – I think for me the most important outcome is that all the 193 members, with the notable exception of the USA, are willing to have an Agreement. This Agreement reached on 16th April identifies the principles and key issues pertaining to pandemic preparedness and response, which is a very important first step. This is a big gain, and even getting to this stage, has been a five-year process. There are other international negotiations, which have gone on for decades and have not produced a structure akin to that of the pandemic agreement, simply because developed countries and their multinationals, especially big pharma, would stall progress. So, this for me is a big gain. There is no doubt about it.
In terms of the principles, the articulation of equity as a goal, and outcomes of pandemic prevention, preparedness and response are important too. The second set of principles are inclusivity, transparency and accountability to achieve the common interests of a more equitable and a better prepared world to prevent, respond to and recover from pandemics.
The Pandemic Agreement is only one step forward in the standoff between developed and the developing countries on pandemic preparedness and response. Now we must analyse how different parties are going to strategize. It is very important for the developing countries to coordinate their efforts. And one country that contribute in doing so is India. I think it is very important for India, to push further using this opportunity and using this current framework. . India must develop coalitions on specific issues. However, developing countries’ grouping is not homogenous, there are inter se differences and a lot of differentiation and we must acknowledge this reality and learn to deal with this. I think developing countries must proceed issue by issue, taking one issue at a time, and building coalitions. We can then use our collective strengths to agree on a treaty that would be best suited to our interests. India and the other large developing countries like South Africa and Brazil, need to coordinate for a favourable outcome.
TS – So can we take up some of these issues? Let us start with the PABS (Pathogen Access and Benefit Sharing) which was the major one.
BD – Let me begin with a short introduction to this issue. For production of vaccines, access to the pathogen, usually a virus, is essential. Countries providing the pathogens have a right to get certain benefits arising from the fact that they have provided these pathogens. This follows from the Convention on Biological Diversity (CBD) which says that every sovereign country has a right over all the biological material in its jurisdictions. And if the country provides this biological material to any commercial or third party outside, it has the right to get certain benefits. And what are the benefits? The benefits include preferential access to the products developed on the basis of the pathogens that have been made available. The provider country also has the right to get access to the technologies developed using the pathogens on a preferential basis. Rapid and timely sharing of pathogens has to be ensured, not just on the basis of physical access to pathogens but also by way of digital sequence information (DSI). Timely sharing of the pathogens, followed by fair and equitable sharing of benefits, in both monetary and non-monetary forms. Say, for instance, the pathogens have been provided by India to a multinational pharmaceutical company, which develops a vaccine using the pathogen. The benefits India gets would be monetary, in terms of financial resources and also non-monetary, in terms of technology transfer, training etc. And this could include access to vaccines, therapeutics and diagnostics. All these things come in a package. PABS ensures companies get access to pathogens and it ensure countries providing the pathogens get access to the technologies.
CBD became effective in December 1993. In 2010, the Nagoya Protocol on Access and Benefit Sharing adopted under the CBD, created greater legal certainty, and transparency for both providers and users of genetic resources and specified the legal obligations. Over 140 countries are signatories to the protocol. But despite this development, access and benefit sharing has been the most difficult part of implementation of the CBD. Though these are binding commitments, the treaty commitments cannot be enforced by UN agencies, unlike with the WTO.
The difference that the Pandemic Agreement makes is that now we have the WHO, as an honest broker interacting between the provider and the user countries. Both pathogen and benefit sharing would be routed through WHO. This would ensure that the pathogen is available to all companies and countries in an unrestrained manner. The benefits can be allocated by WHO across countries who need it, even if they were not the original source (supplier) of the pathogens.
The Agreement includes a provision that allows WHO to lay a claim to 20 percent of the production, 10 percent as donation and the other 10 percent at agreed upon rates. Though these numbers are grossly inadequate to meet global needs, it, nonetheless, is a step forward in a scenario where in practice there is no commitment as of now. It a principle that has been recognised. In other words, provider countries that are mostly developing countries have been able to put their foot at the door and, and that door can be, can be opened wider depending on how effectively developing countries can make their presence felt on the system. That is why I mentioned earlier that it is very important for the developing countries to coordinate their efforts and to negotiate with one voice so that when there are windows of opportunity these gains can be maximized.
TS – Coming to the intellectual property sharing. I find it heartening that the TRIPS and the Doha declaration has been reaffirmed, which again was something that the absence of USA may have helped. Of course, this is far short of the main demand that whenever a pandemic is pandemic a patents waiver goes into effect. But what have we got? Are there more spaces where the WHO can play a broker role to enable more public companies and more developing countries to access essential technologies?
BD – Issues of transferring technologies protected using Intellectual Property Rights (IPR) are included in Article 11 of the Pandemic Agreement. But many of the provisions are in the nature of “best endeavour” clauses. They only facilitate or incentivize transfer of technology “as mutually agreed.” Now this is problematic. The owners of proprietary technologies are these big corporates. At least since the 1970s, technology transfer has been among the most problematic aspect of North-South relations. In most international agreements where technology is a big issue, in climate change for instance, technology transfer from North to the South has not been realized. The language used in this Article 11 speaks of encouraging holders of relevant patents and licenses for the production of pandemic related health products to charge reasonable royalties, to encourage manufacturers to share information relevant to the production of pandemic related health products. Now we know from the Covid 19 experience that despite pressure from the majority of countries, companies were not willing to make technology available even during that worst phase of pandemic, and even for the limited duration of the pandemic. What is the chance that they would do so voluntarily, for a longer period of time?
From my experience as a researcher and a participant in negotiations in both the WTO and the WHO, I can say that the term “technology transfer” is an oxymoron. Technology is an intangible which is bought and sold in the marketplace. Technologies are owned by private entities who sell technologies to the most “appropriate” buyer from their perspective. Therefore, we need to find ways in which technologies can be obtained on preferential terms. Article 16 of the CBD takes a step in this direction as it says, “access to and transfer of technology … to developing countries shall be provided and/or facilitated under fair and most favourable terms, including on concessional and preferential terms …”. However, it goes on to say that “in the case of technology subject to patents and other intellectual property rights, such access and transfer shall be provided on terms which recognize and are consistent with the adequate and effective protection of intellectual property rights” thereby allowing the technology owning transnational corporations to dictate the terms on which they would provide the technologies. This is not good enough. We need language of the sort included in Doha Ministerial Declaration on TRIPS Agreement and Public Health, which insists that Intellectual Property Rights (IPR) will not come in the way of addressing public health problems. Such language is missing in the Pandemic Agreement. This is a lost opportunity, in my view.
TS– And what is the progress on One Health? What are the points of disagreement? What advance has the Pandemic Agreement made.
BD– Article 5 of the Agreement addresses One Health. It states the broad principles, but the details are still to be worked out. Much of the interpretation and implementation is left to the Parties of the Agreement. One Health is putting together standards and regulations across different areas: humans, animals, agriculture, environment, wildlife, the entire ecosystem, all in one comprehensive package.
There is considerable disquiet and controversy on existing language of Article 5. Civil society has argued that the current understanding is that countries would have to align with international norms, which, as always, would be laid down by the advanced countries. Article 5 could provide opportunity, they say, for the advanced countries to impose their process/product standards in agriculture and environment, that could then be used as non-tariff barriers against exports from developing countries.
We recognize that developing countries need to put in place their own standards to counter the proliferation of standards by the advanced countries. But non-availability of the necessary resources and capacities are formidable barriers, which most of these countries cannot overcome, at least in the near future. Therefore, while One Health as a concept is important, its implementation could leave developing countries with considerable problems.
BD– Article 5 of the Agreement addresses One Health. It states the broad principles, but the details are still to be worked out. Much of the interpretation and implementation is left to the Parties of the Agreement. One Health is putting together standards and regulations across different areas: humans, animals, agriculture, environment, wildlife, the entire ecosystem, all in one comprehensive package.
There is considerable disquiet and controversy on existing language of Article 5. Civil society has argued that the current understanding is that countries would have to align with international norms, which, as always, would be laid down by the advanced countries. Article 5 could provide opportunity, they say, for the advanced countries to impose their process/product standards in agriculture and environment, that could then be used as non-tariff barriers against exports from developing countries.
We recognize that developing countries need to put in place their own standards to counter the proliferation of standards by the advanced countries. But non-availability of the necessary resources and capacities are formidable barriers, which most of these countries cannot overcome, at least in the near future. Therefore, while One Health as a concept is important, its implementation could leave developing countries with considerable problems.
TS – Coming to the other two issues. Are we better placed after this agreement for an early detection and notification of disease outbreaks? And what of the core capacity, the preparedness of health systems, especially in developing countries, to respond, which relates to financing and governance issue? These are all inter-related.
BD – There are a number of Articles in the Pandemic Agreement which deal with these aspects. Article 4 on pandemic prevention and surveillance, Article 5 on One Health, Article 6 on preparedness, readiness and health system resilience, and Article 7, covering health and care workforce. These are all about preparedness and response to pandemics for the next pandemic that many experts warn may be just around the corner. Now the problem is that all these Articles require the Parties to the Agreement to implement them. For example, Article 6 calls for “each party to take appropriate measures to develop, strengthen and maintain a resilient health system, particularly primary health care for pandemic prevention, preparedness and response. And then on healthcare and workforce (Article 7), the Agreement says, “each party shall take appropriate measures with the aim to develop, strengthen, protect, safeguard, retain and invest in multidisciplinary skill, adequate, trained domestic health and care workforce”. We all understand how important these factors are not just for pandemic preparedness and response, but for the overall health care system of any country. But we also know that little is happening by way of strengthening of health systems in developing countries, including in ours. Most countries are inadequately prepared despite having faced repeated epidemics in recent past. Of course, the Pandemic Agreement does put an additional sense of urgency to make our health care systems resilient, but this requires investing in infrastructure, in people, in facilities and so on. Now where do the finances come from? Once again it is the same approach, of kicking the can down the road…. we’ll see later. Most developing countries have not prioritized strengthening their domestic public health systems. It is a big question mark, whether countries, giving their other spending priorities will able to focus on health sector spending for pandemic preparedness in the near term.
The big question of financing for implementation of international treaties has mostly drawn a blank. There has seldom been a decent financial package for developing countries to implement their international commitments. And now that US has reneged from supporting developing countries, many European countries may follow suit in a context where they are being forced to ramp up their defence budgets. So, my apprehension is, that this will go the way of climate change preparedness, where despite the Paris agreement, financial resources promised by the developed countries have not been forthcoming. So even if a financing mechanism under the Pandemic Agreement was to evolve tomorrow, availability of funds is always going to be a problem. So now you have, in this Agreement, all the good things needed for pandemic preparedness and response on the table, but will countries be able to partake of them? That’s the issue. And that’s my problem.
TS: The US is not part of this consensus and will not be a signatory to this Agreement. But did it influence the outcome? A pandemic treaty without the US, what does it mean? Should we be grateful because it happened at all or should we be worried because its implementation is compromised? Is it an opportunity or a threat?
BD – Well, it is an opportunity in the sense that the global community may not have reached this far if the Americans were at the negotiating table. I firmly believe that the US would not have actually allowed the adoption of draft, weak as it is. So, to that extent, there was an advantage in not having the ‘elephant in the room’. Further there are many international treaties which the USA has not joined because they do not agree with the objectives. CBD is one of the more prominent among these. But though it does not formally participate in the processes, the US operates through several proxies which routinely make a mess of the deliberations. So, I do not think that the absence of USA from the room is going to make a major difference. For instance, Donald Trump’s pressure on the European countries to increase their defence spending will result in the availability of less resources from the developed world. Though this is not a new augury, in the Trump-era, inadequacy of financial resources would be a severe problem.
TS – A related question. Does the current tariff regime of Trump affect the implementation of the Pandemic Agreement? He is threatening tariffs on pharmaceuticals too. Since India is the pharmacy of the world at least for affordable generic drugs, what implications does it have for implementation of the Pandemic Agreement? And for India’s own position?
BD – In my view, Donald Trump is weaponizing tariffs. First “reciprocal tariffs” are imposed and then their implementation is postponed for 90 days for all countries except for China. This provides the US an opportunity to negotiate favourable trade deals with all affected countries under duress, covering the entire range of issues that “may” adversely impact US trade. India was the first country to initiate a bilateral trade agreement with the USA. It is interesting to see the USA’s likely wish list. The US Trade Representative (USTR), also the country’s chief trade negotiator, brings out an annual report called National Trade Estimates on Foreign Trade Barriers. This report lists all trade barriers which the USA perceives is preventing access or hurting American businesses. One of the key set issues pertains to protection and enforcement of Intellectual Property Rights (IPRs). The USA has long been very unhappy with India’s patent regime. It does not like any of the flexibilities in the Indian Patents Act, like compulsory licensing, denying patents on minor innovations [Section 3(d)] or the provisions relating to pre-grant opposition provisions, among others. All these are listed in the USTR report. My apprehension is that these issues will be on the negotiating table and India will be pushed very hard to amend some of these provisions. Last year, India signed a trade agreement with four European countries, Switzerland, Liechtenstein, Norway, and Iceland, called the European Free Trade Association (EFTA). This was the first bilateral trade agreement in which India agreed to include IPRs and it marked a departure from the long-held position of both the Indian government and public interest groups, that India’s Patents Act should be seen as a “holy cow”, not to be touched at all, because the health security of the country is involved. But last year, subsequent to this agreement, the government amended an important provision in the Patents Act, which requires patent holders to report the status of “working” of their patents in India. Before the India-EFTA Free Trade Agreement, patentees had to report the “working” status every year, but now they are required to do so once in three years. This amendment would make it difficult to issue a compulsory licence on the grounds of non-working of patent. So, we have started walking down that path of amending our Patents Act, and with the intense pressure of the US, the public interest provisions in the Act could be diluted. Besides, US wants India’s tariffs on major agricultural commodities to be reduced, to enable its agri-business to enter the Indian market. But this move is likely to see a push-back from India’s farmers. What if there is a trade-off between lowering of agricultural tariffs and amendment of the Patents Act? Would the government like to be pushed into such an impossible choice, where it cannot accept either, since on the one side there is food security, on the other, health security? It is therefore very important for us to remain vigilant on the developments in the India-US bilateral trade negotiations, for the issues at stake are not just tariffs, it is also our Intellectual Property regime and the country’s health security, which is up for grabs.
TS – Another related question, because you follow these trade negotiations. You know, India is a leader of the pharmacy of the developing world. So how did it play its role in these whole negotiations on pandemic? We know that in climate change it has played a proactive role has helped us consolidate the position of the developing countries. Did it have an equivalent role in the pandemic agreement in the negotiations?
BD – No, we played a relatively small role, whereas our role should have been much larger, because we have the experience in implementing an access-benefit sharing regime under the CBD. We know what the problems are. Moreover, we were very active in the WTO discussions on waiving IPRs on medical products during the pandemic. India is in the right position to provide the leadership to developing countries. It can guide the developing countries on how to proceed because, in terms of the expertise that is available here, it is second to none. India really needs to take the bull by the horns. Of course it can’t do it itself. It has to build partnerships with other developing countries. And one good thing I would say that is happening in the political scene, is that after a long time, India is talking about the importance of the voices of the South. The government of India has organised summit meetings of southern countries where the importance of South as a political entity was highlighted. The Pandemic Agreement provides us with an opportunity to practice what we are preaching in terms of the power of the South. We need to bring together countries of the South that suffered so enormously during the covid-pandemic, to put our collective strength, our collective will, together so that we have an agreement which is not only good on paper. At the end of the day, we need an Agreement that is robust in terms of its outcomes.
TS The assumption in the push for benefit sharing, is that the developing world would have the manufacturing capacity required to absorb the technology and undertake domestic or regional manufacture. India had a good lead ahead on that. But with India increasingly dependent on imports of active pharmaceutical ingredients (API), which are the basic ingredients for making medicines, even India’s drug security seems again open to question. I don’t know how that plays into this. What is the extent of Indian dependence on imported API? How did this occur and can it be reversed? Or should we accept this in a larger global understanding that since the have a competitive advantage it need not be reversed?
BD – In a paper I wrote last year, I had analysed India’s dependence on China for imports of active pharmaceutical ingredients (APIs). My observations were quite significant and worrying. In several critical areas like antibiotics almost 100 percent of the APIs are imported from China. This is extremely worrying for two reasons. First, the political uncertainties in our relationship with China may prevent India’s generic industry from accessing APIs from China. Even though relations have improved considerably in recent months, a significant level of import dependence on a single country can be used as a handle to manipulate us. Our independent foreign policy can be severely impacted as it has happened during the 1960s when India was dependent on American wheat that was provided under the PL 480 scheme. The second issue is that API is at the heart of any medicine, and it is vitally important to get this intermediate product of the right quality. Problems in the quality of imported APIs have been plaguing the Indian industry, which, in turn, is adversely affecting the reputation of made-in-India medicines. Therefore, we need to ensure that APIs for most medicines are manufactured in India so that they are of the right quality. Now as far as production in India is concerned, my view is that the only way we can be self-reliant in API manufacture is to revert back to the model where it was the public sector which was doing the heavy lifting by producing the critical APIs. Unfortunately, the government’s current initiative to increase domestic production of APIs through the Productivity Linked Incentive (PLI) Scheme has not worked as the private sector does better in producing formulations. Is it possible to revive our public sector units to at least some reasonable level, so that we can improve availability of domestically produced APIs? I have my doubts if this could happen on account of the current ideological orientation.
TS – It is interesting that you raise the need for public pharma, in the context of drug security. I think with a number of Indian pharmaceuticals being acquired by international big pharma, there is a need to both revive public pharma and support domestic manufacture. The pandemic agreement does provide space for shared technology pool. While there are no binding commitments on big pharma or on developed countries, could developing countries with relatively more progressive governments and adequate manufacturing capacity make use of these provisions for an alternative. Countries like Brazil, India, South Africa, Cuba, Thailand, even Bangladesh could, facilitated by the agreement, create a parallel stream of technology transfers, manufacturing, product development, with WHO playing what you called the “honest broker” role. Perhaps Big Pharma will play ball, if it sees an alternative can be built without it. Vaccine innovation and manufacture did advance in many of these countries without any support from Big Pharma. During the pandemic WHO did try and initiate a technology pool transfer, but it just had no takers since it was looking largely to pharmaceuticals to participate voluntarily. It was often dismissed as impractical. What was put in place to ensure vaccine access to less developed countries was something called COVAX which did not deliver. Is there a potential, a window opening up, for a parallel regime for access to technology that public pharma, more progressive countries, smaller players can together challenge the monopoly structure of big Pharma?
BD – As you know, several developing countries have ambitions of developing their domestic pharma industry, including Bangladesh and countries in Africa. South Africa has the largest pharmaceutical industry in the African region, followed by Egypt and Nigeria. Two decades back, one of the India’s largest companies, CIPLA entered into a joint venture in Uganda with plans to supply pharmaceuticals to the East African region. But the joint venture did not perform as planned. The experience in Uganda notwithstanding, I feel that India can play an important role in supporting the growth of pharmaceutical industries in the larger African countries. And if Indian government can encourage and facilitate a lot can be done. For instance, India has been utilising the services of EXIM Bank of India to facilitate the Indian companies going to other parts of the third world, to start joint ventures. And I think we need to do it more aggressively. We now also have a critical number of countries who are interested.
WHO would behave differently if developing countries like India, Brazil South Africa, and Cuba can work in close coordination in this organization. Here lies the importance of multilateralism for developing countries, which Trump is trying to kill. This is the reason why Trump took USA out of the WHO. Trump has clearly stated US’ aversion to multilateralism, and though his predecessors could not express this as candidly, they, too, never believed in multilateralism. They consistently and systematically practised unilateralism in every multilateral organization.
Multilateral institutions provide opportunities to developing countries to make common cause, allowing them to negotiate as a group, that can then alter the behaviour of any institution. We saw this happening in the WTO. We could not have got the Doha Ministerial Declaration if the multilateral trading framework was not available. We should work with the African region because this region holds a lot of potential. In fact, the Africans are coming together economically. If there is any example of a South-South trade developing, it is happening in Africa. So, Africa can be the continent which provides the wherewithal for developing countries to plan a push back in the WHO, and to change the dynamics of the discussions that are taking place. If we can bring a critical minimum number of countries on the negotiating table with substantial interest in the issues that we are discussing in the Pandemic agreement, that could open the way for alternative approached. I feel that there is opportunity now. This Pandemic Agreement is a double-edged sword. You could allow yourself to be cut. That’s bad! But you could be on the other side where you are able to cut through the opposition to a balanced agreement on pandemic preparedness and response.
Acknowledgements: Thanks to Dr Ismail Rifai for assistance in recording, transcripts and editing and to Ms Roubitha David for her support in this production and to M. Hasan for the IT support.
About the Participant:
Prof. Biswajit Dhar
Distinguished Professor, Council for Social Development, New Delhi.
Professor Biswajit Dhar is Distinguished Professor, Council for Social Development, New Delhi. He was a Professor at the Centre for Economic Studies and Planning in Jawaharlal Nehru University, New Delhi and has served as the Director General of the Research and Information System for Developing Countries (RIS), a think-tank of Ministry of External Affairs. Professor Dhar was instrumental in the establishment of the Centre for WTO Studies of the Government of India and was the Head of the Centre for several years. He had also served as a Senior Consultant in the Planning Commission.
Professor Dhar has served as a member of the Indian delegation in multilateral treaty negotiations, including the World Trade Organization, the UN Framework Convention on Climate Change, the World Intellectual Property Organization, and the Convention on Biological Diversity. He was nominated in the expert groups of several inter-governmental organizations, including the WHO and the Convention on Biological Diversity. He served as a member of the Advisory Mechanism on “Pandemic Influenza Preparedness: Sharing of influenza viruses and access to vaccines and other benefits” established by the WHO DG in 2008 and was also a member of WHO’s Working Group on Fair Pricing of Medicines, during 2020-21.
Professor Dhar has served on the Board of Directors of the Export-Import Bank of India and was a Member of the Board of Trade, Government of India. He serves as an Adviser to the Asia-Pacific Research and Training Network on Trade of the UN Economic and Social Commission for Asia and the Pacific and is on the Governing Board of the Inter-University Centre for IPR Studies of the Government of Kerala.
