Governance Needs for Pandemic Preparedness and Response (PPR)

The COVID-19 pandemic has been characterized by mistrust in science, the manipulation of science for political purposes, the “infodemic” of mis- and disinformation, and a repeated failure to base policy decisions on scientific findings.

The crisis of confidence in scientific analysis is paradoxical and disquieting, particularly in light of increasing international regulation to manage acute or systemic risks and its reliance on science.  This so-called “science-policy interface” (SPI) incorporates scientific expertise into global policy-making and regulation in fields as diverse as climate change, biodiversity, and nuclear safety, but it is arguably less developed in global health and in particular for pandemic preparedness and response (PPR).

As international policymakers consider various proposals aimed at preventing another pandemic through better and stronger global rules — whether in the form of a WHO “pandemic treaty,” revised International Health Regulations, a UN political declaration, or regulatory framework — the integration of SPI in their design will be of crucial importance for their credibility and effectiveness.

SPI, however, is only one side of the regulatory coin; the other side consists of the normative commitments that must guide national action and international cooperation in implementing measures inspired by scientific consensus.

From this latter perspective, two critical aspects are: 1) compliance mechanisms to assess national progress and challenges, identify systemic problems, and build mutual confidence among states; and 2) an institutional framework to manage compliance oversight, provide a forum for consensus building and technical support, and turn SPI findings into agreed targets and benchmarks.

Examples of SPI that present interesting features for our purposes are: the Intergovernmental Panel on Climate Change (IPCC), the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES), the IAEA Safety Standards, and WHO’s standard-setting. All of these examples (excepting WHO’s standard-setting) are linked functionally to international treaties.

Some recurring elements in those initiatives should be carefully considered:

1. Institutional framework: IPCC is an inter-agency program (WMO, UNEP, IUCN) with an independent secretariat, IPBES is a self-standing intergovernmental program serviced by UNEP, while the other two are part of the regular programs of IAEA and WHO, respectively. The main consideration here is between institutional integration versus a dedicated framework controlled by participating states. For a “One Health” approach, which targets the interface of human and animal health and environmental protection, the parallel competence of multiple organizations may require mechanisms to compile scientific findings and channel them into an intergovernmental process.
2. Relations between science and policy: One of the challenges of SPI is to balance the integrity of scientific analysis with political acceptability. In the case of IPCC, summaries for policy-makers are adopted line-by-line by the full intergovernmental panel, in dialogue with the authors, while technical summaries are left untouched. In contrast, WHO guidelines and similar standards are mostly elaborated by the secretariat with the support of experts and technical partners, with governments limited to providing comments. Intergovernmental endorsement of scientific findings is seen as more conducive for negotiations, with the notable example of the IPCC, whose periodic assessments have coincided with, and deeply influenced, major international legal developments.
3. Process: IPCC and IPBES use a structured and public process to select large numbers of authors and reviewers and organize their work, with successive draft reports undergoing intergovernmental review. WHO, in contrast, usually appoint experts from existing internal rosters with relatively limited transparency, and the final outcomes are issued by the secretariat. Considerations of legitimacy and accountability should weigh heavily in considering options for the future.
4. Policy-relevant or prescriptive? The examples mentioned above are mostly policy-relevant, where SPI leads to findings or recommendations left to the discretion of states. A possible exception are IAEA’s safety standards that constitute benchmarks for compliance with the Convention on Nuclear Safety. A different and preferable approach for a future PPR instrument is policy-prescriptive SPI, where the implementation of treaty obligations is assessed against compliance with the scientific conclusions and guidance generated within the SPI process, subject to technical and financial support and capacity-building.

If we consider pandemics along a continuum starting with the identification of pathogens and ending with the deployment of countermeasures, there are several points where SPI is, conceptually, a critical component of future international regulation.

To illustrate this need with an example, we may consider one such time point: the pre-pandemic identification of pathogens phase and the management and reduction of the risk of spillover of pathogens from animals to humans. In a recent, co-published Lancet comment, I argued that a future pandemic treaty should incorporate “deep prevention” of zoonotic spillover, a legal blind spot between global health law, which focuses on containment of occurring outbreaks, and environmental law, which addresses different risks. This is an area of considerable complexity that is receiving increasing attention given the frequency of outbreaks of zoonotic diseases including (possibly) COVID-19.

Recent research projects, such as Predict and the Global Virome Project, aim at prospectively identifying and characterizing animal viruses of zoonotic potential. Concurrently, WHO, FAO, OIE and UNEP each have been pursuing a One Health agenda, both under their individual mandates, as well as through an intensifying quadripartite cooperation embodied most recently by the establishment in November 2020 of a One Health High-Level Expert Panel (OHHLEP).

Still, the confluence of different disciplines and epistemic communities make coordination and coherence challenging.  What is missing from these initiatives, moreover, is the regulatory interface, given the absence of dedicated international legal instruments.  Scientific findings are at best policy-relevant, offering empirical bases or guidance for discretionary national or local measures.

The challenge for the negotiators of a future pandemic instrument will be to devise an SPI framework that will simplify and integrate the inherently complex and intersectoral nature of zoonotic risk management through processes that are at the same time scientifically cogent and politically conscious so as to inspire and guide intergovernmental processes.