The World Health Organisation (WHO) has started debating a draft "pandemic treaty" to address the failures of the Covid-19 response and prevent another global crisis.

The ongoing negotiations, which have been taking place in Geneva (which the pharma lobby describes as "the global health capital of the world") are essentially a proxy war between corporate interests aiming to entrench intellectual property protections for profit and the WHO and its Global South allies seeking greater accountability and transparency from wealthy governments that enable pharma profiteering.

Though it acknowledges the "catastrophic failure" of the pandemic response and recognises the "threats" of intellectual property restrictions, the treaty falls far short of what is needed.

Following the failures of both national and international responses - ranging from vaccine hoarding by wealthy countries to profit-driven vaccine distribution decisions by pharmaceutical companies - it's clear the power imbalance within the global health world needs to be seriously confronted.

While the WHO technically leads the global health architecture, the real power is held by governments, pharmaceutical companies, and philanthropic foundations from the Global North.

This power was on full display during the Covid-19 pandemic when the pharmaceutical industry, (namely Pfizer, Moderna, and Johnson and Johnson), as well as philanthro-capitalists (led by the Bill and Melinda Gates foundation) solidified their outsized influence and control of the already dysfunctional global health architecture.

For people in the Global South, this lack of representation was nothing new.

These communities have been forced to endure and repeatedly challenge the global health architecture's colonial, white supremacist, patriarchal, and market-driven responses to Aids, Ebola, and Mpox and now Covid-19.

Rather than address these failures head on, the recent round of negotiations have seen Global North governments advocating positions that will facilitate further Big Pharma profiteering.

In the US for instance, senator Ron Johnson, introduced a Senate bill in anticipation of the draft pandemic treaty, asserting that "a significant segment of the American public is deeply sceptical of the World Health Organisation, its leadership, and its independence".

The attacks on the WHO were also echoed by House Foreign Affairs Committee chair Michael McCaul who, supported by House Energy and Commerce Committee chair Cathy Rodgers argued: "As the WHO begins the process to move this pandemic treaty forward, America's sovereign rights and biomedical leadership and innovation must be protected."

These Republican calls to "protect" innovation are reiterated in the pharma coalition's recommendations for "robust intellectual property protection" in the pandemic treaty, perpetuating the dubious assertion that innovation is dependent on intellectual property rights.

Their unsubstantiated claims place corporate interests and profit over peoples' lives by deliberately obstructing efforts to share biomedical knowledge such as vaccine recipes during global health emergencies.

(Some lawmakers on the other side of the aisle, such as Bernie Sanders and Elizabeth Warren are challenging the "corporate greed" of the pharmaceutical industry and advocating for reforms to lower drug prices.)

Decolonising global health

In anticipating the next pandemic, we have to reimagine the global health architecture outside of its Genevan centre.

A comprehensive pandemic treaty should offer concrete measures that chip away at the capitalist and colonial power at the centre of global health. It should include legal obligations on governments or pharma companies (as suggested by the Third World Network) to prevent corporate profiteering and vaccine apartheid, and redirect resources to protecting the right to health and saving lives.

This process requires redrafting geographies of power that shape global health outcomes, including supporting efforts to shift vaccine research, manufacturing, and distribution to the Global South. Such initiatives include the Partnerships for African Vaccine Manufacturing (PAVM), which aims to increase African vaccine manufacturing capacity from less than 1% of the continent's total doses currently to 60% by 2040. Led by the Africa Centers for Disease Control, the PAVM would reduce Africa's dependency on Euro-American charity, moving the continent toward greater self-reliance.

In addition, we should think creatively about reconstituting the global health architecture by limiting the profit-driven pharma sector's influence on access to medicines through the development of a public option that supports democratically controlled pharmaceutical development, production and distribution.

For instance, the creation of the Moderna vaccine was publicly funded through taxpayer money. It is therefore conceivable that governments could extend their existing financial support for vaccine research and development, to manufacturing and distribution. This would result in a publicly controlled pharmaceutical ecosystem centred on equitable access, rather than a profit-driven system led by corporate greed and narrow shareholder interests.

A new global health order is possible, but it requires solidarity and imagination, more than myopic greed and intellectual property.

From openDemocracy