How the Next Pandemic Could Be Stopped Before It Starts — If the World’s Health Systems Can Agree on One Protocol

When the World Health Assembly concludes and delegates leave the Palais des Nations with heavy binders and courteous exhaustion, a certain silence descends upon Geneva in late spring. They departed with something heavier than normal in May of last year. The text of a Pandemic Agreement, which, on paper, commits the world to doing what it failed to do in late 2019, was finally agreed upon by 194 countries after three years of negotiations. The question of whether it truly works is quite different.

The goal is fairly simple. Create a common early warning system. Distribute pathogen samples more quickly. When the next outbreak occurs, more fairly distribute vaccines. Organize supply chains before they break down rather than after. In theory, none of this is debatable. The word “binding” was softened, sharpened, and softened again more times than anyone wants to count during the more than 1,200 hours of negotiations.

When you read the final text, you’ll notice how much it reflects lessons that ought to have been clear in March 2020 but weren’t. Tens of thousands of lives were saved by South Korea’s vigorous testing and tracing. Despite having far more resources, other nations struggled during the first half of the year. There was no scientific basis for the gap. It was logistical, political, and occasionally simply bureaucratic inertia. While a new virus is already destroying hospitals, the new agreement attempts to pre-negotiate the decisions that nobody wants to make.

It’s difficult to ignore the soft spots, though. No nation is required by the agreement to share pathogen data within a certain time frame. When it comes to border closures, it does not supersede national sovereignty. Penalties for noncompliance are not specified. Good faith is crucial for the mechanisms that really matter, the ones that could prevent an outbreak from spreading into a pandemic. Furthermore, there is a well-known half-life for good faith in geopolitics.

The threats themselves continue to grow, which is the other silent issue. Mosquitoes and ticks are being forced into areas that have never experienced dengue or Lyme due to climate change. Millions of people are crammed into dense respiratory networks as megacities continue to grow. Southeast Asian poultry farms continue to act as unintentional testing grounds for strains of avian influenza. The next spillover event is most likely already happening somewhere between the wet markets and the melting permafrost, but it’s happening so slowly that nobody has noticed it yet.

Parts of the new strategy can be seen in unexpected places. Wastewater samples are sequenced in a Nairobi surveillance lab. A group at the NIH in Pakistan is discreetly increasing its genomic capability. Researchers at Johns Hopkins are conducting tabletop exercises that eerily resemble Event 201, the 2019 simulation that eerily predicted the world’s cascading failures months later. Veterans of public health feel that the resources are available. The political clout to employ them at the appropriate time is what’s lacking.

Perhaps that is the true question hidden within the contract. It doesn’t matter if science can identify the next pandemic—it most likely can—but rather whether 194 governments can take action based on that knowledge within the limited time frame. As we watch this play out, it seems like we’re going to find out if the world learned anything from COVID or if we just put the lessons in writing and moved on. It is signed. The ratifications have not yet been completed. There’s no waiting for the next virus.