The 194 member countries of the World Health Organization (WHO) began a final push to reach an agreement on a pandemic preparedness treaty in Geneva on Monday, with the draft text criticized as too weak by several stakeholders.
The talks, which last 12 days, are expected to be vexed as representatives race to meet a looming deadline to finalize the text.
In the wake of the Covid-19 pandemic, WHO members called for an robust accord aimed at ensuring countries are better equipped to handle the next catastrophic outbreak and have the global response be less chaotic.
For instance, advocates want the planned treaty to include a supply chain network coordinated by the WHO so that all countries have access to the medicines they need in an emergency without trade restrictions.
Similarly, part of the production of medicines or vaccines could be made available to poorer countries free of charge or at low cost.
The provisions would only apply to countries that ratify the agreement. It would come into force once 60 countries have done so.
The goal was to have the treaty adopted at this year's World Health Assembly, which is the WHO's supreme decision-making body. The meeting is due to be held starting at the end of May.
But the last round of negotiations earlier this year failed to reach a breakthrough. The talks that begin on Monday are seen as the last opportunity to forge an agreement before the May deadline.
"The level of ambition has already been lowered," said one diplomat.
In the struggle to reach consensus, the negotiators have presented a radically shortened draft compared to the earlier version. It now runs to 23 pages, with numerous contested provisions omitted and more non-committal language included.
Governments should strengthen monitoring capacities in the health-care system "where appropriate," says one passage. Another says that technology transfers for the production of medicines or vaccines should take place "on mutually agreed terms."
One of the most controversial issues has been whether and how pharmaceutical companies should be obliged to share expertise and make a portion of their products available to poorer countries.
But the diplomat, who spoke on condition of anonymity to speak candidly about the status of the talks, said that the watered-down draft text still offers "added value."
"Having nothing at all would be worse," he said.
More than 20 organizations that have campaigned for the fair participation of poorer countries criticized the draft. They said it did not guarantee that all countries would receive pandemic products or funding for their health-care systems without delay, and that the text contained onerous health-monitoring obligations that would be difficult to fulfil.
The well-known medical aid organization Doctors Without Borders (MSF) said that the treaty must better regulate global health and justice issues - and not just protect the interests of the pharma industry.