The World Health Organization is holding its annual assembly in Geneva from May 21 to 30. She still claims to be looking for the origins of Covid-19. Negotiations on a new treaty aimed at preventing the next pandemic are also underway there. But what are the chances of success?
This content was published on May 19, 2023
More than three years into the Covid-19 pandemic – the worst in modern history – the origin of the virus remains largely unknown. China, where the disease was first detected in an animal market in Wuhan, is accused of lacking transparency. Investigators from the World Health Organization (WHO) were only able to go there a year after the virus appeared. And while the majority of scientists believe that the virus jumped from bats to humans via an intermediary animal present at the Wuhan market, some voices in the United States have recently revived the hypothesis of a laboratory leak. .
“The Chinese government has come under intense scrutiny for why it hasn’t shared data faster, more openly, and on a wider scale,” says Suerie Moon, co-director of the Global Health Center at the IHEID in Geneva. I don’t think it harms the WHO. The question is rather: why did this government not make the information available sooner or more openly?”
She evokes the latest twist in this saga. In March, a group of researchers from several countries said they had found and downloadedExternal link newly released Chinese data. These had briefly appeared in a genetic database called GISAID. According to the scientists, these data indicated that the most likely intermediate host of the virus was the wild raccoon dog. An animal sold alive at the Wuhan market. The data was removed from GISAID soon after as a Chinese research team updated its own reportExternal linksubsequently published by the scientific magazine Nature.
Faced with this late publication, Professor Edward Holmes of the University of Sydney in Australia, an expert in infectious diseases and co-author of the study on the new Chinese data, says he feels a mixture of “anger and frustration”. “This data was produced at the start of 2020 and it took three years for it to be published. This is unacceptable,” he laments.
Is it too late?
According to Edward Homes, the raccoon dog data “probably is the best evidence for a zoonotic origin that we will ever be able to obtain.” “The main observation from this data is that there were several wild species at the Wuhan market in 2019, contrary to what we were originally told,” he explains. “Additionally, we know that some of the wild species found in the market are susceptible to SARS-CoV-2. These data do not prove that any of the animals in the market were infected with the virus, but they correspond exactly to what one would expect for a zoonotic origin.
Will we one day be able to know with certainty the origin of Covid-19? “I think it is most likely too late to find the exact zoonotic origin,” replies Edward Holmes. The virus would probably have spread rapidly in intermediate animal hosts and would no longer be present in this population today. He disappeared. The only way to trace it would be to look for antibodies against the virus in these animals, thus proving a past infection. But we don’t know exactly what species, where the animals came from, or if any of them living at the end of 2019 are still alive today.
Suerie Moon of the Global Health Center reminds us that there are other diseases, such as HIV, whose exact origin is still not known. In the case of Covid, she believes that there are real scientific challenges, but it is also difficult to know if all the existing data has been shared. “Even if all the swabs, all the fragments of data had been shared, could we be certain with solid evidence of the origin of the disease? The answer could be no. I think it’s a real challenge. And, of course, it is also a very political question.”
In March, WHO director Tedros Adhanom Ghebreyesus denounced the “relentless politicization” of the question of the origin of Covid. He asked once again that it be left to the scientists. At a press conference in Geneva, he claimed that the WHO had no intention of abandoning its research and that the Scientific Advisory Group on the Origins of New Pathogens (SAGO) had recommended the year last of the remaining measures to be taken.
SAGO, a group of scientists from different countries, including Switzerland, saidExternal link on March 18 that “although these data do not provide conclusive evidence as to the intermediate host or the origin of the virus, they provide additional evidence of the presence of susceptible animals in the market, which may have been a source of human infections.
Pandemic Treaty
As part of WHO’s efforts to learn lessons from Covid-19, its Member States decided by consensus in December 2021 to begin talks on a possible pandemic treaty. The goal: to protect the world against future health emergencies. An Intergovernmental Negotiating Body (INO) was created to draft the treaty and held its fifth meeting in April. The ISO is working from a “zero version”External link with an end of negotiations scheduled for May 2024.
“One of the most contentious, sensitive and important issues is whether governments can make a deal and say that in return for a commitment to share data, there will be a commitment to share data. vaccines, drugs and diagnostics,” says Suerie Moon. For the moment, there is no agreement, the governments have not agreed on this point.
When it comes to data sharing, she says governments also need to agree on platforms and rules. GISAID, which holds the largest amount of scientific data on Covid-19, is a private platform. This creates a “huge vulnerability”, she believes. Governments also need to make public platforms such as INSDC more attractive to scientists by better protecting their intellectual property rights.
According to Suerie Moon, there are currently many hurdles, including with respect to the definition of a pandemic, intellectual property rules, funding and compliance provisions. The issue of data sharing in exchange for access to vaccines and medicines is at the heart of the problem, she believes. And if the debate on this issue reflects the same divide between the countries of the North and those of the South that has been observed during the pandemic, Suerie Moon hopes that emerging middle-income countries such as China, India, Brazil and South Africa, which has an interest in both cases, can serve as a “gateway” to a compromise.
Civil society on the sidelines
Meanwhile, civil society groups say they are not sufficiently involved in the talks. “This is a major concern, which got worse as we entered the drafting phase,” laments Courtenay Howe, of STOPAID and the Civil Society Alliance for Human Rights in the Pandemic Treaty (CSA).
Civil society has been pushing for more inclusion from the start, and there has been some progress with open hearings and sessions available online, acknowledges Courtenay Howe. But only NGOs with official relations with the WHO (“a long process”) or nominated by member states were allowed to participate. “We are very concerned, because now that the text has passed to the drafting group (February 2023), there are only Member States left,” she adds.
“If we look at past responses to Covid-19 and other health emergencies, we find that these are not always based on human rights and that access to medical treatment is unequal” , she says.
Accountable
Courtenay Howe believes that civil society must be more involved in the drafting phases, but also in the follow-up phase. She stresses that even if we arrive at a legally binding text, the Member States will have to show the political will to apply it.
“What we call treaty compliance and implementation is of great importance because all of these commitments can be just words on a page if you don’t have an effective accountability mechanism in place” , recognizes Suerie Moon of the Global Health Center.
So what happens if binding commitments on data sharing and health service funding are made, but governments don’t follow through? Suerie Moon replies: “If the British government says, ‘yes, we signed this treaty, but we have no money to invest in the national health service’, can it be forced to act differently? No. But there is evidence that follow-up, regular conferences where governments peer review, snitch and snub can help. There are many small tools that can, over time, encourage countries to do what they promised to do”.
Text translated from English by Dorian Burkhalter
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