Understanding the Proposals on Pandemics: An Orthodox Public Health Standpoint

Questioning the Urgency of the Pandemic Agreement

There has been a significant amount of discussion regarding the current proposals that place the World Health Organization (WHO) at the forefront of future pandemic responses. The Pandemic Agreement and International Health Regulations (IHR) amendments have been promoted based on claims of a rapidly increasing risk of pandemics. However, recent analysis from the UK's University of Leeds suggests that the increase in reported natural outbreaks, which the WHO, the World Bank, G20, and others have based their claims on, is unfounded. The GIDEON database, the primary source for most outbreak analyses, shows a decrease in natural outbreaks and resultant mortality over the past 10 to 15 years.

Assessing the Real Risk of Future Outbreaks

Despite growing evidence suggesting that Covid-19 was not a natural phenomenon, the World Bank's modelling predicts that a Covid-like event will recur less than once per century. This contradicts the World Bank's claims of a threefold increase in outbreaks over the next decade. Diseases that the WHO uses to suggest an increase in outbreaks over the past 20 years, including cholera, plague, yellow fever, and influenza variants, were significantly worse in past centuries.

Challenging the WHO's Approach

It is perplexing that the WHO is bypassing its own legal requirements to expedite a vote without Member States having sufficient time to properly review the implications of the proposals. The urgency appears to be driven by reasons other than public health need. Furthermore, the burden of acute outbreaks is a fraction of the overall disease burden and is far lower than many endemic infectious diseases such as malaria, HIV, and tuberculosis, and a rising burden of non-communicable disease.

Examining the Evidence Base and Centralization

Investment in public health requires evidence that the investment will improve outcomes and will not cause significant harm. The WHO has not demonstrated either with their proposed interventions. Moreover, the response to Covid-19, which predominantly affects elderly sick people, led to 15 million excess deaths and even increased mortality in young adults. The WHO's approach of centralizing the response to a problem that is highly heterogeneous is also questionable.

Addressing the Absence of Prevention Strategies

The WHO's proposed amendments and Pandemic Agreement focus on detection, lockdowns, and mass vaccination, but overlook prevention strategies through host resilience. Improvements in sanitation, nutrition, antibiotics, and housing have halted the great scourges of the past. Investing in nutrition and sanitation could dramatically reduce mortality from occasional outbreaks, more common infectious diseases, and metabolic diseases such as diabetes and obesity.

Recognizing Conflicts of Interest

The WHO's approach has changed significantly since its formation. With 80% of its use of funds specified directly by the funder, its approach is now different. This raises concerns about conflicts of interest, as the WHO now works with its private and corporate sponsors to shape the world to their liking.

Conclusion: A Critical Decision for Member States

While it is prudent to prepare for outbreaks and pandemics, it is even more important to improve health by directing resources to where the problems are and using them in a way that does more good than harm. The new pandemic proposals appear to be more of a business strategy than a public health strategy. The key question is whether the majority of the Member States of the World Health Assembly will choose to promote a lucrative but potentially unethical business strategy, or the interests of their people.

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