Implementation of the New Pandemic Treaty: The Last Mile Will Be Critical

On 17 June, the Global Cities Hub, in partnership with UN-Habitat and the Global Parliament of Mayors co-organized a Geneva Urban Debate, focused on the newly adopted pandemic treaty and its implications for local and regional governments. With cities having been the epicentres of the COVID-19 pandemic, the discussion explored how urban authorities can leverage this global instrument to better prepare for future health crises.

Urban Realities during Pandemics

Cities were central to the COVID-19 story as over 90% of reported cases occurred in urban settings. Their size, density, and connectivity made them particularly susceptible to the spread of the virus. At the same time, local and regional governments (LRGs) played an essential role in managing the crisis, leading efforts to respond, recover, and rebuild. Their importance will only grow when the next pandemic arrives, despite varying responsibilities across national contexts.

Opening the event, Graham Alabaster, Head of UN-Habitat’s Geneva office, underscored the importance of equitable and well-designed urban environments to prevent and contain disease. Equity is a central goal and principle of the new pandemic treaty and he emphasized that addressing vulnerabilities in low-income urban areas is essential to protect entire populations. He also emphasized the importance of collecting disaggregated local data – something only LRGs can do effectively.

Although many States were eager to reaffirm their sovereignty during the treaty negotiations and in the treaty itself, the final text still offers opportunities to strengthen the role of LRGs in pandemic prevention, preparedness, and response and work closely with them to gather local data, reinforce local infrastructure and design urban space in a way that minimizes equities and reduce the risk of pandemics.

The Pandemic Treaty: Origins and Aims

Priti Patnaik, journalist and founder of the Geneva Health Files, outlined the political context that led to the development of the treaty. Frustration with the limitations of the International Health Regulations (IHR) during COVID-19 created momentum for a new legally binding instrument. Spearheaded by the European Union and supported by countries such as Chile, the initiative gradually gained broader support.

Equity, especially for low- and middle-income countries, is at the core of the treaty. This principle is reflected in commitments to establish a new Pathogen Access and Benefit-Sharing (PABS) system, enable technology transfer, scale up local production of pandemic related-health products, and ensure sustainable financing. Not surprisingly, both PABS and technology transfer were among the most debated issues during negotiations.

What’s in it for Local and Regional Governments

Initially, the draft text included references to several points advocated for by the GCH: the need to ensure equity within States, the vulnerability of urban settings, some references to the subnational level, and the need to think about Pandemic prevention, preparedness and response at all levels. Earlier versions even referred to the need to delegate authority during pandemics to local government in order to better respond to pandemics.

However, as negotiations progressed, many of these references were weakened or removed. Still, the final treaty text includes important provisions that LRGs can use to assert their role:

• Whole-of-government and whole-of-society approaches (Article 15): This provision encourages States to apply a whole-of-government/society approach to empower community-ownership and to establish national multisectoral coordination mechanisms, indirectly reinforcing the importance of LRGs as essential conduits between national governments and citizens.
• Pandemic prevention and One Health (Articles 4 and 5): These articles highlight the need for coordinated multi-sectoral surveillance and risk mitigation, both areas where local knowledge and infrastructure are crucial.
• Health systems and healthcare workforce strengthening (Articles 6 and 7): States are called upon to reinforce healthcare systems and capacities and to promote the use of social and behavioural sciences, risk communication and community engagement, all of which require engagement with LRGs.
• Communication and public awareness (Article 16): The treaty recognizes the need to strengthen pandemic literacy, as well as trust in science and public health institutions through community level engagement – something only LRGs can effectively implement.
• Reports to the Conference of Parties (Article 21): While reporting on the implementation of the treaty will be the responsibility of national governments, LRGs should be able to contribute with valuable data and insights on ground-level implementation.

Key Recommendations for Local and Regional Governments

The debate concluded with practical guidance for LRGs:

1. Use Article 15 as an advocacy hook: Demand inclusion in national pandemic planning and implementation based on the whole-of-government approach referenced in the treaty.
2. Establish formal dialogue channels with your national governments: Engage proactively in national consultations on pandemic preparedness and response. Don’t wait until the next pandemic hits.
3. Push for access to international funding: Advocate for eligibility in instruments such as the Pandemic Fund administered by the World Bank, which may offer grants for pandemic prevention and preparedness infrastructure.
4. Provide inputs to national reports: Use Article 21 to contribute subnational data and best practices, helping shape accurate and inclusive national implementation reports.

What’s Next

The treaty will only enter into force once the annex on the PABS system is negotiated (it is expected to take up to two years) and after ratification by at least 60 countries. Meanwhile, cities should not wait. As Priti Patnaik emphasized, many of the treaty’s principles can and should be implemented now to build long-term urban resilience to future pandemics.

As global health governance moves forward, LRGs must not be seen solely as responders. Their proximity to communities, operational capacity, and ability to foster public trust make them essential strategic partners. Ensuring their active role from the outset will be vital to making the treaty meaningful where it matters most: at the last mile.

Watch the recording of the event

Photo by Martin Sanchez on Unsplash