The COVID-19 pandemic has created enormous challenges for national economies, livelihoods, and public services, including health systems. In January 2021, the World Health Organization proposed an international treaty on pandemics to strengthen the political commitment towards global pandemic preparedness, control, and response. The plan is to present a draft treaty to the World Health Assembly in May 2021. To inform the design of a support system for this treaty, we explored existing

more »

... for periodic reviews conducted either by peers or an external group as well as mechanisms for in-country investigations, conducted with or without country consent. Based on our review, we summarized key design principles requisite for review and investigation mechanisms and explain how these could be applied to pandemics preparedness, control, and response in global health. While there is no single global mechanism that could serve as a model in its own right, there is potential to combine aspects of existing mechanisms. A Universal Periodic Review design based on the model of human rights treaties with independent experts as the authorized monitoring body, if made obligatory, could support compliance with a new pandemic treaty. In terms of on-site investigations, the model by the Committee on Prevention of Torture could lend itself to treaty monitoring and outbreak investigations on short notice or unannounced. These mechanisms need to be put in place in accordance with several core interlinked design principles: compliance; accountability; independence; transparency and data sharing; speed; emphasis on capabilities; and incentives. The World Health Organization can incentivize and complement these efforts. It has an essential role in providing countries with technical support and tools to strengthen emergency preparedness and response capacities, including technical support for creating surveillance structures, integrating non-traditional data sources, creating data governance and data sharing standards, and conducting regular monitoring and assessment of preparedness and response capacities.