Youth versus pandemics: the role of future generations in the pandemic treaty
Authors: Iris Martine Blom, Letícia Nunes Campos, Mohamed El Amine Youcef Ali, Muhammad Mikail Athif Zhafir Asyura, Daniel Zeymer von Metnitz, Bernice Limann, Eglė Janušonytė
Journal: The Lancet Global Health (2021)

The 74th World Health Assembly (WHA)—the highest-level decision-making event on global health—opened on May 24, 2021, and a new pandemic treaty set up by the EU and its 27 member states was introduced. The aim of the treaty is to strengthen and coordinate WHO preparedness and response to health emergencies.1Nikogosian H Kickbusch I The case for an international pandemic treaty.BMJ. 2021; 372: n527Crossref PubMed Scopus (6) Google Scholar, 2Vinuales J Moon S Le Moli G Burci G-L A global pandemic treaty should aim for deep prevention.Lancet. 2021; 397: 1791-1792Summary Full Text Full Text PDF PubMed Scopus (6) Google Scholar If adopted, a WHO convention will be developed, starting in November 2021, after a special session of the WHA.3WHOStrengthening WHO preparedness for and response to health emergencies.https://apps.who.int/gb/ebwha/pdf_files/WHA74/A74_ACONF2-en.pdfDate: May 25, 2021Date accessed: May 27, 2021Google Scholar The draft decision follows the Global Health Summit that took place on May 21, 2021, and which brought together leaders of the G20. The treaty is intended to address the shortcomings of the existing International Health Regulations, which the current pandemic has exposed, and includes creating a mechanism by which the WHO can coordinate a stronger emergency response, through enforcing international rules with incentives and penalties.4Duff JH Liu A Saavedra J et al.A global public health convention for the 21st century.Lancet Public Health. 2021; 6: e428-e433Summary Full Text Full Text PDF PubMed Scopus (11) Google Scholar The pandemic treaty highlights that member states are primarily responsible for planning action. To enable this process, the treaty equally emphasises the need for member state partnership at the whole-of-government and whole-of-society level.3WHOStrengthening WHO preparedness for and response to health emergencies.https://apps.who.int/gb/ebwha/pdf_files/WHA74/A74_ACONF2-en.pdfDate: May 25, 2021Date accessed: May 27, 2021Google Scholar As medical students and youth delegates to the WHA, from the International Federation of Medical Students Associations (the largest and oldest youth-led organisation in official relations with the WHO), we welcome this intent. However, the intended cooperation currently seems unlikely when looking at how this treaty has been developed by member states. By systematically failing to consult youth and wider civil society, member states have neglected opportunities to consider crucial perspectives from these groups. Additionally, the continuing dearth of participation from non-state actors, and the scarce few mentions of youth during member states' interventions at the WHA, shows a disregard for acknowledging civil society contributions to the pandemic preparedness and response, as well as a disregard toward strengthening health system resilience. This conduct contradicts the treaty that mandates a multisectoral and multi-actor approach.3WHOStrengthening WHO preparedness for and response to health emergencies.https://apps.who.int/gb/ebwha/pdf_files/WHA74/A74_ACONF2-en.pdfDate: May 25, 2021Date accessed: May 27, 2021Google Scholar One must question whether the mandated cooperation and frequently mentioned global solidarity from member states will apply to all generations if youth voices are left out of WHA discussions. Moreover, it is explicit in the proposed treaty that leadership and appreciation towards health-care personnel are vital points to rationalise strategies.3WHOStrengthening WHO preparedness for and response to health emergencies.https://apps.who.int/gb/ebwha/pdf_files/WHA74/A74_ACONF2-en.pdfDate: May 25, 2021Date accessed: May 27, 2021Google Scholar This importance is further underlined by WHO, who announced 2021 to be the year of the health and care worker.5WHOYear of health and care workers.https://www.who.int/campaigns/annual-theme/year-of-health-and-care-workers-2021Date: 2021Date accessed: May 27, 2021Google Scholar However, true appreciation should be illustrated by improving working conditions and engaging future and current health and care workers meaningfully in the creation and implementation of pandemic preparedness and response policies. Promoting appropriate health emergency preparedness and strengthening health systems must be a long-term commitment concerning all generations. Thus, it is crucial to apply an intergenerational lens in the analysis, planning, and execution of strategies in collaboration with youth stakeholders, in addition to considerable investments for better economic, social, and environmental objectives, to ensure the health and wellbeing of future generations.6Youth.govGoogle ScholarYouth Roles.https://youth.gov/youth-topics/youth-disaster-preparedness-and-response/youth-rolesDate accessed: May 27, 2021Google Scholar Therefore, we propose five key recommendations for policymakers to harness the potential of 1·8 billion young people around the world. First, include a young person in the design, implementation, and evaluation of every COVID-19-related research and policy project, including all next steps of the pandemic treaty. Second, measure and acknowledge youth contributions towards ending the pandemic and check what concrete solutions you can offer to support these measures. Third, understand the existing pandemic preparedness education gaps in medical schools and fill these together. Fourth, support youth awareness initiatives based on digital solutions and provide funding to help broaden their impact. Fifth, endorse young people as key stakeholders in combating misinformation, including vaccine hesitancy, by spreading awareness in their communities and online. In conclusion, leaving no one behind should be an action to be sustained, rather than a mere catchphrase. The year of the health and care worker should be the year in which WHO and member states implement sustainable solutions for all future health and care workers, rather than solely focusing on the current generation. After witnessing a chronic shortage of meaningful youth engagement in global health decision making, we strongly call on member states and WHO to engage young people in all proceedings of this treaty to ensure a safer world today and tomorrow. We, youth, are ready and willing to be a part of the successful design and implementation on every level of the WHO convention following the treaty, but change can only be achieved if member states and the WHO are on board with us. We declare no competing interests. The research was authorised and approved by the International Federation of Medical Students' Associations (IFMSA) Executive Board, and we acknowledge the IFMSA for facilitating the opportunity to be present at the World Health Assembly, as well as supporting the development of this Comment. Furthermore, we acknowledge Catherine Dominic for her selfless contribution to the phrasing of the manuscript.