Riflessioni sull’equità sanitaria nel diritto internazionale nella prospettiva dei negoziati per il Pandemic Agreement

Many States and international organizations recognize that universal access to both essential healthcare services and drugs contributes to the effectivity of the right to health. Availability, affordability and equity are required to ensure such a universalism. Lack of universal access was considered typical of developing countries, especially of least-developed ones, until the Covid-19 pandemic. This can be inferred, in particular, from the amendment to Art. 31 (f) of the TRIPs Agreement in 2003 and from the international actions towards ‘universal health coverage’ that have been carried out since the beginning of this century. The Covid-19 pandemic has shown that economic advanced States can also experience difficulties, under this perspective. Collective actions have been necessary to pursue health equity and universalism during and in the aftermath of the Covid-19 pandemic, due to the employment of high technology intensive pharmaceutical innovation for the control of its spread. Specific international rules have become desirable to ensure health equity and universalism, in light of the Covid-19 experience. The ongoing negotiations for a ‘Pandemic Agreement’ – coordinated by the World Health Organization and aimed at pandemic preparedness, response and prevention by States – have been launched for this objective. This article assesses the relevant provisions on equity in the draft texts of the ‘Pandemic Agreement’ in context, by focusing on what lessons have been learned from the past and how such an ‘Agreement’ could overcome, in relation to health protection, diversification typical of international law.