Unions in India and Pakistan express concerns over health and care workers' protection in Pandemic Treaty

Public Services International (PSI) and unions representing public service workers in India and Pakistan, have raised serious concerns regarding the ongoing negotiations for the Pandemic Treaty being discussed in Geneva, Switzerland. They have issued an open letter to the Health Ministers and Foreign Ministers of the two countries, asking them to support provisions that guarantee decent work for health and care workers.

The governments of India and Pakistan not only failed to support several worker-friendly provisions, but also proposed deleting some of them from the draft treaty. This is detrimental to the interests of the health and care workers, their unions, and global networks’ efforts to secure decent working conditions for all health and care workers.

For the last two years, countries have been discussing an International Instrument on Pandemic Prevention, Preparedness and Response, informally called the Pandemic Treaty, at the World Health Organization (WHO). An Intergovernmental Negotiating Body (INB) was established to draft and negotiate the agreement. Over the course of negotiations, certain provisions were introduced that aimed at securing the interests of the health and care workers. While that showed some progress in the right direction, PSI and the unions continued to press for additional measures to ensure just and fair working conditions for all health and care workers. However, the draft text that was released by the WHO on 18 April, watered down many wins of the workers that assured critical protection.

We acknowledge India and Pakistan’s support for certain proposals during the negotiations. However, it is unfortunate, that some of these provisions, such as the one on social dialogue, were not supported by the two countries.

INB’s mandate is to finalise a text that will be adopted at the World Health Assembly (WHA) in May 2024. The last meeting of the INB before WHA is scheduled to start from 29 April and will be crucial to put back the language that supports workers’ rights in its entirety.

“We urge the governments of India and Pakistan to uphold the rights of workers in the Pandemic Treaty text. Decent working conditions are needed at all times, not just during pandemics. Strong health systems are necessary to prevent pandemics and put up a strong counter when it strikes. Health and care workers are at the heart of these systems and their rights must be protected,” said Kannan Raman, Sub-regional Secretary, South Asia, PSI.

PSI and the signatories to the letter demand inclusion of “decent work conditions” which was part of the previous texts, but has been removed since. The latest text no longer guarantees decent work conditions for health and care workers, which is critical for their safety and well-being, both during and outside pandemic situations.

Emphasising the significance of these provisions, Abdul Latif Nizamani, Chairperson, PSI National Coordinating Committee–Pakistan, said "Health and care workers were on the frontlines during the COVID-19 pandemic, often under intense pressure and challenging conditions. Removing protections from the Pandemic Treaty risks undermining the rights and well-being of these essential workers. We urge governments to reinstate these crucial clauses."

The letter also demands inclusion of the right to social dialogue, which would protect the right of health and care workers to actively participate in planning and decision-making in pandemic prevention and response. Its removal severely compromises workers' voices in shaping crucial health policies.

 A significant demand is the protection for migrant workers. India is the second-largest source of nurses working abroad. South Asia, in general, is one of the larger source areas for nurses to high-income countries. The latest treaty draft has watered down the provision on ensuring safe and ethical migration, potentially compromising the rights of migrant workers and the responsibility of destination countries to protect national health systems. This provision is crucial to protect the national health systems of the source countries, whose resources they are depleting.

Kuldeep Kumar, Chairperson, PSI National Coordinating Committee-India stressed the importance of social dialogue and said, “We need to ensure that health and care workers are involved in the policy-making process. It is a democratic right and vital to building a resilient health system." Highlighting the significance of safeguarding the rights of migrant workers, he added, “"Migrant health workers play a pivotal role globally. Protecting their rights is not just a matter of ethics; it's crucial for global health stability."

The representatives call on governments to support and reintroduce key provisions in the Pandemic Treaty to ensure the health and care workforce's interests are protected. This will ultimately contribute to a robust and strong national health systems that benefits all.

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