OMICRON SPURS PANDEMIC TREATY URGENCY — The panic Omicron sparked was felt in Geneva, where health officials from around the world met this week and decided to start negotiating an agreement to prevent, prepare for and respond to pandemics.

World Health Organization Director-General Tedros Adhanom Ghebreyesus hailed the move as historic. And the agreement, to be signed in May 2024, would likely cover four major issues: governance and leadership, money for preparedness, global systems and tools that can be activated during health crises and equitable access to goods.

But countries disagree whether the agreement should be a legally binding treaty. Some want the legal form decided before the content, while others want the content negotiated before the legal form, said Jaouad Mahjour, WHO assistant director-general on emergency preparedness.

The U.S. seems to be in the latter camp. Once negotiations get into the substance, the U.S. will get a clearer understanding about what it would be held accountable to, Loyce Pace, assistant secretary for Global Affairs at the Department of Health and Human Services, said Wednesday.

And as we look at several years of negotiations, a fundamental question remains: After nearly two years of Covid-19, can the world come together to make a difference despite its geopolitical fractures?

Here’s where some health officials and global health experts land:

Xavier Becerra, U.S. Secretary of Health and Human Services: “It’s one of those ‘failure is not an option’ type of situations. … I think everybody around the world, certainly those in leadership, understand that, if we don’t do something real, we’re gonna pay the price.”

Jennifer Kates, Senior Vice President and Director of Global Health & HIV Policy at the Kaiser Family Foundation: “It’s going to take a while to negotiate to get it done, and it’s not clear it will make a huge difference … Holding out hope that a newly negotiated treaty is going to solve all the problems that we’ve been through is probably placing way too much emphasis on its ability.”

David P. Fidler, Senior Fellow for Global Health and Cybersecurity: Treaty supporters didn’t explain how it would “increase the political commitment of states to global health governance in a world riven by geopolitics, ideological competition, nationalism, and populism,” he writes for Think Global Health. A better response is partnerships among countries, international organizations and nongovernmental actors working together on global health projects.

Charles B. Holmes, the director of the Georgetown Center for Innovation in Global Health and former chief medical officer in the State Department during the Obama-Biden administration: “It’s important that these negotiations are starting and that we’re working toward something. That’s a much better prospect than each going our own way.”

WELCOME BACK TO GLOBAL PULSE, where we’re looking for someone great to temporarily write Global Pulse in the first part of next year as your host goes on maternity leave. Reach out with questions or suggestions.

Global Pulse is a team effort. Thanks to my colleague David Lim and editors Eli Reyes and Barbara Van Tine. Follow me on Twitter: @carmenpaun. Send tips and ideas to [email protected].

WHEN VACCINES DROP FROM ABOVE — The emergence of the Omicron variant adds new importance to distributing vaccine doses in developing countries, and a drone service in Ghana shows how shots can be delivered to hard-to-reach places.

There, vaccines are literally falling from the sky.

Drones have delivered more than 300,000 Covid vaccine doses: That includes getting 80,000 Pfizer-BioNTech shots to the West African nation. The service is provided by Zipline, a drone company that has delivered vaccines, blood bags and other medical supplies in Rwanda and Ghana for five years.

The drone delivery helps solve three obstacles that make Covid immunization harder in parts of the world: the lack of ultra-cold freezers for mRNA vaccines; poor transport infrastructure and wasted doses when they go unused within a few hours.

No cold feet: Zipline’s freezers can store up to 1 million shots at -130 to -76 degrees F, Daniel Marfo, the company’s senior vice president for Africa, told Global Pulse. The vaccines sent to health facilities are thawed to fridge temperatures of 35.6 to 46.4 degrees F before being loaded onto drones. The aircraft drops the water-resistant vaccine packages by parachute from about 32 feet.

“So our protocol with [health facilities] is: ‘How many people do you expect to vaccinate within the next three hours?’ ” Marfo said. Zipline workers calculate how many vaccines are needed and send them. The drones can fly 62 miles one way, which can take up to an hour, he said.

Zipline has also delivered AstraZeneca and Sputnik V shots since vaccinations started in Ghana, the first country to receive doses from the global vaccine equity effort COVAX in February. But a lack of shots led to only 2.6 percent of its 31 million people being fully vaccinated.

How it works: Zipline creates maps approved by aviation authorities, which drones are programmed to follow. Drones can fly through bad weather, and in the rainy season, they become crucial because many roads flood, Marfo said. If they need to be diverted, drones send a signal with their location, he said.

“When we want vaccines from Zipline, we send a request through WhatsApp or we just call them,” said Kojo Boateng, who’s in charge of vaccines in the Ejura District.

People in health facilities are trained to use the system and can see when a drone is dispatched, Boateng said. However, he would like to see districts use tablets from Zipline to order vaccines instead of people using their own mobile phones.

Health facilities don’t pay for deliveries: Ghana’s government has a four-year, $12.5 million deal with Zipline, which covers 600 deliveries a day.

Zipline is expected to expand into Nigeria next year. Other countries have reached out to the company for vaccine deliveries. Some have rugged terrains and tried “everything,” but it’s not working, Marfo said.

THE YEAR OF THE VARIANTS — The year is ending just like it started: with travel bans on countries where new Covid variants have been found and vaccines that have held up well against virus mutations but haven’t been distributed equitably around the world. Add persistent hesitation against Covid shots to that mix.

Now, as we wait to learn more about the Omicron variant, southern African countries hit with travel bans are protesting the restrictions, saying they’re unfair and punish them for being transparent.

Travel restrictions aren’t the best response: If nations are serious about them, they must be part of a larger strategy that includes testing and quarantining to slow down spread, experts told Global Insider author Ryan Heath and me. It looks like the White House is taking note, with President Joe Biden expected to roll out today stricter testing rules for travelers coming to the U.S.

Genomic sequencing still lagging: Tracking virus evolution and spread have been priorities for many countries since the pandemic started, but most nations are still sequencing less than 5 percent of their positive cases because they lack the capacity or the infrastructure to do it, Phil Febbo, the chief medical officer of DNA sequencing company Illumina, told POLITICO’s David Lim. Many countries are building laboratories for that, he said.

Fauci: What does ‘enough’ even mean: The emergence of Omicron has renewed recrimination of rich countries and the pharmaceutical industry for their lack of global equitable vaccine distribution. Anthony Fauci, Biden’s chief medical adviser, told reporters Tuesday “enough is a very, very unusual word — compared to what?” He then repeated the administration line that the U.S. is doing more than any other country and has shipped 275 million vaccine doses to 110 countries.

“One of the frustrating aspects of this is that the logistic capability of getting vaccines into people’s arms in Southern African countries and in other low- and middle-income countries is really very difficult,” he said.

A day earlier, groups working on global vaccine distribution laid some blame at the feet of rich countries, which they asked to donate doses with longer shelf lives, give longer advance notices for shipments and send more vaccination supplies.

And then there’s vaccine hesitancy: The U.S. and Pfizer responded, saying that supplies are now plentiful in South Africa, but the demand is lacking. The issue is more complicated than that and includes access issues, fragile health care systems and the difficulty of ensuring the Pfizer-BioNTech vaccine remains ultracold, The Washington Post reports.

Slightly more than a third of South Africa’s nearly 60 million people are fully vaccinated, leading President Cyril Ramaphosa to float vaccine mandates to increase the rate. But the country started vaccinating in March, four months after rich countries. And while some people are bypassing the shots over concerns about side effects, others don’t have the means to make it to vaccination centers, The New Humanitarian writes.

Global health activists push back: Hesitancy as a reason for low inoculation rates, they say, isn’t being used to say that rich countries, also facing hesitancy, don’t deserve vaccines. “But somehow it’s acceptable to do that on the African continent,” Zain Rizvi, research director at Public Citizen, told The Washington Post.

CHINA PLEDGES MORE VACCINES — Chinese President Xi Jinping said Monday his country will deliver 1 billion doses more of its vaccines to Africa, but the timeline is unclear. More than half, 600 million, will be donations; the rest will be provided through other means, he said.

So far, China has donated about 15.5 million doses to African nations, according to UNICEF data.

Omicron could have been Nu or Xi: Meanwhile, conservatives in the U.S. seized on the WHO naming of the new variant to warn that the global health body can’t be trusted when it comes to China. To avoid confusion or stigmatization, the WHO skipped the Nu and Xi letters from the Greek alphabet and settled on Omicron. If you’re interested in what Texas Republican Sen. Ted Cruz said about it, check out POLITICO’s Nightly.

AMERICA IN THE DRIVER’S SEAT ON HIV FUNDRAISING — As he touted the U.S.’s role in fighting HIV/AIDS at home and abroad and laid out some remaining work, President Joe Biden said Wednesday his administration looks forward to hosting the 2022 replenishment conference for The Global Fund to Fight AIDS, Tuberculosis and Malaria. In other words, the U.S. will rally the world to contribute billions of dollars to fight the diseases through an organization it helped found and for which it remains the biggest donor.

The conference is slated for late September or early October 2022, executive director Peter Sands told Global Pulse hours before heading to a White House World AIDS Day event. Experts are trying to determine by early next year how much money is needed over the next three years, he said.

Sands expects the target to be higher than the $14 billion the Fund raised in 2019 when France led the effort. The replenishment would help link funding to fight the old pandemics of HIV, tuberculosis and malaria; battle the current Covid-19 pandemic; and invest in protection against future pandemics. The bottom-line for Sands: Protect the world’s poorest and most vulnerable against the most formidable infectious diseases.

Al Jazeera: South Korea accused of discriminating against its foreign residents on vaccine recognition.

Financial Times: The inside story of the Pfizer vaccine: “a once-in-an-epoch windfall.”

POLITICO: How Trump’s ‘America First’ edict delayed the global Covid fight.