Navigating time equity: Balancing urgency and inclusivity in pandemic treaty negotiations

Since the start of the COVID-19 pandemic, there have been a surge in calls for equity to protect the world from future crises.Calls have emphasized equitable distribution of vaccines, a fair access and benefit sharing (ABS) system, and health systems strengthening, all leading to negotiation of a Pandemic Treaty 1.Unlike previous global health agreements, the finalization of this treaty was expected within two years.Recently, the Director-General of the World Health Organization (WHO) intensified the urgency, stressing that 'time is very short' and countries should get on board to reach an agreement by May 2024 2.Upon first glance, this expedited timeline may seem justifiable.Researchers estimate that almost 16 million people died at the peak of the COVID-19 pandemic between 2021-2022, reversing a 70-year trend in declining mortality rates 3.Given the increased chances of another pandemic, there is a compelling argument for expediting the treaty-making process to facilitate faster and more equitable access to life-saving medications.In response, countries can capitalize on this momentum to swiftly adopt a much-needed global framework aimed at bolstering access to medical countermeasures and strengthening health systems to confront inevitable future pandemics 1.Nonetheless, this rapid pace prompts concerns about what we refer to as 'time equity'--the fair allocation of time and resources for deliberation and decision-making among all stakeholders.