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.