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Correspondence to Dr Thomas R Frieden; tfrieden@ gmail. com © Author(s) (or their employer(s)) 2021. Reuse permitted under CC BYNC. No commercial reuse. See rights and permissions. Published by BMJ. INTRODUCTION As the world continues to grapple with the COVID-19 pandemic, it is clear that countries were not as prepared as they needed to be and did not consistently respond as mandated by the international health regulations (IHR). 2 To address these shortcomings, there is now a global push for a new health treaty on preparedness and response that would supplement and strengthen the IHR. 4 Although this effort has the potential to improve preparedness if structured effectively, discussions must address potential pitfalls and be designed carefully to parallel rather than replace the necessary efforts to strengthen preparedness now. Otherwise, focus on a treaty could do more harm than good. The concept of a new treaty is attractive— WHO DirectorGeneral Tedros Adhanom Ghebreyesus has called it a ‘very good idea’—but has substantial risks. The treaty process is slow, and takes time that we simply do not have to strengthen global pandemic response capacity. The focus on developing a treaty could derail momentum for action on the ground to improve preparedness now. Wordsmithing, and interpretation of that wordsmithing, can supplant action. One treaty model being pointed to is the framework convention on tobacco control (FCTC), the world’s first treaty on public health. The FCTC took 8 years to negotiate, another 3 years to ratify and many more years to agree on protocols for the different components. The FCTC’s first protocol, on illicit trade, was adopted and then entered into force 7 and 13 years after the FCTC itself came into effect. Additionally, the FCTC had little practical impact until it was paired with an implementation strategy—the MPOWER tobacco control technical package—which was not developed until 3 years after the FCTC entered into force. The FCTC along with the MPOWER technical package have been a useful combination. Since MPOWER was introduced, global adult smoking prevalence has declined nearly 15% (from 22.5% to 19.2%) and most countries have implemented at least one strong tobacco control policy. This was largely due to the robust evidence base and existing resources for tobacco control, which has led to slow but steady progress in reducing tobacco use worldwide. By agreeing to spearhead a request by some member states to begin the groundwork for negotiating a binding treaty on health security, WHO will ultimately put the ball back in the court of countries, many of which did not comply with the existing IHR during the COVID-19 pandemic. Proponents of a treaty argue that, given the magnitude, scope and scale of global disruption caused by pandemics, a strong, bold Summary box