The world will have to wait another year for final Pandemic Agreement

Waiting for arrivals at Suvarnabhumi Airport, Thailand, during the Covid-19 pandemic, February 2022. Rungroj Yongrit / Keystone

In early May, the World Health Organization said it needed one more year to finalise the implementation of its Pandemic Agreement. The delay comes as the Geneva-based body coordinates a response to the hantavirus outbreak.

When WHO member states adopted the Pandemic Agreement at the World Health Assembly (WHA) in May last year, it was hailed as a success for multilateralism.

The agreement includes provisions on pandemic prevention, preparedness and response. It is intended to improve global coordination, surveillance, and access to vaccines and other health products.

What is still missing for the treaty to enter into force is an agreement among WHO member states on how to define the rules governing access to pathogenic organisms and the sharing of benefits derived from them.

No agreement will be reached at the next WHA, which will be held in Geneva from May 18 to 23.

WHO member states are instead calling on the WHA to extend negotiations on the so‑called Pathogen Access and Benefit‑Sharing (PABS) system by one year, with the goal of adopting it in May 2027.

“It was a very ambitious goal to try to conclude these highly complex negotiations within a year,” said Ricardo Matute, a global health policy adviser at the International Peace Institute and former Chilean health attaché, who is following the talks.

One of the main reasons delaying a final agreement is the need to consult experts on many technical issues, Matute told Swissinfo.

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The ‘final piece of the puzzle’

The Pandemic Agreement was prompted by Covid‑19, which is to date estimated to have claimed some 15 million lives and exposed stark inequalities in access to vaccines worldwide. While wealthy countries hoarded doses, poorer countries – particularly in the Global South – waited months to receive them.

However, the “final piece of the puzzle”, as WHO Director‑General Tedros Adhanom Ghebreyesus has put it, is still missing.

The core element of the treaty – the PABS system – was left out last year after states failed to reach an agreement. The issue was instead summarised in an annex, with the aim of reaching consensus by the 2026 WHA.

The PABS annex covers pathogens with the potential to cause pandemics, their genetic sequences, and the distribution of medical products – including vaccines, therapeutics and diagnostic tools – manufactured using these pathogens, as well as the financial benefits derived from them. These benefits include research and development, know‑how and technology transfer.

During the latest negotiations held at the WHO in late April, several informal meetings took place between the European Union and African countries, helping to narrow differences. “The negotiations are heading in the right direction,” Matute said.

The aim of the PABS annex is to establish a binding framework linking the exchange of information on pathogens with benefit‑sharing, as already set out in the Pandemic Agreement.

Once the PABS annex is adopted, the next steps will be the signature and ratification of the treaty.

The agreement will enter into force once 60 states have ratified it. With the extension of the PABS negotiations, this process is expected to take several years longer than initially anticipated.

“A delayed outcome can be justified if it is convincing,” said Olena Zarytska, an advocacy advisor at Doctors Without Borders (MSF), who is following the PABS negotiations in Geneva.

Tedros Adhanom Ghebreyesus speaks about the pandemic treaty during the 78th World Health Assembly in Geneva, May 20, 2025. Keystone / Magali Girardin

Not a question of ‘if’, but of ‘when’

At the conclusion of the week‑long negotiations on May 1, Tedros urged negotiators to address the remaining issues with a sense of urgency. “The next pandemic is not a question of ‘if’, but of ‘when’,” he said.

“The hantavirus outbreak linked to the MV Hondius vessel is a reminder of the urgency and importance of implementing international protocols and regulations for disease prevention, preparedness and response,” said Ellen Johnson Sirleaf, former president of Liberia, and Helen Clark, former prime minister of New Zealand, co‑chairs of the Independent Panel for Pandemic Preparedness and Response, in a statement on May 11.

The WHO said the hantavirus does not have the potential to become a pandemic.

Sirleaf and Clark called on governments to ensure a more robust multilateral framework for addressing disease outbreaks by successfully negotiating the PABS annex and then ratifying and fully implementing the new Pandemic Agreement.

Currently, countries send pathogens with pandemic potential and their genetic sequences to WHO‑coordinated laboratories. Pharmaceutical companies then use these pathogens to manufacture medicines, creating a system that results in unequal access to treatment.

Under Article 12 of the Pandemic Agreement, participating pharmaceutical companies are required to make up to 20% of their production of vaccines, tests and medicines available to the WHO for redistribution. At least half of this must be provided as a donation, with the remainder made available “at affordable prices”.

However, the precise terms and conditions still need to be set out in the PABS annex, as do benefit‑sharing obligations arising from access to pathogens, health data and tools outside of pandemics.

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Voluntary or mandatory measures?

The main reason for the delay lies in differences between industrialised and developing countries. The dispute centres on the extent to which countries that share information on pathogens should benefit from resulting products, including vaccines, therapeutics and diagnostics (VTDs).

The Group for Equity and Africa, which represents the vast majority of WHO member states, is calling for binding rules. It argues that the terms should be set out in standard contracts between the WHO and pharmaceutical companies. The group criticises what it sees as industrialised countries prioritising the interests of their pharmaceutical industries over preparedness for future pandemics.

“Developing countries want assurances that access to pathogens will be linked to benefit‑sharing that serves the common good,” Zarytska said.

Several European countries, particularly those with strong pharmaceutical industries, argue that mandatory profit‑sharing would hinder research and development.

Access to databases

According to Matute, one of the main points of contention is whether companies and researchers should be granted open access to databases containing pathogens and genetic sequences, or whether access should be conditional on registration in the PABS system.

Developing countries want a system that registers and tracks users of the PABS database. But industrialised countries – including EU member states, Switzerland and Norway – want to retain the possibility of anonymous access.

Anonymous access would make it impossible to track who is using pathogen data and whether the resulting benefits are being shared, 100 NGOs, including Oxfam and Medicus Mundi International, said in a letter to the WHO.

“In practice, this means that genetic resources from developing countries can be used, marketed and exploited with complete impunity,” the letter said.

Voluntary or compulsory licences

In the event of a pandemic, medical products must be manufactured quickly. Licences are therefore needed to allow more manufacturers, particularly in developing countries, to take part in production. The Pandemic Agreement stipulates that technology transfer should be promoted to this end.

Whether such licensing should be voluntary or mandatory remains under discussion. According to MSF, production licences must be mandatory. “Voluntary measures have not worked, either during the Covid‑19 pandemic or during Ebola outbreaks in African countries,” Zarytska told Swissinfo.

Edited by Virginie Mangin/dos