WHO pandemic agreement | Increasing risk of epidemics, deadlocked negotiations

A new pandemic is not a question of if, but when - but negotiations over fair vaccine distribution are stuck. Photo: AFP/Punit Paranjpe For the eighth time, health diplomats met in Geneva for a week of negotiations to discuss the urgent and controversial appendix to the WHO pandemic agreement. By Friday, delegates to the Intergovernmental Working Group (IGWG) were seeking a compromise for the Pathogen Access and Benefit Sharing System (PABS). In the event of another pandemic, the rules are intended to ensure the rapid exchange of pathogen data and the fair distribution of vaccines, diagnostics and medication.

If the negotiations on the PABS annex, which should be completed by May next year at the latest, the consequences would be dramatic. “If an agreement is not achieved, the entry into force of the entire pandemic treaty will be at stake,” warned Melissa Scharwey, global health officer at the aid organization Doctors Without Borders (MSF), in a statement to “nd”. Because the overarching agreement would then not be released for ratification. In the next global health crisis, humanity would once again be left without enforceable rules - and resource-poor countries would again be left empty-handed when it came to life-saving vaccines, criticizes MSF.

"If an agreement cannot be reached, the entry into force of the entire pandemic treaty will be at stake."

A new pandemic is not a question of if, but of when - experts agree on that. The current pandemic preparedness report from the Organization for Economic Co-operation and Development (OECD) estimates the probability of an epidemic on the scale of Covid-19 to be 50 percent within the next 25 years. The International Monitoring Board for Pandemic Preparedness (GPMB) also warns in its current annual report of rapidly increasing risks from climate change, deforestation, global mobility and dwindling trust in state institutions and multilateral cooperation.

An agreement in Geneva is urgently needed, but the fronts remain hardened, as EU diplomat Americo Beviglia Zampetti emphasized in the run-up to the Geneva round of negotiations. Such assessments rarely reach the outside world because the negotiations are conducted behind closed doors.

At the center of the dispute are two opposing concepts. The states of the Global South – led by the Africa Group – are demanding a federated model. This means that pathogen data remains in regional centers under state control and access is regulated via decentralized queries. Standardized, legally binding contracts should immediately link every data access by pharmaceutical companies or research institutions to fixed consideration, financial contributions and technology transfer. In addition, states in the Global South require regulations on intellectual property rights so that corporations cannot circumvent the sharing of benefits through patents on downstream inventions.

The aid organization MSF puts it similarly, calling for binding rules to avoid repeating the mistakes of the Covid-19 pandemic. Access to pathogens, materials and data must be based on pre-established, global and enforceable agreements. In addition, mandatory, non-exclusive licenses to the WHO are necessary to break up patent monopolies and enable decentralized technology transfer, as well as complete contract transparency against secret agreements and fixed allocations for humanitarian emergencies. This is the only way to avoid global injustice, the organization emphasizes. “Teams from Doctors Without Borders have been observing the same bitter reality for decades: patients and communities in resource-poor contexts who contribute to life-saving innovations with important samples are all too often left behind,” criticizes health expert Scharwey.

However, the European Union considers such far-reaching demands to be unreasonable and fundamentally rejects rigidly agreed advance contracts and direct financial contributions to the WHO. Instead, she proposes a hybrid model that allows more open access routes via existing databases. Accordingly, in an emergency, manufacturers should only conclude private contracts with the WHO for free donations in kind of at least ten percent of their emergency production. In addition, regulations on intellectual property rights should be completely excluded from the PABS Annex. It is therefore close to the positions of the pharmaceutical umbrella association IFPMA, which warns of bureaucratic hurdles and delays in emergency research if contractual obligations are required as a prerequisite for data access.

Despite the polarized positions, observers are cautiously optimistic that an agreement can be reached by the new negotiation deadline in May 2027. At least in terms of the technical framework, results have been achieved since negotiations began in July 2025. Both negotiating camps accept a laboratory network coordinated by the WHO as well as permanent digital identification numbers in order to seamlessly track samples and genomic data. The integration of WHO-recognized databases is no longer in question.

But on the question of benefit sharing, one of the two sides will soon have to make a painful compromise in order to create clear and binding rules. “The pandemic treaty offers a unique opportunity to ensure a fair and effective system for global pandemic preparedness,” emphasizes Scharwey. “We must not let this opportunity pass us by.”

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