World Health Organization member states adopted a treaty on global pandemic preparedness at its 78th annual Assembly on Tuesday, May 20, after three years of protracted negotiations.
It’s only the second time in WHO history that member states have successfully negotiated and agreed a major treaty; the first was the Framework Convention on Tobacco Control in 2003.
“That in itself is an achievement,” Ayelet Berman, a global health law expert at the National University of Singapore, told DW.
The WHO Pandemic Agreement follows the COVID-19 pandemic, which is estimated to have resulted in more than 20 million human deaths. It remains one of the world’s biggest ever health and economic disasters.
What are the main points of the WHO Pandemic Agreement?
Through the treaty, countries have agreed to improve their pandemic prevention measures, monitoring capacities, and establish pandemic prevention plans and infectious disease controls.
Equity measures are also included: The agreement seeks to ensure the “distribution and rapid scale-up of the global production of pandemic-related health products.”
Vaccines are considered the most important of those provisions, but equity measures could also encompass personal protective equipment and medical treatments, such as antivirals and antibiotics.
Genetic data system is central to the treaty
Resource sharing is central to the agreement, particularly the common access to pathogen genetic data between nations through a Pathogen Access and Benefit-Sharing System — “PABS” for short.
Access to a reserve of testing equipment, medicines and vaccines is also provided for. A fifth of available equipment will be set aside for allocation to low-income countries, according to the agreement.
How exactly PABS will work is yet to be decided. Member states must work out the details by May 2026.
But its intention is clear: A rapid sharing of disease information could help slow the transmission of a new, deadly pathogen.
“It will be very important to have rapid communication,” Daniela Manno, an epidemiologist at the London School of Hygiene and Tropical Medicine, told DW.
“Sharing the pathogen [genetic data] would be important because that is what you would use to produce vaccines and tests. This idea that [pharmaceutical] manufacturers and other countries can access the sequence of the pathogen would be important.”
The treaty’s effectiveness depends on its enforcement
The pandemic agreement is effectively a statement of intention; its enforcement is unclear.
Some countries expressed concerns over early drafts of the agreement that it would compromise state sovereignty. That’s not the case in the final version. The agreement’s governing principles explicitly emphasize each nation’s rights to implement laws and policies.
But some experts said that has come at the expense of enforcement.
“Legally speaking, it’s quite limited,” said Berman. “The question is, how will it be implemented?”
“The agreement does not give the WHO any powers of interference in domestic affairs whatsoever.”
Berman said the agreement’s success will depend on how its initiatives are financed — another detail that is yet to be decided — and political will.
A conference of the parties, similar to the “COPs” of the United Nations’ climate and environment programs could align international pandemic preparation, experts said.
“The idea there is that it will be a place where member states will meet and, in a non-adversarial manner, assess implementation,” Berman said. “It’s more of a soft mechanism for encouraging implementation.”
US absence was not overlooked
The most notable absence at the World Health Assembly is the United States. It withdrew from the WHO by executive order when Donald Trump started his second presidency in January 2025.
That move, widely criticized in the global health community, deprives the WHO of its top funder and the largest player in global health. At the opening plenary session on Monday, May 19, WHO Director-General Tedros Adhanom Ghebreyesus asked the remaining WHO member states to support a new budget that would be 21% less for its next two-year funding cycle.
Funding aside, the US will not need to participate in any of the provisions of the pandemic agreement, which means pharmaceutical companies based inside the country may not need to play along with the information-sharing provisions.
It’s a definite limitation, said Berman.
“So much of the pharmaceutical industry research institutes are based in the United States, so you’re not going to have a government that is supposedly encouraging them to collaborate on research and development … tech transfer and these many other issues,” said Berman.
That could reduce the equity ambitions of the treaty, which aims to assist low-income nations in fighting pandemics by sharing technology, although several of the major COVID-19 vaccine developers, such as BioNTech and AstraZeneca, are based in Europe.
Manno is hopeful, however, the agreement will mark an important first step in stopping — or limiting — the next pandemic.
“I hope having an agreement like this will mean that the public feels a bit more protected, because countries are willing to work together. I hope they would feel there’s more equity in how technology is shared, I hope people living in low- and middle-income countries will have a bit more faith in how the international system operates,” Manno said.
Edited by: Zulfikar Abbany
