Delegates erupted into euphoric cheers when they adopted the WHO Pandemic Agreement at the May 2025 World Health Assembly (WHA). Not only was the treaty to prevent another global catastrophe like the Covid-19 crisis, but its successful conclusion was also raised as a banner for multilateralism in one of the toughest years it has faced since the founding of the United Nations. But the work was not quite finished: the Agreement cannot be opened for signature or ratification until negotiators finalise an “Annex” on pathogen access and benefit-sharing (PABS), for which only basic provisions were agreed in the treaty itself. Countries gave themselves an additional year to hammer out critical details, but PABS was arguably the most technically and legally complex issue to be resolved — the reason it was left unfinished. At this writing, delegates had one week of formal negotiations left on the calendar before the May 2026 WHA deadline, but parties remained far apart on fundamental issues.
At heart, the talks are a search for a global grand bargain that — if struck — could make every country safer. The treaty obligates countries experiencing outbreaks to share biological samples of pathogens and the sequencing data derived from them quickly with the international community. In exchange, the “benefits” resulting from this sharing — including vaccines and drugs, technology transfer, royalties and research collaborations — are to flow back to enable countries to better control and prevent outbreaks. Scientists have previously shared such samples and data relatively openly. But the bitter memory of highly unequal access to vaccines during the Covid-19 pandemic means many countries want credible guarantees they can access these tools for future emergencies.
As negotiators approach their self-imposed deadline, the clearest disagreement rests on who is obligated to share which benefits and when. Political divisions have largely fallen along North–South lines, with the Global South seen as sources of samples and data and therefore pushing for more definitive benefits to flow from the Global North, which is seen as a source of technology and financing.
Further complicating the picture are bilateral agreements recently concluded between the United States and 24 countries in Africa and Latin America (others are under negotiation), in which countries agree to share pathogen samples and data with the US in exchange for health financing estimated at USD 20 billion over five years. These bilateral arrangements could make it easier for companies and other governments to access pathogen data from the US rather than having to provide benefits via a multilateral PABS system, potentially undermining the grand bargain. But this and other critical issues, such as financing, have had almost no air time in the negotiating room, raising questions on how workable the Annex will be.
Pressure to complete a deal is intense, with multilateralists hoping for another win. Meanwhile, the Pandemic Agreement is in suspended animation. Yet if the deal agreed in Geneva is weak, convincing parliaments to ratify the treaty will become a harder sell and the treaty may ultimately fail. Crafting a clear, workable and fair deal may require more time, but would comprise a more genuine vindication of multilateralism than a fast finish this year.
