WHO pandemic treaty talks stall

WHO member states left the final full day of the Seventy-ninth World Health Assembly without a clear breakthrough on the unfinished part of last year’s pandemic accord: the pathogen access and benefit-sharing system, known as PABS. WHO’s May 22 daily update highlighted other assembly decisions, including a new member-state-led process on global health architecture reform, but did not announce closure on the pandemic agreement annex. (who.int 1) (who.int 2) That matters because the treaty itself was already adopted on May 20, 2025, but WHO says the agreement cannot open for signature and ratification until the PABS annex is also adopted. In other words, the political headline from 2025 was not the end of the process; the operational fight over how countries share pathogens and how benefits are returned is still unresolved. (who.int) ### If the treaty was adopted last year, why are talks still stalling? The World Health Assembly adopted the WHO Pandemic Agreement by consensus on May 20, 2025, after more than three years of negotiations launched during the COVID-19 era. But WHO’s own explainer says the next crucial step is the Intergovernmental Working Group’s negotiation of the PABS system, which will sit as an annex to the agreement. (who.int) The practical effect is that countries have settled the broad framework but not the mechanism at the center of the equity dispute. WHO describes PABS as the system meant to ensure rapid sharing of pathogens with pandemic potential and, on “an equal footing,” fair and equitable sharing of benefits from their use. (who.int) ### What is PABS, and why is it so contentious? WHO says PABS is supposed to link two things that often pull in opposite directions during outbreaks: fast access to samples and sequence data, and fair access to resulting vaccines, treatments and diagnostics. The design matters because lower- and middle-income countries have long argued that they are asked to share biological materials quickly but cannot count on timely access to the products developed from them. (who.int) The unresolved question is not whether countries support preparedness in principle. It is how binding any obligations should be, who pays, and what manufacturers and governments must deliver in return when pathogen data is shared. Those disputes are reflected in the fact that WHO’s assembly update on May 22 recorded no final settlement on the annex. (who.int) ### What did the assembly do instead on May 22? The World Health Assembly on May 22 agreed to establish a joint process, led by member states and hosted by WHO with global health partners, to support reforms of the global health architecture. WHO said the process will develop options and recommendations aimed at improving access, impact and equity. (who.int) The same WHO update said member states asked Director-General Tedros Adhanom Ghebreyesus to submit a final report with options and recommendations to next year’s World Health Assembly. That gives governments a parallel reform track even as the pandemic agreement’s unfinished annex remains unsettled. (who.int) ### Where does the United States fit into this? Think Global Health reported on May 15 that the Trump administration is finalizing bilateral arrangements under an “America First Global Health Strategy” after withdrawing from WHO, reducing foreign health assistance and dissolving USAID. The outlet said 31 countries had signed memoranda of understanding with the United States as of May 15. (who.int) Those bilateral deals are not the same thing as the WHO process, but they show a competing channel for health diplomacy. Think Global Health said the agreements are designed to move the United States away from aid and toward jointly financed arrangements, with varying co-financing demands on partner countries. (who.int) ### What happens next if the annex is still not done? WHO says the full pandemic agreement will enter into force only 30 days after 60 countries ratify it, and ratification cannot begin until the PABS annex is adopted. That means the calendar for implementation still depends on a negotiating step member states have not completed. (thinkglobalhealth.org) The next visible milestones are procedural. The Seventy-ninth World Health Assembly ran from May 18 to May 23, 2026, in Geneva, and WHO has already set a further checkpoint by requesting Tedros’s report on global-health architecture reforms for the 2027 assembly. (who.int) (who.int) (thinkglobalhealth.org)