At around 3am Wednesday, after three years of often intense negotiations, World Health Organization (WHO) member states agreed on a draft Pandemic Agreement, which sets out basic terms of engagement to prepare for, prevent and respond to pandemics.

Bleary-eyed negotiators and co-chairs Precious Matsoso and Anne-Claire Amprou welcomed the final greening of the entire text after another tough, long day of talks.

“Now the real work begins to make this agreement a reality,” said Matsoso, with the draft due to be presented to the World Health Assembly (WHA) next month. Once adopted, it will become a legally binding document.

Amprou, admitting that she addressed the Intergovernmental Negotiating Body (INB) with great emotion, said: “Together, we have achieved an impressive work that has led to a massive step forward for global health, health security, equity and international solidarity. The world is watching us, and you can be very proud of what you have just achieved.”

For an hour after the entire agreement was finally “greened” at the WHO headquarters in Geneva, negotiators expressed their support – and often relief.

Tanzania, speaking for 77 African states, described the agreement as a “significant, and challenging step forward in our collective commitment to enhancing global health security. 

“While the process may not have yielded all the outcomes we aspired for, it has opened an important avenue for future collaboration and growth in our efforts to be better prepared to face potential pandemics,” said Tanzania.

“We have not achieved all our objectives in the negotiation, but we believe that the new agreement, if effectively implemented, will make the world more resilient and better equipped to face the global health security challenges of the future,” said the European Union (EU).

“The COVID 19 pandemic was suffering on a worldwide scale and tested public health system to the limit. Our collective achievement today shows that international solidarity, enhanced collaboration and decisive action are the way forward.”

Germany stressed that, “once adopted, the pandemic agreement will serve as a new collective tool to jointly address the risks of future pandemics across the full spectrum of necessary action”.

Germany also warned that countries would need to ensure its practical implementation.

“This why we have also advocated strongly for transfer of technology to be voluntary for technology holders, and this is how we understand the current provisions in the text,” stressed Germany, highlighting one of the most contested aspects of the talks.

At around 4am, WHO Director-General Dt Tedros Adhanom Ghebreyessus got his turn to address the INB, saying that the agreement “reflects your resilience, unity and unwavering commitment to the health and well being of people everywhere.

“In the face of enormous challenges, you have come together, rising above borders and differences, united by a common goal, the protection of humanity,” said Tedros.

“By reaching this milestone together, you have made history and shown how powerful collaboration can be,” added Tedros, who paid special tribute to “my African compatriots who saved the day with your flexibility”.

A WHO statement issued after the close of the meeting stressed that the agreement: “affirms the sovereignty of countries to address public health matters within their borders, and provides that nothing in the draft agreement shall be interpreted as providing WHO any authority to direct, order, alter or prescribe national laws or policies, or mandate States to take specific actions, such as ban or accept travellers, impose vaccination mandates or therapeutic or diagnostic measures or implement lockdowns.”

An extensive and damaging misinformation campaign incorrectly asserted that the agreement is a “power grab” by the WHO aimed at imposing various demands on countries.

Sharing pandemic products

The INB was set up in December 2021 to negotiate an agreement to ensure more equitable access to vaccines, therapeutics and diagnostics (VTDs) in the next pandemic. 

Over time, much of the agreement has been watered down – but it has retained one of the important stipulations: that the WHO will get 20% of the real-time production of vaccines, therapeutics, and diagnostics (VTDs) for the pathogen causing the pandemic, with 10% as a donation.

The WHO will then distribute these vaccines, medicines and tests to low- and middle-income countries according to need – partly righting the inequitable access to vaccines during COVID-19 when wealthy countries hoarded scarce vaccines.

All manufacturers who want to be part of a Pathogen Access and Benefit-Sharing (PABS) system will need to agree to this 20% allocation – although the details of the PABS system still need to be agreed on.

“My initial mandate was for 45% of VTDs to be made available for the WHO because you can be effective with that. But negotiations are negotiations, give and take. You have to be flexible,” Dr Aquina Thulare, who heads the South African negotiations, told Health Policy Watch. 

Further tough negotiations lie ahead to bring this PABS system into existence, something that has been deferred to the Conference of the Parties that will bring the agreement into being.

Dr David Reddy, Director General of  the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), said  that the industry has “made proactive commitments to deliver equitable access, pledging to reserve an allocation of real-time production of vaccines, treatments and diagnostics for priority populations in lower income countries and take measures to make them available and affordable”.

 But Reddy stressed that “intellectual property protection and legal certainty are essential for the innovative-based pharmaceutical industry to invest in high-risk R&D and enable voluntary partnerships that we will need in the next pandemic.

“We hope that in subsequent negotiations Member States maintain the conditions for the private sector to continue innovating against pathogens of pandemic potential.”

Recognition of human-animal connection

The agreement also sets out countries’ obligations to prevent disease outbreaks from becoming pandemics – including a “One Health” approach to prevent zoonotic diseases – those that spread from animals to humans.

“By embedding One Health and prevention at source into the pandemic agreement, member states are finally acknowledging what science has long confirmed: we cannot prevent future pandemics without improving how we treat animals and our environment in the present. This is a paradigm shift in the scope of global health policy and a victory for animals, for people, and for the planet,” says Nina Jamal, from the animal rights group Four Paws.

“For the first time, an international binding agreement has enshrined One Health principles and collaborative surveillance,” noted Wildlife Conservation Society’s Dr Chris Walzer.

Research and development

Medecins sans Frontieres (MSF) and DNDi, which develops new treatments for neglected tropical diseases, expressed support for the “groundbreaking research and development (R&D) access requirements”.

“Countries have recognised that when they finance research and development for new treatments, diagnostics, or vaccines through public funding, they need to attach conditions to that funding that ensure public benefit,” said Michelle Childs, Director of Policy Advocacy at DNDi.

Other positive issues highlighted by MSF include the commitment to ensuring frontline healthcare workers get priority access to medical products during emergencies, building a global supply chain and logistics network, and more transparency in government purchasing agreements.

Impact on young people

Katja Čič, a member of the WHO Youth Council based in Slovenia, said that the COVID-19 pandemic “cancelled the world in a few weeks… Schools were closed. Work happened over Zoom, socialising got uprooted. Stress was through the roof. Lots of people as their loved ones.

“Young people will live with the long-term consequences of today’s decisions the longest and be the most impacted. Everyone deserves to grow up in a world that can handle a health crisis, whether that means we will get a faster warning when something’s wrong, equal access to vaccines and tests and treatments, or our education is not disrupted.”

Success of multilateralism

Green. pic.twitter.com/6fH1Um5WDZ

— Tedros Adhanom Ghebreyesus (@DrTedros) April 16, 2025

“The pandemic agreement is a beacon of unified multilateral cooperation at a critical time, and we salute the member states for their tenacity and commitment in getting to this point.” said Helen Clark, Co-Chair of The Independent Panel for Pandemic Preparedness and Response, the Pandemic Action Network, Panel for a Global Public Health Convention and Spark Street Advisors.

Clark, and her co-chair Ellen Johnson Sirleaf, urged leaders to take action today to build the platforms which will stop an outbreak from becoming a pandemic.

“We need to invest in regional resilience today because it will take time,” said Sirleaf. “Don’t wait. Start now to build regional capacities for research, development, and manufacturing of pandemic countermeasures. ”

“Recently announced cutbacks to global health funding have devastating implications for global health security,” added Clark. “Currently, countries will need to scramble for the funds required in the event of another pandemic emergency. Leaders should be investing now in pandemic preparedness and emergency response – domestically, regionally, and internationally. We can’t afford another pandemic, but we can afford to prevent one.”

Dame Barbara Stocking, chair of the Panel for a Global Public Health Convention, described the agreement as “a breakthrough in global collaboration – helping countries better prevent, detect, and respond to future pandemics” but highlighted that “there’s still work to do on surveillance for both humans and animals, and on government preparedness”.

Thulare also sees the agreement as a triumph for multilateralism in the face of the rise of “very conservative governments, not just in the US, but also in Europe and elsewhere”.

“We have to make sure that we save this multilateral space, and we also save the WHO, which is the most neutral arbiter – especially in pandemics,” Thulare added.

Germany noted that the pandemic agreement “has the potential to become a milestone for multilateralism and global solidarity”, and pledged that it “has been and will remain, a committed and reliable partner for the World Health Organisation and an advocate of pandemic prevention, preparedness and response”.

United States President Donald Trump removed the US from the WHO – and explicitly from the negotiations upon assuming office in January, while Argentina also dissociated itself from both the WHO and the agreement.

However, 191 countries remained in the process – including those at war with one another, making consensus even more commendable.

Image Credits: Kerry Cullinan.