Governing Pandemics Snapshot: Will 2025 Deliver a Meaningful Pandemic Agreement?
The Intergovernmental Negotiating Body (INB) is at its most recent meting in Geneva.

Welcome to the fifth issue of the Governing Pandemics Snapshot. This issue provides critical insight into the past six months of negotiations over a World Health Organization (WHO) Pandemic Agreement, examining whether a meaningful agreement can be achieved this year. 

It addresses remaining contentious issues such as Pathogen Access and Benefit Sharing (PABS) and One Health, whilst highlighting recent successes in Research and Development (R&D) and Sustainable Financing. 

The recent US withdrawal from the WHO, however, will add a significant layer of complexity to the negotiations, with potentially far-reaching implications for the future of the pandemic agreement and global health governance. 

The second piece explores the recent Convention on Biological Diversity (CBD) Decision on Digital Sequence Information (DSI) and its implications for the pandemic agreement negotiations, particularly for its PABS System. Finally, this edition analyzes the governance challenges that lie ahead in creating coordination and synergies between the newly amended International Health Regulations (IHR) and the pandemic agreement.

Small steps in the right direction – but will the center hold?

Under the leadership of a reshuffled Bureau, the six-member body leading the negotiations, three additional rounds of negotiations of the International Negotiating Body (INB) took place in the last six months, and member states made considerable progress. 

At the most recent meetings, the INB agreed on essential provisions including Research and Development (Article 9), Sustainable and Diversified Local Production (Article 10), and Sustainable Financing (Article 20). 

While this represents progress on some core provisions of the future pandemic agreement (PA), deep divides remain on issues such as establishing the novel Pathogens Access and Benefit-Sharing System (PABS), prevention and One Health, and more equitable access to pandemic health products.

Article 9: First internationally binding agreement on R&D? 

INB co-chairs Ambassador Anne-Claire Amprou and Precious Matsoso

If Article 9 is adopted as the text currently stands, the PA will be the first internationally binding agreement to mandate strengthening research and development (R&D) for health products and to reference the inclusion of conditions “that promote timely and equitable access to […] products” in publicly funded R&D agreements. 

This could set a global precedent by formalizing cooperation and promotion in the area of R&D, which has traditionally been guided by voluntary or non-binding agreements. Additionally, language incorporating equity into the publicly funded mechanisms for R&D will have the power to potentially affect how pandemic-related products are developed and distributed, particularly benefiting developing countries.

Article 20 on sustainable funding requests member states to strengthen sustainable and predictable financing for the implementation of the agreement “to the extent feasible”. It also establishes a Coordinating Financial Mechanism to promote the implementation of the agreement but falls short of creating new funding sources devoted to the PA. 

In a context of declining international assistance and widespread national fiscal constraints, this article is very much the product of its time. However, it strives to align with the newly adopted coordinating financial mechanism of the IHR, as further analyzed by Gian Luca Burci in the last section of this Snapshot.

On the procedural side, after continuous requests for greater access to the closed-door proceedings, the 11th meeting of the INB (9 – 20 September) saw the introduction of short, daily briefings open to relevant stakeholders duly accredited to the process. These sessions provided a glimpse into discussions from the previous day of negotiations and offered an opportunity to relevant stakeholders to make interventions and ask questions. 

Since the resumed 12th meeting of the INB (2 – 6 December), these daily briefings are publicly webcast and onscreen negotiating text is shared with relevant stakeholders at the end of each day, enabling more informed interventions. This long-sought change in the working modalities increases transparency in the process. It is hoped that these practices will be maintained going forward. 

One Health: Divergence between higher- and lower-income countries 

Kenya
Kenyan farmer Kibet Ngetich Stephen keeps cattle in Narok county. Developing countries fear onerous One Health commitments could increase expenses for people like him.

Some high-income countries, foremost among them the European Union, are pushing hard for detailed and operational commitments on prevention and the One Health approach. They see such obligations as the most important gain beyond the status quo that they would achieve through the PA. 

In contrast, many low- and middle-income countries (LMICs) are concerned about the costs and potential trade disadvantages One Health commitments could entail, as they could require more extensive, and expensive, surveillance systems and have far-reaching implications for livestock rearing, wildlife and land use practices. 

There is also continued debate over whether legally binding One Health rules should be under a WHO-managed treaty or involve all four international organizations (Food and Agriculture Organization, the United Nations Environment Programme, WHO, and the World Organisation for Animal Health) that now work together in a quadripartite collaboration and under whose competence the different components of the One Health approach fall.

Negotiation roadblock: The PABS system

Whether these and other open provisions can be finalized ultimately depends on resolving a complex and difficult issue known as the PABS System. 

In brief, tracking the spread and mutation of pathogens that could cause pandemics requires the global community of scientists to share pathogen samples and genetic sequence data rapidly and internationally, and scientists largely did so during the COVID-19 pandemic. 

Such sharing is also the starting ingredient that allows researchers to develop diagnostic tests and vaccines rapidly when a new outbreak is detected. Currently, no international rule – including the recently amended IHR – requires governments to share pathogen samples and data internationally, and this gap in the legal architecture leaves every country at greater risk. 

Yet many LMICs hesitate to accept such obligations without clear, binding guarantees of access to the benefits arising from the utilization of their samples and data, fearing they will be denied access to the products developed from what they share.

Research conducted in a lab in Ghana
Scientists at the West African Centre for Cell Biology and Infectious Pathogens (WACCBIP), University of Ghana, setting up a genome sequencing experiment in the laboratory.

Complicating matters, the 1992 Convention on Biological Diversity (CBD) and its 2010 Nagoya Protocol govern benefit-sharing for access to genetic resources, including pathogen samples. However, these agreements typically involve lengthy bilateral negotiations, which are unsuitable for the urgency of a pandemic. 

The rise of digital sequencing information (DSI), which can replace physical samples in developing new health products, falls in a legal grey zone and has further complicated agreeing on modalities to ensure fair and equitable benefit-sharing. 

While CBD negotiations have tried to address the DSI issue, it remains a work in progress as analyzed by Adam Strobeyko in the next article of this edition of the Snapshot. 

Also highly debated is the so-called ‘legal architecture’ of the treaty, including the level of detail that needs to be included in the text of the PA and how much can be deferred for further negotiation of one (or more) follow-on annex(s) to the treaty after the latter is adopted or after it enters into force. This issue is becoming increasingly significant in the PABS negotiations, as the complexity of the matter and the remaining two weeks of formal negotiations are unlikely to suffice in agreeing on detailed provisions. 

US withdrawal from WHO

Adding another complicating factor into the mix is the US withdrawal from WHO, enacted by an executive order issued hours after Donald Trump was inaugurated as US  President on Monday, 20 January.

The executive order specifically directs the US Secretary of State to cease negotiations on the PA and the amendments to the IHR and to take action to ensure the agreement and the amendments will have no binding force on the United States. 

As the largest funder of the WHO, the withdrawal of the US will greatly amplify the fiscal pressures on the remaining WHO member states and have immense consequences, not only for the treaty’s future implementation but for the stability and functionality of global health institutions and multilateral systems. 

What remains to be seen is how WHO’s other 193 member states will proceed within the INB. As the US ratification of a pandemic treaty has always been in serious doubt, they should remain focused and carry these negotiations to the finish line by May 2025.  

Daniela Morich is Senior Manager and Adviser at the Global Health Centre.

Ava Greenup is Project Associate of the Governing Pandemics Initiative at the Global Health Centre.

Suerie Moon is Global Health Centre Co-Director and Geneva Graduate Institute Professor of Practice.

This is an article from the fifth issue of the Governing Pandemics Snapshot, which also discussed the recent Convention on Biological Diversity (CBD) Decision on Degistal Sequence Information (DSI) and its implications for the pandemic agreement negotiations, by Swiss National Science Foundation Researcher Adam Stobeyko, as well as an analysis of the governance challenges that lie ahead in creating coordination and synergies between the newly amended International Health Regulations (IHR) and the  pandemic agreement by Geneva Graduate Institute Professor Gian Luca Burci.

Image Credits: International Federation of Red Cross and Red Crescent Societies / The Kenya Red Cross Society, WACCBIP.

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