A dispute over technology transfer rights pushed the World Health Organization (WHO) to delay its Global Action Plan on Antimicrobial Resistance (AMR) for further informal talks.

Instead, the Executive Board approved a compromise drafted by Nepal and Ethiopia on Wednesday to reopen negotiations on intellectual property, specifically regarding “voluntary and mutually agreed technology transfers.” This procedural shift prevented the adoption of the draft plan, delaying final consensus until the specific language on intellectual property (IP) and manufacturing rights is resolved.

Voluntary and mutually agreed technology transfers are non-coerced, negotiated agreements where the owner of technology shares expertise, skills, or IP with another party based on freely agreed-upon terms, such as licensing, joint ventures, or technical collaboration.

In contrast, international law allows governments to issue compulsory licenses to manufacturers without the patent holder’s consent in certain situations, such as health emergencies.

Brazil ignited the stand-off by challenging the draft, arguing that “voluntary” transfer rules would trap developing nations in a cycle of dependency. Delegates from Colombia and Indonesia added that the plan could strip governments of their legal power to demand local manufacturing under international trade law.

Switzerland pushed back, describing the text as a merely “technical document” already shaped by experts, warning against reopening a file that addresses an urgent global concern. Brazil retorted that the implications of the language were far from technical.

To break the deadlock, Ethiopia proposed an amendment to limit the new consultations strictly to the contested technology transfer language, rather than reopening the entire document. The board adopted this compromise, ensuring the broader technical work remains intact while reopening the specific political debate before the World Health Assembly in May.

A blueprint to counter AMR

The draft plan for 2026-2036 aims to preserve the efficacy of medicines by reducing bacterial AMR-associated human deaths by 10% by 2030 compared to the 2019 baseline. The strategy addresses the economic fallout of resistance, warning that without robust action, global treatment costs could reach $412 billion annually by 2035.

AMR occurs when pathogens evolve to withstand medicines, threatening to reverse decades of medical progress by rendering standard treatments ineffective. Health experts classify AMR not merely as a disease issue, but as a “significant threat to global health security” that transcends national borders.

Critical objectives of the plan include ensuring equitable access to antimicrobials and diagnostics, alongside stronger governance to track national progress and minimise environmental pollution.

It promotes a “prevention-first” approach, emphasising infection control, vaccination, and biosecurity across human, animal, and environmental sectors to curb the need for antimicrobials. And it highlights a “One Health” approach, integrating agricultural and environmental data to detect hotspots and guide pollution prevention.

Divide between donor countries and Global South

High-income nations, including the United Kingdom and Japan, urged the board to adopt the plan without further delay, citing the extensive consultations already conducted over the past year. Spain, speaking for the European Union, specifically welcomed the text’s “balanced approach” in ensuring public-private cooperation remains on mutually agreed terms to incentivise innovation.

Conversely, Indonesia and South Africa aligned with Brazil, warning that the current specifications on technology transfer restrict the policy space for developing nations to manufacture essential health tools.

The African Region, represented by Cameroon, did not explicitly align on the issue of technology transfer. Their statement emphasised the need for “stable and sustainable financing,” because national action plans would otherwise fail to transform into tangible action.

Non-state actor Médecins sans frontières (MSF) urged member states to match implementation with sustainable financing strategies, particularly for conflict-affected settings. MSF added that the plan must move beyond tracking biological resistance patterns to generating evidence on where and why patients cannot obtain treatment to ensure equity.

Market failure spurs intellectual property dispute

The market for antibiotics faces a unique failure that spurs the intellectual property dispute. While new drugs are essential, regulation demands they be used sparingly, cutting the link between sales and revenue and deterring investment.

The International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) echoed the call for support of the original draft for the Global Action Plan on AMR, reiterating that “effective R&D incentives” remain critical to nurture the research expertise required to tackle future threats.

Low- and middle-income countries contend that this restricts their policy space to manufacture affordable generics, thereby entrenching inequity and denying access to life-saving tools.

Image Credits: Felix Sassmannshausen, European Union/José-Joaquín Blasco Muñoz.