All World Health Organization (WHO) member states supported the extension of talks on the last outstanding piece of the Pandemic Agreement, the Pathogen Access and Benefit-Sharing (PABS) annex, at the World Health Assembly’s (WHA) Committee A on Monday.

A draft PABS annex was due to have been presented to the WHA for approval, but instead, a report from the World Health Organization (WHO) Director General notes that member states need more time to reach an agreement.

The PABS annex will govern how dangerous pathogens are shared during public health emergencies and how to share any medical products (benefits) produced as a result of manufacturers getting access to this information. 

A draft annex will either be presented at next year’s WHA or at a special WHA if agreement is reached beforehand, according to the report.

Several of the many member states speaking on PABS in Committee A expressed confidence that the annex would be completed by the end of the year.

However, divisions between developed and developing countries remained stark.

Pakistan warned that the PABS negotiations should not be concluded in a way that “preserves the commercial privileges of a handful of manufacturers”.

Pakistan’s representative told the committee: “We are witnessing a sustained effort by some member states to hollow out Article 12 [of the Pandemic Agreement], which clearly establishes the principle of equal footing” between sharing dangerous pathogens and sharing any benefits that manufacturers accrue from such knowledge.

“We will not sign off on a multilateral system success story that serves the interests of industry over the health security of billions,” he added.

‘Conducive to R&D’

On the other end of the spectrum, the European Union warned that a PABS agreement should not stifle research and development.

“The Pandemic Agreement, as well as the revised IHR [International Health Regulations], contain important provisions that will significantly increase our capacity to confront pandemic emergencies and do so in a more equitable manner,” said the European Union.

“The PABS system has an important role to play in this context, but we need to ensure that the system is also conducive to innovation, and research and development for medical countermeasures, then it can lead to a robust uptake by the private sector.”

African countries, represented by South Africa, explained once again their demands for an equitable PABS system, including that the annex should include legally binding contracts between the WHO and manufacturers.

Impetus for a global PABS system comes from the need to correct the inequities of the COVID-19 pandemic, when developing countries were initially unable to get vaccines – even for healthworkers – as these had all been bought by wealthy countries.

As Namibia reminded the committee: “We negotiated the Pandemic Agreement because the world watched developing countries bury their loved ones due to COVID-19 while vaccines sat unused in warehouses elsewhere. That memory must anchor every line that we now draft.”

“The credibility of this agreement now rests on the PABS annex. If access obligations read ‘shall’ while benefit-sharing obligations read ‘options’, and ‘where available’, we will have written inequity into international laws with our own hands.”

“Benefit-sharing obligations must be legally binding and enforceable,” said Nigeria. “Technology transfer and non-exclusive licensing and local production partnerships must be obligations manufacturers sign onto, not options they select from a menu.”

Malaysia emphasises that annex must clearly spell out the rights and obligations of parties, and be “operationally implementable”.

Referring to the current hantavirus and Ebola outbreaks, Spain urged the completion of the annex so that the Pandemic Agreement could come into force and provide a solid regulatory framework “to prevent, prepare, and respond to health emergencies”. 

After six formal meetings and several informal sessions, the Intergovernmental Working Group (IGWG) will reconvene in July.