Countries keep increasing their military budgets yet seem unwilling to prepare for an “invisible enemy” – a pandemic-causing pathogen that can be more damaging than a war, World Health Organization (WHO) Director-General Dr Tedros Adhanom Ghebreyessus warned at the start of the final negotiations for a pandemic agreement on Monday.

The COVID-19 pandemic killed up to 20 million people and wiped $10 trillion from the global economy, while the 1918 influenza epidemic killed up to 50 million people – and First World War killed 15-22 million people, Tedros pointed out. 

WHO member states have a mere five days to reach consensus on the pandemic agreement if they are to present it to the World Health Assembly (WHA) next month – yet three ‘big ticket’ items and a myriad of process questions are still on the table.

Articles on how to share information about dangerous pathogens – the Pathogen Access and Benefit-Sharing (PABS) system; technology transfer (purely voluntary or not) and the pandemic preparedness responsibilities of member states (including ‘One Health’ measures) are still lacking agreement.

READ: What’s New in the Pandemic Agreement

Waning political will

The opening day coincided with International Health Day and the WHO’s 77th anniversary, and WHO and INB staff wore green to signify all systems go for the talks.

Tedros, hastily tying his green tie, urged all countries to “find a balance in protecting their people from both bombs and bugs” as the next pandemic is an “epidemiological certainty”.

While the talks at the Intergovernmental Negotiating Body (INB) could continue beyond this week and after the WHA, there is widespread consensus that member states’ already-waning political will to nail down a treaty will simply fizzle out.

The pandemic agreement has also been the target of a systematic misinformation campaign based on the incorrect claim that it will enable the WHO to undermine countries’ sovereignty. 

Right-wing parties and organisations, including a significant portion of US President Donald Trump’s Republican Party, have bought into various anti-WHO conspiracies as they have sought to blame the WHO for everything that went wrong during the COVID-19 pandemic.

Several influential countries have swung to the right, including Germany, the Netherlands and France, and this has also undermined support for the agreement as these right-wing parties typically opposed COVID-19 lockdowns and vaccine mandates, and have seen the pandemic agreement as an attempt to enforce these.

Growing health threats

The talks come amid serious and growing health threats. Disease outbreaks in Africa have increased by 41% between 2022 and 2024. Yet the continent has experienced a 70% loss in official development assistance (ODA), from $81 billion in 2021 plummeting to $25 billion in 2025 – largely as a result of US funding cuts – and ODA covers 30% of the continent’s health spending.

Dr Jean Kaseya, head of the Africa Centres for Disease Control and Prevention (Africa CDC), warned last week that the continent no longer has the means to adequately monitor outbreaks – including the mpox outbreak in central Africa.

The reduction in aid means fewer trained health workers, less equipment and medical countermeasures – vaccine, medicines and diagnostics, said Kaseya.

“It means we are, all of us, at risk. Our message to our colleagues from Western countries is:  ‘You are not protected, because if there is a pandemic coming from Africa, you will be affected’,” he added.

Ironically, however, the US also poses a risk to the rest of the world as it has dismantled vast areas of its health system, including cutting 2,400 posts at the Centers for Disease Control and Prevention (CDC), which monitors disease outbreaks – amid a serious and ongoing outbreak of H5N1 in cattle and a measles outbreak. In addition, the US’s radical aid cuts have also weakened global disease surveillance and response – including or mpox and Ebola.

Stakeholders’ pleas

Various stakeholders spoke in support of the pandemic agreement – with some caveats – on Monday, with several underlining that enough progress has been made to close the deal.

Grega Kumer, representing the International Federation of Pharmaceutucal Manufacturers and Associations (IFPMA), stressed the need for entrenched intellectual property rights and the voluntary transfer of technology and know-how during a pandemic (Article 11). 

“The significance of including both ‘voluntary’ and ‘on mutually agreed terms’ for tech transfer is paramount as it facilitates the sharing of technologies and expertise in a manner that respects the interests and agreements of all parties involved,” said Kumer.

Various other parties have pointed out that even the US and Germany have laws that allow their governments to enforce compulsory tech transfer during crises such as wars and pandemics.

Oxfam’s Mogha Kamal-Yanni told the INB that “technology transfer cannot be left to the whim of pharmaceutical companies”. 

“We see the clear evidence of the failure of voluntary action in the fact that, four years since the establishment of the mRNA hub in South Africa and despite several attempts to get companies to share the mRNA technology, not a single one agreed,” she said.

“Let’s hope that on Friday, we celebrate your hard work resulting in an agreement that is fair and that protects all people everywhere, and proves that the multilateral system works,” said Kamal-Yanni.

Spark Street Advisors CEO Nina Schwalbe said: “As currently drafted, the pandemic agreement secures important gains, including on research and development, equitable access to pandemic countermeasures and a One Health approach to pandemic threats. 

“While not all policy goals have been achieved, this potentially historic agreement lays essential groundwork for equitable, collective preparedness and response now and can be strengthened through additional protocols in the future,” said Schwalbe, also speaking for the Pandemic Action Network, the Panel for a Global Public Health Convention, Helen Clark, the co chair of the Independent Panel for Pandemic Preparedness and Response, and various members of the Global Preparedness Monitoring Board.

“We urge you, member states, to stay laser focused on the end goal and find room to give and take to reach agreement… We are counting on you to pull together and get this agreement.”