The latest draft of the World Health Organization’s (WHO) pandemic agreement is awash with green highlights – an indication that countries have reached consensus on much of the text.

But the Intergovernmental Negotiating Body (INB) announced on Monday that it would not be possible to reach an agreement by December – and countries would push for the adoption of an agreement by the World Health Assembly (WHA) next May.

During the past two weeks of the 12th meeting of the INB, progress has been made on research and development(Article 9), local production(Article 10) and regulatory systems strengthening (Article 14).

Sticking points

But Article 4 on prevention, which details countries’ pandemic prevention and surveillance obligations, is mostly highlighted in yellow. This means that countries have broad agreement on the text but much of the detail is not agreed.

Many of the proposals are common sense – such as building the capacity to detect pathogens at the community level, routine immunisation, and prevention of zoonotic spillover. 

But these measures are a tall order for some low-income countries, which is partly where the resistance is coming from. Under-resourced countries are unsure of how much prevention will cost them and whether they will get help to implement the provisions. Wealthier countries want assurances that their poorer neighbours can contain outbreaks.

The rapid spread of mpox in central Africa is an example. Several affected countries have been unable to confirm cases as they lack basic diagnostic laboratories and trained staff. 

Negotiators are considering a separate annex on prevention, much as the details of a  Pathogen Access and Benefit Sharing (PABS) system may be accommodated in a separate annex. 

Sticking points also remain on technology transfer (Article 11), the PABS system (Article 12), the global supply chain and logistic (GSCL) system (Article 13) and sustainable financing (Article 20).

However, the most tangible offering of the agreement is back on the table although not yet agreed: that 20% of vaccines, therapeutics and diagnostics produced to combat that pathogen during a pandemic will be allocated to the WHO for distribution with 10% given free and the remaining amount on yet-to-be determined terms.

Earlier, there were reports that some members of the European Union wanted this requirement to be cut down to 10% and 5% respectively.

‘Crucial and delicate’

Tanzanian Ambassador Dr Abdallah Saleh Possi, speaking for the 47 African member states and Egypt, expressed Africa’s disappointment that there was not sufficient consensus to call a special World Health Assembly next month.

“Although we had such slow progress in this 12th session that did not realize the convening of a special session in December as anticipated, we all agree that the remaining issues are not many, but crucial and delicate, requiring decision-making and flexibility,” said Possi at the close of the two-week negotiations on Friday.

“Significantly, the meeting has generated the commitment to finalize them. We thank all the delegations that organize informal meetings on some sticky areas. We support having informal sessions during inter-sessional period with a view to achieving consensus on key areas. The Africa group plus Egypt is happy to be amongst the groups seeking to find consensus on the remaining issues.”

The Philippines on behalf of the Equity Group, expressed appreciation for both the “substantive progress” particularly on articles, 9,10 and 14, and “the cordiality displayed by delegations that helped bring about this progress”. 

However, warned the Philippines’ delegate, “much work needs to be done to achieve consensus on key articles that operationalize equity such as articles, 11,12, 13, 13 (bis)  and 20.”

Unlike the Africa Group, which wanted a December resolution, the Equity Group has always advocated for more time to deliberate on the agreement.

The negotiators reconvene for a short INB session from 2-6 December, where they will decide on the programme of negotiations for 2025.