A snail would have a faster passage than the Pandemic Agreement talks currently underway in Geneva, according to a briefing on Wednesday by civil society observers – some of whom mooted the possibility of World Health Organization (WHO) member states voting on the outstanding annex to break the deadlock.

Only one portion of a single paragraph has been “greened” – fully agreed – since the sixth meeting of the Intergovernmental Working Group (IGWG) started on Monday, according to Third World Network’s KM Gopakumar.

At the opening session, African countries rejected the latest draft text proposed by the IGWG Bureau, and a closed session of the meeting finally agreed to revert to the text of IGWG 5, reported Professor Lauren Paremoer, a member of the People’s Health Movement.

Member states are negotiating the one outstanding piece of the Pandemic Agreement – the Pathogen Access and Benefit Sharing (PABS) system, which will govern how dangerous pathogens should be shared and how any benefits that accrue from this information are also shared. 

Numerous countries, particularly in Africa, want the assurance that if they share pathogen information, they will be able to benefit from any vaccines, therapeutics or diagnostics (VTD) that are developed as a result.

They also want the PABS Annex to include standard contracts with pharmaceutical companies, setting out the terms of access and benefit-sharing.

Several European countries – notably those with powerful pharmaceutical industries – argue that compulsory benefit-sharing will stifle research and development. 

They are also against set contracts, giving companies “a lot of wriggle room” to negotiate terms of benefit-sharing, said Gopakumar.

Some European countries also favour allowing parties to use pathogen information without registration as a PABS user – something that the civil society representatives said would enable them to bypass any obligations to share benefits.

There is also a dispute over when countries will receive a share of the benefits. According to the current draft, the WHO will receive a donation of 10% of vaccines or medicines produced by the pharmaceutical companies that sign up to PABS during a pandemic only, not a public health emergency of international concern (PHEIC).

Voting to break deadlock?

Pedro Villardi, representing Public Services International – a trade union federation with over 30 million members, more than half of whom are health and care workers – warned that a binding benefit-sharing system is essential to protect frontline health workers.

“If we don’t have a benefit-sharing system that truly works with binding commitments, the risk is that, when we face the next pandemic, frontline workers will not receive priority access to [VTDs] and we will have the same tragedy that we had during the COVID-19 pandemic.”

“Some delegations are framing the non-conclusion of these negotiations as a failure of multilateralism,” said Villardi.

But he warned that a weak PABS system would undermine the global solidarity that multilateralism was supposed to build.

“So if we need [to reach an agreement], why don’t we vote? We have a majority of countries pushing for equitable provisions… and we have a few countries that are opposing these measures and defending the position of the pharmaceutical industry and other big corporations.”

Villardi said that voting had happened on other issues, including a recent vote at the WHO Executive Board meeting in Febrauary on an Israeli proposal on Palestine.

“The WHO Essential Medicines List was created through a vote,” he added.

Pressure to adopt ‘stripped down’ Annex

Guilherme Faviero, director of the AIDS Healthcare Foundation Global Public Health Institute, warned that member states are under mounting pressure to “accept a stripped-down annex that is devoid of meaningful benefit-sharing provisions and adequate legal guarantees”. 

However, the PABS Annex is supposed to address the “deep structural inequities within the global health system” exposed by the COVID-19 pandemic, said Faviero. 

“Pathogen samples and genomics sequence data moved quickly across borders, but life-saving technology did not and this is precisely what this Annex must solve,” said Faviero.

“Despite months of good faith efforts by delegations to advance text-based negotiations, the European bloc and key developed countries have been resistant to commonsense proposals to operationalise equity and ensure that these commitments, that are set forth in Article 12 of the Pandemic Agreement can be implemented successfully on an equal footing.”

He blamed the “delaying tactics of the European bloc” for the current impasse, adding that “civil society organisations have coalesced around very clear principles that should be reflected in the agreement”.

‘Europe to blame’

Alessandra Tisi, executive secretary of the Geneva Global Health Hub (G2H2), agreed: “The biggest threat to the successful outcome of this negotiation is the position of the European Union and other developed countries. Basically, they just keep rejecting key proposals from developing countries, and we have now arrived at this deadlock.”

Tisi said that some of the positions of the European Union contradicted its own internal regulations and other international agreements.

“The European Union was a very vocal, if not the main proponent, of the creation of a WHO Pandemic Agreement back in 2020. So it’s very hard to understand why, rather than advancing health for all and trying to build a more equitable and resilient healthcare architecture, it actually reinforces the very same status quo which has caused the pandemic in the first place.”