World Health Organization (WHO) member states have entered their final week of scheduled negotiations on the pandemic agreement (PA), amid renewed urgency following the United States withdrawal from the organization and widespread aid cuts that carry serious implications for global health. With limited time before the May World Health Assembly, when a final version of the accord is supposed to be ready, the Governing Pandemics Initiative Team at the Global Health Centre of the Geneva Graduate Institute offers a preliminary analysis of the 21 February draft.

The newly released policy brief “What’s new in the draft Pandemic Agreement?” shows how the draft agreement builds on lessons from COVID-19 by proposing a systemic approach to pandemic prevention, preparedness, and response (PPPR).

The analysis is structured in three parts: (1) a comparison with the amended International Health Regulations (IHR) to understand why a new instrument was deemed necessary and how the two frameworks could work together; (2) a thematic grouping of related articles, illustrating the integrated logic of the draft text; and (3) a focus on the ‘green’ provisions—articles already broadly agreed—which introduce meaningful innovations and mark progress beyond existing international health law.

A summary of Part 2 is included below. The full paper is available on the Governing Pandemics Initiative’s website.

Main content and interlinkages

Treaty negotiations must often focus on specifics – an article, a sentence, a single word. After over three years of intense negotiations, as the finish line approaches, it is not always easy to consider the totality of what has been negotiated and achieved, especially for those who have been closest to the process.

Here we offer a high-level summary of the main substantive topics addressed by the draft PA, as reflected in the draft of 21 February 2025. We also highlight linkages between articles, since the provisions of a treaty cannot be read in isolation but have to be interpreted in light of the overall text, including the preamble and any annexes.

While it is understandable that attention focuses on the issues where consensus has not yet been forged, it is also important to recognize the breadth, depth and novelty of what has been agreed. 

After laying out the context, definitions, objectives, overarching principles and approaches (Preamble and Chapter I), the draft PA addresses five main thematic areas (Chapters II and III):

Preventing pandemics (Articles 4 and 5) 

These articles are still largely under negotiation. The current text lays out obligations on parties to reduce the likelihood of pandemics by mitigating the risks that outbreaks emerge in the first place – whether in humans, animals, the environment, or the intersection among them – and that once they do, they are detected quickly through surveillance.

The obligations go further upstream than the International Health Regulations (IHR) in seeking to reduce the risk of outbreaks occurring in humans in the first place. It is recognized that obligations on a Party to implement such preventive measures will be “in accordance with its national and/or domestic laws and subject to the availability of resources,” reflecting flexibility, and underscoring the importance of effective governance arrangements to enable the Conference of the Parties (COP) to discuss whether an appropriate balance is being struck between national sovereignty and effective implementation (Chapter III).

In addition, international cooperation in the form of “technical assistance, capacity building, technology transfer and financing” may be needed to implement these articles fully, highlighting the connection to international support (Articles 19 and 20). 

Societal and health system capacities (Articles 6, 7, 17, 18) 

These articles are nearly uniformly green, and lay out obligations on parties to “develop, strengthen and maintain a resilient health system” capable of providing healthcare services and public health functions during and between pandemics, and ensuring the appropriate healthcare workers (HCW) to do so (see further discussion of Articles 6, 7 and 17 below).

Some of the key provisions in Article 4 on prevention (i.e. on routine immunization, infection prevention and control, and lab safety) rely on day-to-day functioning health systems. Parties also commit to strengthen their societal capacities to address pandemics by adopting inclusively-developed whole-of-government, whole-of-society plans, and increasing population literacy and trust through community-engagement and risk communication.

No other treaty binds countries to such specific or deep obligations on societal or health system capacities to address pandemics. Repeated throughout is language that gives Parties flexibility, such as “taking into account its national circumstances” and “as appropriate,” underscoring the importance of effective governance arrangements (Chapter III). Implementing these obligations will also require domestic and in some cases international financing, and hence should be read alongside Articles 19 and 20 on international support.

Pandemic-related health products (Articles 9-14)

Convergence has largely been achieved on most of these articles, with the exception of Articles 11 on technology transfer and 12 on a Pathogen Access and Benefit-Sharing (PABS) system. They establish an interconnected set of obligations on Parties with the aim to improve equity in access to pandemic-related health products.

Obligations span from R&D to manufacturing of products, from regulatory review to stockpiling. The provisions are both nationally-oriented (i.e. commitments to invest in R&D domestically or develop regulatory capacities), and internationally-oriented (i.e. licensing publicly-owned technologies and refraining from stockpiling more than a country needs).

A connecting thread throughout is transparency, including parties’ commitments to transparency of R&D priorities, clinical trial protocols, research results, licensing agreements, supply chains, and relevant terms of procurement contracts. Another area of emphasis is consideration for access to health products in fragile or humanitarian settings. 

The specificity of norms on what countries commit to do and/or should do with respect to pandemic-related products, and the depth of international cooperation they establish, are unprecedented in international treaty law (see, for example, further discussion of Articles 9 and 13 below).

That said, throughout these articles, there is frequent appearance of language such as “promote”, “encourage”, “within means and resources at their disposal”, and “in accordance with national and/or domestic law and policy,” underscoring (as elsewhere) a fair amount of flexibility for implementation and the importance of effective governance arrangements for follow-up and accountability.

Article 12 is still under negotiation, but if agreed close to its current form, it would eventually establish a PABS system with additional details to be negotiated subsequently in an annex.

This Article connects and mutually reinforces two major parts of the draft PA: a functioning PABS system could enhance international surveillance (Articles 4 and 5 on prevention and surveillance) while facilitating product development and access (Articles 9-14 on products).

Under such a system, parties would commit to provide access to “PABS Materials and Sequence Information” in accordance with data safety, biosafety and biosecurity standards, in a manner that would provide legal certainty to participating actors, and facilitate research and innovation.

On an equal footing, parties would commit to benefit-sharing during pandemic emergencies, with different benefits potentially during public health emergencies of international concern (PHEICs) and to prevent outbreaks from progressing into emergencies. Such benefits are envisioned to include monetary and non-monetary benefits, including a percentage of real-time manufacturing of products to be supplied to WHO for allocation to countries in need.

Implementing these obligations will require domestic and international resources, both financial and technological, such that Articles 19 and 20 on international support and financing are highly relevant here, as is Article 11 on technology transfer. The PABS system may generate its own financing through sources such as annual fees or royalties, but this issue remains to be agreed in future negotiations of the Annex.

International support (Articles 19 and 20)

These articles are almost entirely green, and obligate Parties to cooperate to strengthen capacities for implementation, especially in developing countries. Domains of cooperation may include technology transfer, sharing of legal and scientific expertise, capacity-strengthening and financing.

Parties commit to “maintain or increase domestic funding” for PPPR, “work to mobilize” additional international financing and establish a Coordinating Financial Mechanism that is to provide strategic information, analysis and support to parties in securing financing.

A core purpose of the mechanism is coherence and increased transparency in a fragmented and opaque financing landscape; it is envisioned that a single mechanism would address financing issues related to both IHR and PA obligations. As flagged above, financing and other forms of international support are critical to all three substantive thematic areas – prevention, societal and health systems capacities and pandemic-related health products.

Governance, including the role of WHO (chapter III, Articles 21-37)

These articles are largely green, with the exception of Articles 30 and 31 on Annexes and Protocols. They establish the governance arrangements for the PA, including a COP, voting rights, reporting obligations, settlement of disputes, reservations and amendments, annexes and protocols, and arrangements for entry into force and withdrawal.

As flagged above, effective governance is critical for meaningful implementation in all three substantive thematic areas, since many commitments are subject to caveats (i.e. “within means and resources at their disposal,” “taking into account its national circumstances,” “in accordance with national and/or domestic law and policy,” “as appropriate”) or exhortatory rather than obligatory (i.e. “encourage,” “promote,” “work to”).

Establishing what is “appropriate,” for example, will certainly be discussed by the COP and other governance arrangements. How monitoring and accountability will function has been left to a “mechanism” that the COP is to establish at its second meeting; the draft PA specifies that the mechanism is to “facilitate and strengthen effective implementation” and is to be “transparent, cooperative, non-adversarial, non-punitive and cognizant of respective national circumstances.”

Article 24 establishes the WHO Secretariat as the Secretariat of the PA. The role of WHO is also specified in various articles throughout the draft PA, for example, as a provider of support to Parties including reviewing national policies; offering training programs; developing norms, frameworks and recommendations; coordinating technology transfer; operating the PABS system; convening the Global Supply Chain and Logistics (GSCL) Network; and coordinating with other international relevant organizations and bodies. While the envisioned role of WHO is varied and extensive, a key distinction between the PA and IHR is that the PA entails far more extensive obligations on states (Parties) as also discussed above in Part 1. 

Read the full policy brief here: “What’s new in the draft Pandemic Agreement?”

To read the Governing Pandemics Snapshot—a series of periodic briefings on the state of global reforms for pandemic preparedness and response—please visit  the Governing Pandemics Initiative’s website.

Gian Luca Burci is Senior Visiting Professor of International Law at the Geneva Graduate Institute and Academic Adviser at the Global Health Centre.

Ava Greenup is Project Associate with the Governing Pandemics Team at the Global Health Centre, Geneva Graduate Institute.

Ricardo Matute is Policy Engagement Advisor with the Governing Pandemics Team at the Global Health Centre, Geneva Graduate Institute.

Suerie Moon is Co-Director of the Global Health Centre and Professor of Practice at the Geneva Graduate Institute.

Daniela Morich is Senior Manager and Adviser at the Global Health Centre, Geneva Graduate Institute.

Adam Strobeyko is an affiliated international law researcher at the Global Health Centre, Geneva Graduate Institute.