On May 10th, 2025, the World Health Organisation (“WHO”) announced a finalised draft of the WHO Pandemic Agreement (the “Agreement”) after years of behind-closed-doors negotiations.
Introduction
On May 10th, 2025, the World Health Organisation (“WHO”) announced a finalised draft of the WHO Pandemic Agreement (the “Agreement”) after years of behind-closed-doors negotiations. Click here to read it.
On May 20, 2025, the 78th World Health Assembly (“WHA”) adopted the Agreement pursuant to Article 19 of the WHO Constitution. The language of equity, solidarity and preparedness pervades the Agreement and it is presented, by the WHO, as a step towards global health security. In reality, the Agreement’s actual function is less about health protection and more about the building out of the infrastructure of the pandemic-industrial complex that will result in increased surveillance, relentless fear propaganda and massive profit for the few.
Adoption, Abstentions and Silence
While WHO headlines suggest broad global consensus, the reality is a more complex story. Out of one hundred and ninety-four member states (194), one hundred and eighty-one (181) were entitled to vote, forty-six (46) were absent, one hundred and twenty-four (124) voted in favour, none opposed, and eleven (11) abstained, including Bulgaria, Poland, Israel, Italy, Russian Federation, Slovakia, and Iran. Thirteen (13) were either not entitled to vote or were not registered to attend the voting session: Afghanistan, Argentina, Dominica, Lebanon, Myanmar, Nauru, Somalia, South Sudan, Sudan, Surinam, Bolivian Republic of Venezuela, USA and Yemen.
Notably, the United States did not participate in the vote. This, as a consequence of President Trump’s announcement in January 2025, of the U.S. withdrawal from the WHO, citing dissatisfaction of the organisations handling of the Covid-19 pandemic.
These developments suggest that rather than a unanimous consensus, significant unresolved concerns persist among member states. Namely, the Pathogen Access and Benefit-Sharing (PABS) System.
African Nations: PABS
Central to the Agreement is the PABS system. Under this framework, manufacturers would be required to allocate twenty percent of pandemic-related products (ten percent donated and ten percent sold at affordable prices) to the WHO for global distribution. However, the final annex outlining how this system will function is yet to be agreed and is scheduled, tentatively, for completion by May 2026.
While several African nations have broadly welcomed the Pandemic Agreement, they have raised serious concerns about the lack of enforceability and equity within the current draft of the PABS framework. They argue that the language around equitable access is aspirational, with no binding guarantees for technology transfer, local manufacturing capacity or timely access to critical tools during health emergencies.
Countries in the Global South (arguably) often rich in genetic resources and the source of pathogen samples would be obligated to share those samples freely. Yet the current draft text provides them with no assurance with regard to access to the resulting vaccines, diagnostics, therapeutics and profits from these medical products. This perpetuates the claims that biopiracy and exploitation are embedded within international health governance.
It is this fundamental difference of opinion between the Global South and the Globe North that has led to the unorthodox decision by the WHA to adopt the Agreement in the absence of consensus on the entirety of the text. Let’s not forget the mantra of the last few years nothing is agreed until everything is agreed. This deadlock will not be easy to overcome as many African nations fear that the text, as it currently stands, enables pathogens to flow freely to wealthy nations with the benefits remaining beyond the reach of those countries most impacted.
Ratification: The Sixty Country Threshold
The Agreement will not be open for signature or ratification until consensus is reached on the PABS and the annex is formally adopted by the WHA at its 79th session in May 2026.
Once adopted, the Agreement will enter into force after sixty (60) WHO member states ratify in accordance with their respective domestic processes.
Who Benefits? Let’s Ask the Question Again
Big Pharma, biotech companies, and pandemic-focused startups, particularly those involved in diagnostics, vaccines, therapeutics, data collection and surveillance stand to benefit financially from the formalisation and expansion of the global pandemic industrial complex. This process will entrench the patterns of the Covid-19 era by perpetuating the vast wealth transfer from the people to corporations and their shareholders.
Conclusion: The Real Agenda
Key mechanisms in the Agreement such as the PABS System and the One Health approach are not about preventing pandemics rather they exist to perpetuate a system in which disease is opportunity and the emergency, that inevitably follows, is profit. It’s not about safety and solidarity instead the Agreement sets the stage for a permanent state of biomedical anxiety and fear where constant pathogen monitoring, surveillance and testing, stockpiling and response protocols justify permanent funding and centralise control. Private corporations get rich at the expense of the resources and freedoms of the people across the world.
The Agreement does not empower communities to become healthier: it entrenches a global system built around pathogen surveillance, pharmaceutical dependency and public-private preparedness, the very model that transferred trillions of dollars in wealth from the public to a technocratic elite during Covid-19.
This Agreement is not about health: it’s a business plan for perpetual crisis.
Next Steps
- WHO member states to resume negotiations on the PABS annex no later than July 2025 – you can read about this here.
- PABS annex to be adopted at the 79th WHA in May 2026.
Additional Resources
Adoption of the Pandemic Agreement at the World Health Assembly Statement made on 21 May 2025
China Daily – World Health Assembly adopts global pandemic agreement
Health Policy Watch – Next Steps: Tension About How to Settle the Pandemic Agreement’s Annex
The Guardian – World agrees pandemic accord for tackling outbreaks of disease
