Closure of the 13th INB Session for the negotiation of the Pandemic Treaty, 16th of April 2025.
By Sylvia Mesesi
On 15th April 2025, the Intergovernmental Negotiating Body (INB) concluded its 13th and final session of discussion on the WHO Pandemic Agreement. [1] The green light has now been given to the final draft, with only editorial and formatting adjustments remaining. This means the text is ready to be tabled at the 78th World Health Assembly (WHA) in May for formal adoption by a two-thirds vote. The Agreement will then be opened for ratification by States and formal confirmation by regional bodies.
The Agreement is not yet binding. But if 60 countries ratify, it enters into force in those States 30 days later.[2] Ratification is the legal act by which a State consents to be bound by the Agreement. Adoption, on the other hand, is a political signal, showing the willingness of the Assembly to promote the Agreement and encourage Member States to take the next steps.
It is worth noting that the technical Annex to the Agreement, on the "Pathogen Access and Benefit-Sharing System" (PABS), still needs to be negotiated.[3] Countries hope to conclude negotiations by May 2026. However, this may take until 2027 or 2028. Because the main Agreement and the PABS Annex are considered a package deal, the WHO will not open the main Agreement for ratification until the PABS Annex has been finalized. This means the Pandemic Agreement is unlikely to enter into force before 2029.[4]
Persistent Key Concerns
The Agreement aims to ensure that the chaotic, uncoordinated and inequitable global response to COVID-19 is not repeated. Its goals are to strengthen national and global capacities in pandemic prevention, preparedness and response (PPPR).[5] But behind the aspirations lie controversial provisions, ambiguous language and some serious concerns even after the revisions made.
- Vague and Loosely Defined Terms
The agreement includes numerous ambiguous terms that leave significant room for interpretation and potential manipulation. A prime example is the phrase "essential health services." According to the WHO’s 2022 Abortion Care Guideline, comprehensive abortion care is now classified as an essential health service.[6] This means that wherever the term appears in the agreement, it may implicitly include abortion services and abortion-related products.
Although the amended International Health Regulations (IHR) attempt to define "relevant health products" more clearly,[7] the language remains open to manipulation. This problem is systemic throughout the document even the definition of the term "pandemic" lacks clarity. Such vagueness poses serious risks to national sovereignty and legal transparency.
- Equity and Pathogen Sharing
The agreement emphasizes the swift sharing of pathogens (microorganisms such as bacteria and viruses that can cause diseases) for global benefit. However, there is no clear assurance that medical products developed from these pathogens will be distributed equitably especially to countries in the Global South. While the rhetoric centers on "equity," experts have noted that the focus is primarily on commodity-equity (ensuring equal access to products), rather than reducing the actual health burden across populations.[8] This centralizes pandemic response and imposes uniform measures, regardless of local needs and realities.
- The Conference of the Parties (CoP)
The agreement proposes establishing a Conference of the Parties (CoP) a new bureaucratic entity tasked with overseeing implementation and interpreting the treaty.[9] This body would meet within a year of the agreement entering into force and set its own future rules. However, it lacks democratic accountability, and many substantive decisions are expected to be deferred to the CoP. While their decisions are officially "non-binding," the CoP could still significantly influence national policy and interpretation of the treaty’s terms.
- The “One Health” Approach
The "One Health" approach integrates human, animal, and environmental health.[10] This integration has raised serious ethical and philosophical concerns particularly around the dignity and uniqueness of human life. The approach is presented with binding language, using terms like "shall," making its implementation mandatory for all member states. This opens the door to potentially dehumanizing policies.[11]
- Role of Regional Organizations
The draft grants regional organizations such as the EU and other multilateral organisations a formal role in implementation, but it fails to clarify how this intersects with national accountability.[12] This could dilute democratic checks and transfer decision-making away from national governments. Furthermore, voting dynamics within the CoP may be influenced by regional economic blocs, putting undue pressure on individual countries to conform to regional rather than domestic interests.
- Financial Prioritization
There is growing concern over the budgetary emphasis in the agreement.[13] The funds proposed for pandemic preparedness, prevention, and response far exceed those allocated to combat ongoing and deadly diseases such as malaria and tuberculosis. This raises serious questions about global health priorities and whether real, pressing health burdens are being sidelined in favor of hypothetical future scenarios.
What Can Member States Do?
- Consult Stakeholders: Governments should conduct national consultations, including parliaments, civil society and medical professionals, before taking any binding action.
- Preserve sovereignty: The IHR allows WHO to make recommendations, not orders. This type of relationship must be emphasized.
- Delay Ratification: Signing the Agreement signals political support but is not binding. Ratification is what makes it binding. Countries can wait until the PABS Annex is finalized before deciding.
- Know Your Legal System: In dualist systems, ratification requires parliamentary approval. In monist systems, ratification by the executive may automatically bind the country.
- Watch the CoP and the Intergovernmental Working Group: The Conference of the Parties will play a powerful role once established, but it will not meet until after the agreement enters into force. In the meantime, the Intergovernmental Working Group responsible for finalizing the PABS annex is already shaping the agreement’s operational core. Its proceedings must be closely monitored.
Conclusion
The Pandemic Agreement is a sweeping attempt to reshape global health governance. Although it includes laudable goals, it still raises serious questions. Member States should proceed with caution, ensuring that any commitments made serve the public good and respect the dignity of the human person.
Sylvia Mesesi is CCI Policy Officer Africa
[1] Health Policy Watch, “Countries Say YES to Pandemic Agreement”, April 16, 2025. https://healthpolicy-watch.news/countries-say-yes-to-pandemic-agreement/
[2] “This Agreement shall enter into force on the thirtieth day following the date of deposit of the sixtieth instrument of ratification, acceptance, approval, formal confirmation or accession with the Depositary.” — Pandemic Agreement, Article 35.
[3] Lexology, “ What Companies Should Know About the WHO Pandemic Agreement”, April 18, 2025. https://www.lexology.com/library/detail.aspx?g=145189cf-d122-4b69-abe9-f5c43dfbd5c6
[4] Lexology, “ What Companies Should Know About the WHO Pandemic Agreement”, April 18, 2025. https://www.lexology.com/library/detail.aspx?g=145189cf-d122-4b69-abe9-f5c43dfbd5c6
[5] “The objective of the WHO Pandemic Agreement, guided by equity and the principles further set forth herein, is to prevent, prepare for and respond to pandemics.” — Pandemic Agreement, Article 2.
[6] World Health Organization. Abortion Care Guideline. Geneva: WHO, 2022. https://www.who.int/publications/i/item/9789240039483.
[7] World Health Organization. (2024). International Health Regulations (2005) – Amendments Adopted by the Seventy-seventh World Health Assembly, Resolution WHA77.17. Retrieved from https://apps.who.int/gb/ebwha/pdf_files/WHA77/A77_ACONF14-en.pdf
[8] David Bell and Thi Thuy Van Dinh, “The WHO Pandemic Agreement: A Guide,” Brownstone Institute, March 22, 2024, https://brownstone.org/articles/the-who-pandemic-agreement-a-guide/
[9] “A Conference of the Parties is hereby established.” — Pandemic Agreement, Article 21.
[10] ““One Health approach” for pandemic prevention, preparedness and response recognizes that the health of humans is closely linked and interdependent with the health of domestic and wild animals, as well as plants and the wider environment…”— Pandemic Agreement, Article 1.
[11]“The Parties shall promote a One Health approach for pandemic prevention, preparedness and response…”— Pandemic Agreement, Article 5.
[12] “A regional economic integration organization that is Party to the WHO Pandemic Agreement, in matters within its competence, shall exercise its right to vote with a number of votes equal to the number of its Member States that are Parties to the WHO Pandemic Agreement.” ;”— Pandemic Agreement, Article 22.
[13] “In this regard, each Party, subject to national and/or domestic law and available resources, shall: (a) maintain or increase domestic funding, as necessary, for pandemic prevention, preparedness and response;”— Pandemic Agreement, Article 20.