Multilateralism in Global Health on the Razor’s Edge: Countries Adopt New Pandemic Agreement at the World Health Assembly
Newsletter Edition #129 [Treaty Talks]
Hi,
One of the escalators at the Palais des Nations, the United Nations’ Geneva offices broke down merely hours after the World Health Assembly began on May 19th this week.
I read some meaning into it. It quite literally could be an indicator of the financial crisis impacting the UN. It also signified the one final effort that delegates had to take to climb up the last flight of stairs to wrap up the Pandemic Agreement negotiations.
Much like what subsequently transpired, the escalator was promptly fixed. Countries adopted the Pandemic Agreement not without some theatre that has often accompanied this process.
In today’s edition, we unpack the final hours before countries adopted the Pandemic Agreement today. We will update this story subsequently.
Thank you for reading.
Also, we are launching our new book on the negotiations on the amendments to the International Health Regulations. If you are interested, and are in Geneva, drop by. Register here, last few spots!
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Our gratitude to our subscribers who ensure we stay in the game!
Until later!
Priti
Feel free to write to us: patnaik.reporting@gmail.com, Follow us on X: @filesgeneva
I. PANDEMIC AGREEMENT: WHA 78
Multilateralism in Global Health on the Razor’s Edge: Countries Adopt New Pandemic Agreement at the World Health Assembly
By Priti Patnaik & Nishant Sirohi
Ellie Yau contributed to the production of this story.
A rubicon has been crossed.
WHO member states wrought victory on the Pandemic Agreement from populist, well-oiled, anti-science, disinformation forces, by adopting the Pandemic Agreement at the World Health Assembly today.
Countries adopted the much-contested, hard-fought Pandemic Agreement with the aim to prevent, prepare and respond better to acute health emergencies like the COVID-19 pandemic that wiped out nearly 20 million lives in the worst years during recent times.
The annual World Health Assembly began this week in Geneva on May 19th with an explosive start, when a vote on the draft resolution containing the Pandemic Agreement, precipitated in the proceedings of Committee A, at the request of a single member state - Slovakia. Countries responded by voting in favor of the agreement, including, inexplicably by Slovakia, and with zero votes against the motion.
In this story we recount the discussions as they unfolded. And we also present excerpts of statements made by countries.
Final Hours Before Adoption
The eventual adoption was not without anxious hours on May 19th, when rumours swirled on a possible vote on the resolution adopting the Pandemic Agreement. The rumours came to a stead after Slovakia called for a vote as it had threatened it would publicly and behind-the-scenes, during the day, in the lead up to the discussions at the Assembly that afternoon.
Diplomats made frantic efforts to de-escalate the possibility of a vote. After all the whole emphasis in these negotiations, and at WHO, has been on reaching consensus and not feed the fodders for the disinformation machine globally. In a deeply divided world, bereft of trust and solidarity in international relations in general, a vote on a Pandemic Agreement would mean deeper divisions among WHO member states at a time of acute geopolitical turmoil and multiple health emergencies.
So while countries had to vote based on the call for a vote on the resolution as per procedures, what happened next was nearly surreal. The country that called for a vote – Slovakia – did not oppose the resolution accompanying the treaty. So in effect, no one voted against the resolution. As many as 124 countries, voted in favor of the resolution adopting the agreement.
A momentary, surprised and rapturous applause erupted in the room as all eyes were on a single member state who had called for a vote and yet, did not oppose the resolution. However, there were as many as 11 abstentions in Committee A (including Russia, Iran, Italy, Slovakia, The Netherlands, Poland, among others) for a range of reasons including pending agreement on the PABS annex, adopting the agreement into domestic systems, reservations pending domestic review, among others.
THE VOTE
Even as scores of countries lent their voices for the adoption of the Pandemic Agreement (see statements below), there was resignation and an unease among delegations that a vote will be called by Slovakia. Many were caught off guard, and did not see the point of conducting a vote, given that countries had fought hard for over three years to reach consensus on the Pandemic Agreement.
And yet, a vote was called. And the results of the vote sought, did not weaken the organization, but in fact provided proof on the strength of the consensus achieved when 124 voted in favor and none against.
(Those entitled to vote: 181; Absent: 46; Voted in favor: 124; Voted against: 0; Abstentions: 11; Number of votes required for the majority of two thirds of members present and voting: 83)
Slovakia expressed concerns about the draft agreement, highlighting its failure to address proposals aimed at protecting human rights and national sovereignty, influenced by experiences during the COVID-19 pandemic. A statement made on the floor said, Slovakia's proposals, based on human rights instruments, were not adequately reflected in the draft, which also lacks clarity on which obligations member states should prioritize. The agreement's overlapping obligations and the inclusion of regional economy integration organizations as parties, particularly the EU, raise constitutional and democratic issues, especially regarding EU health policy and competition law alignment, the delegate said. Slovakia requested that these concerns be addressed in the final text.
THE DIPLOMACY
Many countries were puzzled about the timing of the vote, coming at the end of a long process. Some questioned the point of the vote, considering that Slovakia ultimately had not voted against the resolution. At the time of the vote, the country appeared isolated with no support from others to vote against the resolution.
Diplomatic sources told us that efforts were made to persuade Slovakia at multiple levels. Prime Minister Robert Fico said on social media platform X, alleging that he had received a phone call from DG Tedros Adhanom Ghebreyesus, persuading him to not call for a vote. WHO had not denied this, by the time this story went to print.
“This is not very diplomatic for Slovakia to take to social media be public about such a call”, a diplomat told us.
Observers were of the view that by calling for a vote, Slovakia had probably intended to highlight issues of sovereignty in the context of a WHO Pandemic Agreement.
THE ADOPTION
On May 20th, the plenary adopted the report from the Committee A, effectively adopting the Pandemic Agreement. A number of high-level statements were made by senior and world leaders including heads of states from Australia, France, India, Norway, Vietnam, Philippines, Mongolia, Angola, Thailand, among others.
In his remarks, DG Tedros told the Assembly:
“Step by step, you moved from red lines to green text, from entrenched positions to landing zones and from contradiction to convergence and consensus. You led your work in the middle of one crisis, and you managed this milestone in the middle of another. And today, you have sent a strong message that multilateralism not only works, but is the only way to find shared solutions, to share trust.”
Tailpiece:
So while the vote on the treaty scarred the final mile of these negotiations, it will likely be a mere footnote in the column inches that will be written on multilateralism in global health. The vote was both: a test for international cooperation, and an indicator of its fragility in the current climate.
Last word:
The proceedings on the treaty session at the Assembly concluded with a video statement with Robert F. Kennedy Jr., United States Secretary of Health and Human Services, said, “… the WHO has to come to terms with its failures during COVID, let alone ..significant performance. Instead, it has doubled down into the pandemic agreement, which will lock in all of the dysfunctions of pandemic response. We're not going to participate in that. We need to reboot the whole system…” (See full statement below). [China took the floor to respond to the statement made by the U.S.]
EXCERPTS OF STATEMENTS MADE BY COUNTRIES [COMMITTEE A, MAY 19, 2025]
Compiled by Nishant Sirohi & Ellie Yau.
South Africa
“…To ensure the effective and equitable implementation of the pandemic agreement, South Africa wish to emphasise the following critical elements: a robust Pathogen Access and Benefit sharing system is paramount. Timely and transparent sharing of pathogen samples and genetic sequence data, which is essential for the rapid development vaccines, diagnostics and therapeutics must be matched with the fair and equitable benefit sharing, including affordable VTD (vaccines, therapeutics, diagnostics) access. As such, we urge the swift finalisation of the PABS annex.
While the agreement considers technology transfer and know-how, it should earnestly facilitate this, particularly to developing countries in Africa. This includes pursuing manufacturing capacity and recognising that concrete mechanisms and incentives are vital for equitable access. Adequate and predictable financing is essential for effective implementation. We call for sustainable mechanisms, including contribution from all member states to support preparedness, strengthen health systems and to ensure equitable access.
The need for accountability cannot be over emphasised. Beyond PABS, equity must be embedded across areas, including access to funding resources and decision making.
Special attention to developing countries and vulnerable populations is crucial. We urge members this to recommit to multilateralism and inject the political impetus needed to ensure a strong, equitable effectively finance agreement and PABS system…”
Egypt, on behalf of the Eastern Mediterranean region
“…We believe the agreement must go beyond early warning to ensure real time, equitable access to counter measures for all, while strengthening local capacities and reducing dependency. Equity is not an optional it is a true measure of success.
We acknowledge that key work lies ahead, particularly in finalising a fair and functional pathogen access and benefits sharing systems. Such a system must ensure that countries with shared pathogen information often is amidst of public health emergencies and can account on guaranteed timely access to the benefits that arises from that data.
Transparency, trust and mutual accountability will be essential in shaping this next phase. In this regard, we reaffirm that the Intergovernmental Working Group process must remain member state driven with the development of a PABS annex, guided by proposals from member states and associate members.
Let us seize this moment not as an end point, but as a turning point. Let us ensure that the agreement will now hold in draft, become a tool of empowerment, a shield of equity and a symbol of what multilateralism can achieve when anchored distrust.”
France
“…This agreement is the beginning of a new era, the inclusion of equity in international law on public health.
France is very happy to see the use, for the first time in a national international agreement, the One Health approach, recognising that human health, animal health and the health of the environment are intricately linked. We can act at the root of pandemics. This agreement makes equity the cornerstone of our action and facilitates access for all to vaccines, treatments and diagnostics, particularly in the context of health emergencies. This principle of equity can be seen in strengthening of diversification of global production capacities. This agreement is one that we will make live through our collective mobilisation. France will continue its commitment for the implementation of the future development of this historic agreement.”
Samoa
“There are not enough words that go to emphasise the importance of pandemic prevention, preparedness and response, and this agreement, in particular, for small island developing countries such as Samoa. The special circumstances of SIDS (small island developing states) should not be disregarded. As our unique characteristics and vulnerabilities relate to our very survival and must be taken into account when implementing this agreement. We therefore appreciate its inclusion in the pandemic agreement before us.
The pandemic agreement is not the final destination, but rather marks the beginning of our journey of global solidarity and equity. It represents our strong commitment to not have history repeat itself by cooperating amongst ourselves and with relevant stakeholders to address our shortfalls and build a more resilient health system.
While there is no absolute certainty, we are able to prevent a pandemic virus from reaching our peaceful shores in the Pacific, we recognise the strengthened laboratory capacity and enhanced surveillance and early detection through a One Health approach could delay its entry to Samoa and provide more time for our health sector to be more adequately prepared.
Article 19 on international cooperation and support for implementation is paramount in realising our objectives for safer side. Two-thirds of Samoa population were lost because of the 1918 influenza pandemic. And right before the global outbreak of COVID 19, we had undergone yet another tragic point in our history, with measles fatalities in 2019. This agreement is a promise to our people and those who have passed on from the pandemic that we member states promise to better prevent, prepare and respond to future pandemic events.”
Senegal
“Senegal aligns itself with the declaration made by South Africa on behalf of the 47 member states of the Africa region. Pandemics are complex events which involve both political and health aspects. They are also political, because of the widespread major upset that it poses to the economy, particularly interruption of trade flows, of supply chains and movement which accentuates social inequalities and make international relations more difficult.
In Senegal, fighting the COVID-19 pandemic required a coordinated response, which revealed weaknesses in the preparedness of our health system. It is obvious that broad actions must be carried out in order to meet the priority measures to develop, maintain and consolidate the main public health capacities required by the IHR 2005, and the agreement on the pandemic prevention and preparedness response.”
South Africa, on behalf of the Africa Group
“…While the International Health Regulations focuses on core capacities, the pandemic agreement encompasses areas such as healthcare, workforce, the acceleration of innovation, pathogen and benefit sharing, local production and manufacturing, resilient global supply chains, equitable access and distribution of health products, as well as sustainable financing.
Looking ahead, the negotiation of the pathogen access and benefit sharing, or PABS holds significant as a region that has shared its pathogens, often without equitable returns. The PABS is paramount in rectifying these imbalances and ensuring the realisation of gaining equity and equitable access.
While our initial aspiration included a higher percentage for set asides, we acknowledge the agreed target of 20% of real-time production by participating manufacturers with a commitment of at least 10% to be made available to WHO as a donation for affected countries during future pandemics, as a positive first step.
Taking into account the importance of PABS, which is key for the completion of the ratification process, the African region supports the request to mandate the finalisation of the annex within the shortest time of to be adopted by the 79th World Health Assembly 2026…”
Jamaica
“Jamaica has the honour to deliver the statement on behalf of the following countries of the region of the Americas, Peru, Dominican Republic, Grenada, Haiti, Chile, Colombia, Brazil, Mexico, El Salvador, Uruguay, Nicaragua, Trinidad and Tobago, Panama, Guatemala, Suriname, Cuba, Belize, the Bahamas, Barbados, Venezuela, and my own country, Jamaica.
…this agreement means stronger commitments to regional manufacturing capacity, coordinated surveillance, research and development and transfer of technology, especially for developing countries.”
China
“…Through the negotiation, China has adhered to the principles of fairness, equity, science and solidarity, and has played a constructive role in advancing the agreement process. The adoption and implementation of the agreement will contribute to the fair disruption of health products, relevant technologies and resources help developing countries enhance their capacities for prevention, preparedness and response and support the global community in more successfully addressing future pandemic threats, bringing last benefits to the generations to come.
China will continue to contribute actively, participating in the drafting and negotiation of the agreements and annexes, promoting the early signing, early entry into force and implementation of the agreement.
We also note that the successful implementation of the agreement will depend on the establishment of some follow up mechanisms, as well as sustained investment and capacity-building efforts from all countries.”
Cuba
“…Cuba will do what it can to help ensure PABs as established in the agreement. The multilateral system will enable more rapid risk assessment and more effective access. Technological and scientific capacity enjoyed by Cuba as well as its human reasons will always be available to help address pandemics. Every country should contribute as it can and should make it successful all with a view to making progress. In this regard, you can always count on Cuba's support…”
Germany
“…While we would have welcomed stronger provisions, particularly regarding prevention, we recognise this agreement as a critical and timely step toward global solidarity and multilateralism. However, our work is not yet complete. Establishing an effective pathogen access and benefit sharing system as a core element of the agreement will be essential to successfully concluding this process. We, therefore, urge all member states to engage in the upcoming annex negotiations with the same political will and unity that have brought us this far…”
Switzerland
“…As Member States, we have reached an agreement on provisions aimed at bolstering global capacity in prevention, preparedness and response to pandemics, inter alia, in the areas of prevention and surveillance, health and care personnel, regulatory systems and sustainable financing.
Further, the agreement acknowledges the One Health approach and Member States desire to support sustainable technology transfer carried out in partnership between holders of technology and recipients. We believe that this will mark a turning point in terms of increasing equity in health, particularly in pandemic situations and emergency situations. We are, however, very much aware of the fact that there is a need to deal with one significant area still, i.e. access to pathogens and benefit sharing in order to better prepare and respond to the next health emergency. We as member states need to ensure that this mechanism can be effective, promoting innovation. To achieve such a result, we support a pragmatic, voluntary approach within existing frameworks takes into account the advice and contributions from experts which are most valuable.”
Japan
“…Japan has committed to the INB process to achieve an international agreement that genuinely works for the pandemic PPR, enabling a universal or widest possible support and participation from members of the international community. We respectfully commend a good spirit of compromise reached in the INB based on the shared determination of all delegations.
We have one remaining important task to initiate the PABs next, importantly, to obtain a truly functional legal [system]. The PABS system needs to be reasonable and viable boss from scientific and economic perspective. Otherwise, the pandemic agreement will be a castle in the air without being supported by the industry. Having this in mind through seeking necessary expertise as effectively as possible, we look forward to the successful conclusion of the negotiation on the annex.”
Indonesia
“…What we are adopting here is more than an agreement. It is the foundation of a safer and more equitable world that will protect future generations from the devastation we had to endure during the COVID-19 pandemic. The leaves cut short the inequitable access to life-saving tools and the consequences of fragmented actions. Never again.
Can we allow equity to be an afterthought? This agreement might not be the most perfect one, but it reflects a hard-earned consensus, a victory of multilateralism, a timely victory we so desperately need to prove that in a word defined by division, unity is still possible. And this is why disagreement matters, and no one can say otherwise. Let us carry this momentum forward to ensure the WHO remain the place where multilateralism delivers.
Very soon we will begin the Member State led process for the development of PABS system. For Indonesia, an ambitious, accountable and operational PABS system is very critical to delivering equity in future pandemics.”
Russia
“…The COVID-19 pandemic demonstrated that the states of the global south were left defenceless in the face of the collective west and their big pharma corporations. This spurred the WHO member state to developing an instrument for international cooperation in combatting pandemics.
During the negotiations, we repeatedly encountered attempt to impose approaches and standards that did not enjoy general support as well to turn the agreement into a mechanism of coercion, as well as lobbying for industrial interests from certain states.
Through joint efforts….focussed the document on priority areas as equitable conditions for dialogue, exchange of best practice, supporting developing countries in preparedness and response to emergency health situations, inter alia. But the working agreement has not been fully completed. We trust that the work on a system for PABS, which is an essential part of the agreement will be carried out on the basis of consensus and outmost consideration of the needs of the countries which are most vulnerable to the pandemics.
For its part, Russia Federation will activate a range of possibility of increasing assistance of the states in Global South on the basis of their needs without imposing political conditions such that these partner states can attain full autonomy when it protecting their populations.”
Spain
“Spain aligns itself with the declaration made by the European Union. Spain feels that finishing these negotiations on the international pandemic agreement represents a great achievement, particularly in this geopolitical context. It's a key moment in a time of isolationist discourse that undermines trust in science. Spain is more committed than ever to multilateralism, to global health and to strengthening the institutions that protect all of us. This is a decisive step towards a common global framework that strengthens our ability to prevent, prepare and respond to future health emergencies, protecting the most vulnerable and promoting equity.
We recognise the technical, political and diplomatic efforts made by the delegations, and we hail the consensus achieved in the INB. It's key to maintain this energy and to continue working for moving forward in a through constructive cooperation. We call on flexibility to achieve the negotiation on annex to Article 12 on PABS, which will allow us to adopt the Nagoya protocol with particularly to pathogen access, guaranteeing equitable sharing of benefits, improving equitable access in global emergencies..”
The current Mpox epidemic in the African continent is proof of that. Spain has been one of the first countries to respond, donating 20% of its strategic reserve of vaccines, 100,000 doses, to face this epidemic. The international response is moving forward, but we need to re-double our efforts. We hope that very much that the international agreement on the pandemic preparedness and prevention and preparation will marks a new era in cooperation among states to face health risks.”
India
“…India has been an active participant, and has co-facilitated the preparation of articles on pandemic prevention and surveillance and the One Health approach to pandemic prevention, preparedness and response. Additionally, India's contributions have been grounded in the principles of equity, solidarity and justice.
India, strong advocacy has played a pivotal role in shaping key provisions, including traceability in PABS, access to critical raw materials for diversified geographical production, and the recognition of digital health as an enabler of an equitable pandemic response. These foundational elements will not only safeguard equity and accountability, but also unlock pathways for scientific innovation, empowering developing countries to respond swiftly and effectively in times of crisis.
Being mindful that while PABS is the heart of this instrument, the annex to PABS is the soul of the treaty. We acknowledge that further work is needed for development of the annex through the IGWG. IGWG also addresses the modalities of the GSCL network, the coordinating financial mechanism and the Conference of Parties. However, India cautions that simultaneous efforts across multiple modalities should not cause the IGWG to lose focus on completing the PABS annex before the next world assembly.
India interprets that the recommendations by WHO, as outlined in the resolution A78/10-1 are non-binding in nature, with full respect to sovereign rights of member states to adopt legislations to ensure manufacturers accountability.
India remains committed to the IGWG and ensuring that its work is completed by the 79th World Health Assembly in 2026.”
Colombia
“…Colombia was active and a staunch defender of Article 11 on tech transfer and know-how transfer which is key to local production on a sustainable basis in developing countries. We reiterate that no country should be pressured not to use TRIPS flexibilities. Voluntary approaches do not rule out states right to apply compulsory measures in emergencies. Promoting tech transfer is an act of cooperation and solidarity to safeguard the right to health.
We welcome the commitments achieved in surveillance and R&D and the adoption of a One Health approach. This is essential to responding to the interdependent relationship between human, animal and environmental health, particularly in the face of a climate emergency.
With regard to the PABS annex, we look forward to its successful adoption. We reiterate that states are sovereign of their genetic resources. We state that Colombia will act in line with its national capacity, legal framework..”
Brazil
“The adoption of the WHO pandemic agreement actually marks a historic milestone for global health, and a powerful reaffirmation of multilateralism in a time of growing cultural-political tension and fragmentation. In this spirit, Brazil would be pleased to co-sponsor the resolution on the adoption and on the next steps for the pandemic agreement, reaffirming our commitment to its full and timely implementation.
…..Now we understand (with) PABS, it’s crucial to move promptly towards a conclusion of the PABS agreement to ensure that the pandemic agreement can effectively enter into force. President Lula, speaking at the UN General Assembly 2024, called for an urgent conclusion to this agreement, and today we celebrate not the end of the negotiations, but the beginning of a new global commitment to cooperation, equity and shared resilience…”
Malaysia
“…Malaysia appreciates rationale behind calls for this legally binding international instrument, which must operate in full complementarity with the IHR 2005. Its implementation must be aligned with national legal frameworks to ensure that member states can adhere to the obligations within the agreement. As expressed by many member states before us, we underline that sovereignty remains a cornerstone. Countries must retain the sovereign rights to legislate (and) determine public health responses and govern access to biological materials.
We welcome the establishment of the IGWG and Malaysia stands ready to actively participate and contribute in drafting of the Annex under Article 12, which obviously is key to the opening of the agreement for the signatures. Equity, transparency and access must be translated into tangible mechanisms, especially benefit-sharing for pathogens, fair vaccine access and sustainable financing. The global supply chain and logistics network must reflect regional needs and empower manufacturing capabilities. We also urge WHO to ensure that preparatory activities include robust technical support and legal guidance, particularly for developing countries.”
Norway
“…This is a historic achievement that will deliver improved equity in access to medical countermeasures in pandemic emergencies and beyond. And it is an agreement that will improve our protection against pandemics by increasing prevention efforts. The agreement is a victory for multilateralism and a proof that we can achieve more by working together, and it is a great achievement for WHO; even in a challenging environment, we managed to reach an agreement that will strengthen the organisation’s ability to prepare for and respond to pandemic emergencies as well as more effectively assist its member states in PPR.
We are also deeply grateful to everyone who has participated in making this possible, in particular the INB Bureau who steered us across the finish line and the Secretariat supporting us all along. We recognise that we still have an extra mile to walk before the agreement is complete. We need to be guided by the same collaborative spirit when finalising the operational solutions of PABS.”
Guyana
“…Guyana is comforted that the pandemic agreement establishes One Health as a vehicle for more effective health response to pandemics. We are comforted that the treaty recognises the centrality of equity as a vehicle for Health For All. We recognise this is a work in progress, therefore we look forward to strong and constructive actions to support a more equitable geographical expansion of vaccine and medicine production.
Similarly, we are hopeful that this agreement will facilitate more effective technology transfer than presently exists. We are hopeful that the spirit of compromise that led to the agreement will be sustained as we conclude the PABS annex in time for May 2026. Without the PABS annex, the agreement is considerably weakened. Guyana looks forward to contribute to the discussions ahead. Guyana supports the adoption of the agreement with the hope that we could rapidly resolve the issues that we have deferred for future consideration. Guyana strongly supports the adoption of the pandemic agreement.”
Uganda
“….During the three years while negotiating this pandemic agreement, Uganda experienced two ebola virus disease outbreaks. At the national level, these health emergencies, which have pandemic potential to continue to other parts, tested our health systems. The pandemic agreement will go a long way in providing much needed support in the strengthening of our capacities for pandemic prevention, preparedness and response. Madame Chair, Uganda welcomes the inclusion of provision in the pandemic agreement relating to research and development, pathogen access-and-benefit sharing, equity access to pandemic-related health products like vaccines, therapeutics and diagnostics, access to financing on day zero.
Working with WHO on process of emergency use listing, access to benefits for communities where clinical trials are done and will be done, and also ensuring the safety and mental health of all health workers. These articles are critical for equity in ensuring that every nation, every community and every individual irrespective of their geographical or economic standing, is protected.
Madame Chair, these articles are critical, and more so, financing remains a critical element in this pandemic agreement. Uganda calls for a robust, timely, and functional financial mechanism to pre-empt epidemics and mitigate their spread. We also support a strong and operational pandemic access-and-benefits sharing system that ensures that resources are allocated efficiently and equitably without delay where they are most needed.”
Bangladesh
“The conclusion of the pandemic agreement negotiation is a beacon of hope in the current complex dynamics of multilateralism. Hence, we all should be in a festive mood for celebrating of our success in the INB. In our assessment, the pandemic agreement, as agreed has useful deliverables and actions that will serve the entire humanity, hence it would be exigent to adopt this agreement on a consensual basis. We do firmly believe that the pandemic agreement will help find solutions not only during pandemic term, but (will) also be useful during pre-pandemic times. Towards that, we need to be sincere, bold, and cordial at its implementation stage.
The annex on pathogen access-and-benefits sharing system, which was once called the heart of the treaty, would record the following at the drafting stage. First, access to VTDs to vulnerable and affected populations has to be ensured for effective prevention of PHEICs from progressing to a pandemic emergency. Second, manufacturing licenses are to be made available to manufacturers in all regions and developing countries, especially when there is a shortage of supplies of VTDs. Third, traceability and accountability in PABS, and finally legal certainty and guarantees are to be ascertained….”
Iran
“Distinguished delegates, the delegation of the Islamic Republic of Iran aligns itself with the concerns expressed by many member-states regarding the current draft of the WHO pandemic agreement. While we acknowledge the efforts to reflect shared objectives, particularly the commitment to achieving the highest attainable standard of health for all, the current text still falls short in adequately addressing the key priorities of developing countries.
We emphasise that equity, solidarity, national sovereignty and the right to development must serve as the foundation of this instrument. The absence of binding commitments on unhindered and equitable access to medical counter-measures, as well as on the transfer of technology and know-how, undermines both the credibility and effectiveness of the agreement…”
Paraguay
“Paraguay recognises the historical value of the negotiations that led to the pandemic agreement. We agree that an instrument of this nature can be favourable, providing that it’s legally clear, operationally viable, and equitable in its implementation. From our national perspective, the efficiency of the multilateral system is indispensable in guaranteeing equitable access to vaccines, health technology and international financing mechanisms. We warn that in the absence of this, there is a risk that countries such as Paraguay will be left on the fringes of these benefits and it will reproduce the inequalities that were seen during the COVID-19 pandemic.
My country actively and constructively participated in the negotiations. We recognise progress in the supply chain network proposal, for example, and the inclusion of principles such as technology transfer and equitable access. However, we have reservations in the final text, particularly on the definition of responsibilities and governance and financial sustainability which my country insisted on in the negotiations. Paraguay would like it noted that we cannot currently support the text in its current form, but we will be awaiting the outcomes of the annex, at which time we will analyse the viability of the instrument. We would like to reaffirm our availability to continue actively participating in a constructive spirit for more effective, fair, and equitable international cooperation…”
The U.S.
[via video]
“I am Robert F Kennedy Jr, the US Health and Human Services secretary.
As you know, President Trump has made the decision to withdraw the United States from the World Health Organisation. I would like to take this opportunity to offer some background to that decision, and more importantly, to chart a future path towards global cooperation on health and health security. Like many legacy institutions, the WHO has become mired in bureaucratic bloat, entrenched paradigms, conflicts of interest and international power politics.
While the United States has provided the lion's share of the organisation's funding, historically, other countries, such as China, have exerted undue influence over its operations in ways that serve their own interests and not particularly the interests of the global public. This all became obvious during the COVID pandemic when the WHO, under pressure from China, suppressed reports at critical junctures of human-to-human transmission and then worked with China to promote the fiction that COVID originated from bats or pangolins, rather than from Chinese government-sponsored research at a Biolab in Wuhan.
Not only has WHO capitulated to political pressure from China. It has also failed to maintain an organisation characterised by ransparency and fair governance by and for its member states. The WHO often acts like it has forgotten that its members must remain accountable to their own citizens and not to transnational or corporate interests.
Now I believe that for the most part, the staff of the WHO are conscientious people who sincerely believe in what they're doing, and indeed, WHO has, since its inception, accomplished important work, including the eradication of smallpox. Too often, though, WHO’s priorities have increasingly reflected the biases and interests of corporate medicine. Too often, it has allowed political agendas like pushing harmful gender ideology to hijack its core mission. And too often, it has become the tool of politics and turned its back on promoting health and health security.
Global cooperation on health is still critically important to President Trump and me, but it isn't working very well under the WHO, as the failures of the COVID era demonstrate.
The WHO has not even come to terms with its failures during COVID, let alone make significant reforms. Instead, it has doubled down with the pandemic agreement, which will lock in all of the dysfunctions of the WHO pandemic response. We are not going to participate in that. We need to reboot the whole system, as we are doing in the United States.
Here in the United States, we are going to continue to focus on infectious disease and pandemic preparedness, but we are also fundamentally shifting the priorities of our health agencies to focus on chronic diseases, which are prevalent in the United States. It's the chronic disease epidemic that is sickening our people and bankrupting our healthcare system.
We are now pivoting to make our healthcare system more responsive to this reality. We are going to make healthcare in the United States serve the needs of the public instead of industry profit-taking. We are removing food dyes and other harmful additives from our food supply. We are investigating the causes of autism and other chronic diseases. We are seeking to reduce consumption of ultra-processed foods, and we are going to support lifestyle changes that will bolster the immune systems and transform the health of our people.
Few of these efforts lend themselves easily to profits or serve established special interests. These changes can only occur through the kind of systemic overhaul that President Trump has brought to our country. We would like to see a similar reordering of priorities on the global stage, especially considering the fact that with the leadership of the United States, funding from our country, over the past 25 years, millions of global citizens have seen a reduction in premature death due to HIV, TB and Malaria.
Let's return to the core focus of global health and global health security, back to reducing infectious disease burden and the spread of diseases of pandemic potential.
I urge the world's health ministers and the WHO to take our withdrawal from the organisation as a wake-up call. It isn't that President Trump and I have lost interest in international cooperation, not at all. We just want it to happen in a way that's fair, and efficient and transparent for all the member states we've already been in contact with, like-minded countries, and we encourage others to consider joining us.
We want a free international health cooperation from the straitjacket of political interference by corrupting influences of the pharmaceutical companies of adversarial nations and their NGO proxies.
I would like to take this opportunity to invite my fellow health ministers around the world into a new era of cooperation. We don't have to suffer the limits of a more abundant WHO.
Let's create new institutions. We're revisiting existing institutions that are lean, efficient, transparent and accountable. Whether it's an emergency outbreak of an infectious disease or the pervasive rot of chronic conditions that have been overtaking not just America but the whole world, we are ready to work with you.
Thank you, and may God bless you, and let's all pray for the health of our children and our grandchildren.”
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