WHO: final talks on mandatory vaccine equity annex reach crisis point
Geneva, Switzerland/London-UK
GLOBAL HEALTH POLICY:
Intergovernmental Working Group in Geneva Battles Over Pathogen Access and Benefit-Sharing (PABS) Annex, Delaying Ratification of the Historic WHO Pandemic Agreement
In a moment of profound tension that threatens to undermine the world’s most ambitious post-pandemic reform effort, the World Health Organization (WHO) in Geneva is locked in a high-stakes struggle to finalize the operational details of its landmark Pandemic Agreement.
While the overall treaty framework was adopted by the World Health Assembly in May 2025, the entire legally binding instrument is effectively stalled as nations battle over the Pathogen Access and Benefit-Sharing (PABS) Annex.
This annex is the engine of global equity, and failure to reach consensus on its mandatory provisions has brought Global Health Treaty Stalled: Final Talks on Mandatory Vaccine Equity Annex Reach Crisis Point.
The main WHO Pandemic Agreement framework, the second legally binding health treaty in the Organization’s 77-year history, was celebrated as a victory for multilateralism and science.
It mandates strengthened global surveillance, capacity building in low-income nations, and the “One Health” approach, which integrates human, animal, and environmental health sectors to prevent zoonotic spillovers.
However, the framework’s entry into force is dependent on the completion of the PABS Annex, whose drafting was delegated to the newly formed Intergovernmental Working Group (IGWG), which has been meeting under intense pressure since July 2025.
The Equity Engine: PABS and the 20% Commitment
The PABS Annex is designed to fundamentally resolve the massive vaccine inequity that plagued the COVID-19 response, where wealthy nations secured the vast majority of available doses, leaving developing nations vulnerable. The system is based on a reciprocal commitment:
Pathogen Access:
Low- and middle-income countries commit to the rapid and timely sharing of pathogen genetic sequence data to the WHO system, allowing global scientists to track, study, and develop countermeasures for new outbreaks.
Benefit Sharing:
In return, participating manufacturers of vaccines, diagnostics, and therapeutics contractually commit to providing the WHO with a mandatory percentage of their real-time production during a pandemic.
The core proposal under negotiation is a 20% commitment, split between a 10% donation and 10% sold at affordable prices for distribution to high-risk and vulnerable populations globally.
This system is viewed by the Global South as non-negotiable—a necessary insurance policy against being sidelined in a future health crisis.
The Crisis of Sovereignty and IP
The IGWG negotiations in Geneva have become severely deadlocked over two critical and familiar battlegrounds, fueled by opposition from the pharmaceutical industry and several high-income nations.
Mandatory Commitment vs. Voluntary Donation:
Wealthy countries are lobbying hard to ensure that the 20% commitment remains merely a “voluntary” pledge or a goal, rather than a legally enforceable obligation tied to receiving pathogen data.
They argue that a mandatory quota system violates Intellectual Property (IP) rights and disincentivizes the rapid research and development (R&D) crucial for new countermeasure deployment.
Technology Transfer:
Another core battle revolves around technology and know-how transfer (Article 11). Developing nations insist on firm commitments for the transfer of manufacturing knowledge and processes to regional hubs to build production capacity in the Global South.
High-income nations and industry groups are pushing for this to remain strictly “voluntary and on mutually agreed terms,” effectively allowing corporations to maintain monopolistic control over life-saving technologies.
For observers in London-UK, the debate is a direct test of multilateralism. The political capital spent on reaching the main treaty framework is now at risk of being squandered if the final annex fails to secure truly mandatory equity mechanisms.
The urgency is compounded by the fact that the full Pandemic Agreement cannot be opened for signature and ratification by member states until the PABS Annex is finalized, threatening to delay crucial provisions—including financing mechanisms and robust surveillance systems—that are needed now to manage current outbreaks and prevent the next pandemic.
The IGWG is under pressure to deliver a consensus draft by the start of 2026 to allow for formal adoption at the next World Health Assembly in May 2026. Failure to do so risks fracturing global health cooperation and condemning the world to repeat the mistakes of the past.
Headline Points
Treaty Stalled: The WHO Pandemic Agreement framework, adopted in May 2025, is stalled pending the finalization of the legally binding Pathogen Access and Benefit-Sharing (PABS) Annex.
Equity Mechanism: PABS requires countries to share pathogen data rapidly in exchange for a commitment from manufacturers to supply 20% of real-time production (vaccines, diagnostics) to the WHO for equitable distribution.
Crisis Point: Negotiations in Geneva are deadlocked over whether the 20% commitment and technology transfer provisions should be mandatory and legally enforceable or remain voluntary.
Geopolitical Conflict: Low- and middle-income nations demand mandatory terms to prevent vaccine hoarding, while high-income nations cite concerns over Intellectual Property (IP) rights and R&D incentives.
Delay Consequences: The entire treaty cannot enter into force until the PABS Annex is completed, delaying the implementation of crucial global health surveillance and preparedness systems.
