Geneva—After three years of intense negotiations, the World Health Assembly in Geneva has adopted a legally binding “pandemic agreement” aimed at ensuring the world is better prepared for—and protected from—future disease outbreaks. Touted by WHO Director-General Dr. Tedros Adhanom Ghebreyesus as “a gift to the world,” the accord establishes key mechanisms for equitable vaccine allocation, transparent information sharing and coordinated research during pandemics. However, the absence of the United States—the WHO’s largest traditional donor—has raised questions about the treaty’s ultimate effectiveness.
Background: Lessons from COVID-19
The COVID-19 pandemic exposed deep inequalities in access to life-saving medical countermeasures. While wealthier nations secured large vaccine supplies through advance purchase agreements, lower-income countries struggled to obtain doses until late in the global rollout. Delays in case reporting, insufficient pathogen sequencing and fragmented research efforts further impeded a truly global response. Recognizing these shortcomings, the WHO initiated a member-driven process in early 2022 to negotiate a “pandemic accord” that would enshrine lessons learned and prevent a repeat of the inequities witnessed during COVID-19.
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Key Provisions of the Pandemic Agreement
Equitable Allocation of Medical Countermeasures
• 20 Percent Vaccine and Therapeutics Commitment
Manufacturers of vaccines, medicines and diagnostics will be required to allocate at least 20 percent of production to the WHO-managed “Pandemic Pool” at affordable prices. This pool will be distributed first to low- and middle-income countries (LMICs) in proportion to their population and disease burden.
• Advance Purchase and Technology Transfer
The agreement establishes frameworks for voluntary licensing, technology transfer and local manufacturing support, enabling regional hubs—particularly in Africa and South Asia—to produce vital countermeasures swiftly.
Strengthened Surveillance and Information Sharing
• Rapid Pathogen Reporting
Signatories must notify the WHO of novel pathogens with pandemic potential within 72 hours of detection, including genetic sequences, epidemiological data and clinical observations.
• Genomic and Epidemiological Transparency
Member states agree to share genome sequencing data and case counts in publicly accessible databases, precluding export bans or unilateral restrictions that previously hampered global situational awareness.
Coordinated Research, Development and Financing
• Joint Research Platforms
A Global Pandemic R&D Consortium will pool public and private resources to accelerate the development of next-generation vaccines and antivirals, with defined pathways for open-access publishing and data sharing.
• Sustainable Financing Mechanism
An international Pandemic Preparedness Fund, supported by assessed contributions and voluntary donations, will finance R&D, stockpiling and health-system strengthening, prioritizing LMIC readiness.
Governance and Compliance
• Legal Bindingness
Unlike previous WHO agreements, the pandemic accord is a treaty under international law, with a review mechanism every five years and provisions for dispute resolution through a WHO-administered tribunal.
• Transparency and Accountability
An independent Monitoring and Evaluation Panel, comprised of scientific, civil-society and government representatives, will assess compliance and publish annual progress reports.
United States’ Non-Participation and Criticism
Absence from Final Negotiations
• Trump Administration Pullout
In 2020, then-President Donald Trump announced the United States would withdraw from the WHO, citing alleged mismanagement during COVID-19. Although President Biden reversed the formal U.S. exit, the administration opted not to rejoin late-stage treaty talks, citing concerns over treaty scope and sovereignty implications.
• U.S. Criticism at Assembly
In a pre-recorded address, U.S. Health and Human Services Secretary Robert F. Kennedy Jr. lambasted the agreement, claiming it “doubles down” on the WHO’s pandemic response “dysfunctions” and would lock in deficits rather than correct them. The United States neither voted nor abstained, effectively sitting out the final adoption.
Implications of U.S. Absence
• Funding Shortfall
With the United States historically contributing over 15 percent of WHO’s core budget, its absence from the accord raises fears of a funding gap for the Pandemic Preparedness Fund and reduced leverage in global vaccine manufacturing initiatives.
• Geopolitical Ramifications
Analysts warn that without U.S. involvement, other major powers—including China, the European Union and Japan—may steer the accord’s implementation, potentially shifting vaccine supply chains and R&D priorities in directions misaligned with U.S. strategic interests.
Global Reaction and Voting Outcomes
Broad Endorsement by Member States
• 120 Countries in Favor
More than 120 WHO member states voted to adopt the pandemic agreement, reflecting widespread recognition of the need for enforceable global health commitments.
• Zero Oppositions, Eleven Abstentions
No country cast a direct “No” vote, but eleven—including Poland, Israel, Italy, Russia, Slovakia and Iran—abstained, citing domestic legal alignment issues or concerns over WHO governance reforms.
Support from Key Regions
• African Union and Caribbean Community
Regional blocs lauded the accord’s emphasis on manufacturing capacity building, with AU head Moussa Faki Mahamat calling it “a decisive step toward continental health sovereignty.”
• European Union
The European Commission pledged €1 billion in seed funding for the Pandemic Preparedness Fund, matching EU member states’ voluntary commitments and urging the United States to reengage.
Australia’s Stance and Next Steps
Australian Backing and Legislative Process
• Support from Health Minister Mark Butler
Australia’s Health Minister Mark Butler welcomed the agreement as “an important step forward,” emphasizing that future pandemics are “not a matter of if, but when.”
• Domestic Treaty Ratification
Australia will begin its ratification process only after the accord formally opens for signature—anticipated in mid-2026—and concludes parliamentary review. The government must then ensure compatibility with the Biosecurity Act and the Public Health Act before deposit of the ratification instrument.
Implementation Timeline
• Information-Sharing Protocol Negotiations
Beginning July 2025, member states will negotiate annexes detailing data standards, confidentiality safeguards and reporting templates, with the aim of presenting a consolidated text to the 2027 World Health Assembly for adoption.
• Activation of Allocation Mechanisms
The WHO Secretariat will issue guidelines for the 20 percent allocation plan, pilot-testing procurement and distribution procedures through the COVAX facility model by late 2027.
Expert Analysis: Promise and Perils
Optimistic Projections
• Health Equity Gains
Dr. Joanne Liu, former President of Médecins Sans Frontières, hailed the accord as “transformative,” predicting that mandated allocations will save millions of lives in future pandemics by preventing vaccine hoarding.
• Innovation Acceleration
Proponents argue that joint R&D platforms and open-access data will shorten vaccine development timelines from a year to six months or less.
Cautions and Challenges
• Enforcement Difficulties
Critics note that WTO-style dispute mechanisms may lack teeth; if a country fails to report a novel pathogen, sanctions are unlikely without a unified Security Council resolution.
• Manufacturing Bottlenecks
Even with technology transfer, scaling regional manufacturing to meet surge capacity remains a daunting task, requiring massive infrastructure investments and workforce training.
• Political Will and Compliance
Sustaining high-level government commitment during non-crisis periods will be critical. Transparency reports and civil-society oversight will play key roles in holding states to their treaty pledges.
Conclusion: A Test for Global Solidarity
The WHO’s pandemic agreement represents a landmark in public-health diplomacy—establishing binding commitments on equitable access, data sharing and collective financing. Yet its success hinges on robust implementation, sustained funding and universal participation. The notable absence of the United States underscores geopolitical fissures that could hamper treaty efficacy. As countries gear up for signature and ratification, the world watches to see whether this accord will fulfill its promise of a safer future, or become another well-intentioned framework that falters in execution. The coming years will determine if the “gift to the world” can deliver on its potential or remain a treaty on paper.
