21-05-2025
How to fight the next pandemic, without America
HEARTFELT APPLAUSE greeted the adoption on May 20th of the World Health Organisation (WHO) Pandemic Agreement, a treaty that commits governments to be more responsible and less selfish when future pandemics emerge. There was doubtless an edge of relief to the clapping. After three years of fierce argument, an overwhelming majority of health ministers and officials from over 130 countries—but not America, which is leaving the WHO and boycotting the treaty—voted to approve the text.
To cheerleaders, this was hopeful applause. The WHO boss, Tedros Adhanom Ghebreyesus, congratulated governments on a 'victory for public health, science and multilateral action'. Opponents of the new pandemic agreement, who include the Trump administration but also populist politicians in Europe and elsewhere, might call those clapping sinister. An executive order issued on Mr Trump's first day in office announced America's withdrawal from the WHO and from negotiations to craft the new pandemic treaty. The order added that America would not be bound by amendments to international health regulations agreed on in 2024. Those changes, which tighten virus-surveillance and reporting obligations on governments, were demanded by American negotiators during the Biden administration. Mr Trump accuses the WHO of mismanaging the covid-19 pandemic under China's influence, and of demanding too much money from America.
The pandemic treaty has sparked wild if vague claims in several countries. In 2024 a fringe candidate for America's presidency called the pandemic agreement a power-grab by 'international bureaucrats and their bosses at the billionaire boys club in Davos' that tramples Americans' constitutional rights. Alas for the WHO, that long-shot candidate, Robert F. Kennedy junior, is now Mr Trump's health secretary. In Britain, a right-wing political leader, Nigel Farage, falsely charges that the pandemic treaty will allow the WHO to impose lockdowns 'over the heads of our elected national governments'. In fact, the treaty explicitly reaffirms the sovereign authority of national governments.
Was the applause in Geneva naive? Several times talks nearly collapsed, as bold promises made by world leaders during the covid-19 pandemic ran into long-standing divisions between high- and low-income countries. Worryingly, a year or two of hard wrangling still lie ahead, as governments hammer out the details of a political, scientific and commercial bargain at the heart of the treaty, known as the Pathogen Access and Benefit Sharing system (PABS). That compact must balance the interests of very different places: on the one hand, the developing countries where many new viruses emerge; on the other, the wealthier nations where advanced vaccines and treatments are typically discovered.
Success is not a given. For PABS to save lives, some poor or struggling governments will need to step up surveillance of remote rural regions where people live among domestic and wild animals, and which create conditions that favour the spread of viruses into human hosts. They must report troubling discoveries swiftly and share pathogen samples with foreign scientists, even at the risk of suffering travel bans that bring trade and tourism to a halt. In return for free and rapid access to those same pathogens, some of the world's most powerful governments and drug firms must commit to hand to the WHO, in real time, 20% of the vaccines, therapies and diagnostic tests they produce to fight any new scourge.
The politics of inequality nearly derailed the process. With reason, delegates from the global south accused rich countries of taking pathogens found among their populations, using them to create life-saving vaccines and drugs, then hoarding those same miracle cures for rich-world customers. Some developing countries called for cash payments for genetic data, following the model of an international agreement, the Nagoya Protocol, that allows countries to demand fees from drug and food companies or other entities that profit from their genetic heritage. Adopting PABS would make the sharing of pandemic-causing pathogens a public good, keeping Nagoya Protocol payments at bay.
Other emerging economies, notably those with fast-growing pharmaceutical industries, called for intellectual property (IP) rights to be weakened or suspended during pandemics, and for technology transfers so that Africans and Asians can make their own vaccines. European governments said that defending IP was a red line, arguing that companies need a chance to recoup research costs, or innovation will suffer. Rich-world pharmaceutical firms called the expansion of advanced vaccine-manufacture a noble but long-term goal. In the meantime, they argued, haggling with governments over fees for pathogens can slow down vital cures, for example during a Zika-virus outbreak in Latin America in 2016.
Sometimes, avoiding failure is the big win
China was 'very comfortable with the polarised debate' in Geneva, says an expert on the talks. 'They had no interest in eroding IP protection, they have lots of IP. But they liked seeing a geopolitical fight between north and south.'
Mr Trump saved the treaty, argues Lawrence Gostin, a professor of global health law at Georgetown University: governments compromised to save the multilateral order from America.
Aalisha Sahukahn heads the Centre for Disease Control on the Pacific island-state of Fiji and led her country's delegation in Geneva. There is no guarantee that governments will keep treaty commitments, she concedes. Still, the mere act of agreeing on shared principles reassures small countries like hers. 'A standard is set: this is how we should be behaving.'
Much could still go wrong. But if nothing else, rational self-interest was tested and survived. That is surely worth a cheer.
Get 360° coverage—from daily headlines to 100 year archives.
