After more than three years of talks set in motion by the COVID-19 crisis, countries have adopted the first global agreement on pandemic preparedness and response. The World Health Organization (WHO) Pandemic Agreement sets out the principles, approaches, and tools for better international coordination across a range of areas, including equitable and timely access to vaccines, therapeutics, and diagnostics.
During the 78th World Health Assembly (WHA), WHO member States adopted the Agreement by consensus on 20 May 2025, following its approval the day prior by vote, with 124 in favor, zero objections, and 11 abstentions. Bulgaria, Egypt, Iran, Israel, Italy, Jamaica, the Netherlands, Paraguay, Poland, the Russian Federation, and Slovakia abstained, with reasons ranging from the perceived lack of consensus around the decision to concerns about state sovereignty, among other issues. The US did not take part in the vote.
The Agreement outlines measures on pandemic prevention, including through One Health – an approach that unifies the health of people, animals, and ecosystems. It also contains provisions on: building geographically diverse research and development capacities; facilitating the transfer of technology and related knowledge, skills, and expertise for the production of pandemic-related health products; mobilizing a skilled, trained, and multidisciplinary national and global health emergency workforce; setting up a coordinating financial mechanism; taking concrete measures to strengthen preparedness, readiness, and health system functions and resilience; and establishing a global supply chain and logistics network.
At the same time, the Agreement affirms the sovereignty of countries in addressing public health matters within their borders, noting that nothing in the draft agreement shall be interpreted as providing WHO any authority to direct, order, alter, or prescribe national laws or policies, or mandate States to take specific actions, such as ban or accept travelers, impose vaccination mandates or therapeutic or diagnostic measures, or implement lockdowns.
According to a WHO press release, the resolution on the WHO Pandemic Agreement outlines steps to prepare for its implementation. It includes launching a process to negotiate a Pathogen Access and Benefit Sharing system (PABS) through an Intergovernmental Working Group (IGWG). The result of this process will be taken up at the 79th WHA next year. The WHO Pandemic Agreement will be open for signature once the Assembly adopts the PABS annex and will enter into force after 60 ratifications.
WHO member States established an intergovernmental negotiating body (INB) to develop a pandemic agreement in December 2021, in response to the devastation wrought by the COVID-19 pandemic. Following 13 formal rounds of negotiations and numerous informal and intersessional meetings, the INB finalized a proposal for the WHO Pandemic Agreement on 16 April 2025, forwarding it to the WHA for consideration. [WHO Press Release] [UN News Story]