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From 18 to 23 May, Geneva will host the 79th World Health Assembly, the main annual forum of the World Health Organization (WHO), where member states discuss global health threats, reform of the international health system, and future rules for responding to new epidemics.

Formally, the agenda is broad: the resilience of health systems, access to medicines, WHO funding, non-communicable diseases, and the impact of climate change on health. But politically, the central question is already clear: why, several years after COVID-19, has the world still failed to build a truly effective mechanism for preparing for the next pandemic?

COVID-19 has already shown how costly unpreparedness can be. According to WHO estimates, excess mortality directly or indirectly associated with the pandemic reached around 14.9 million people in 2020–2021. The International Monetary Fund estimated cumulative global economic losses at nearly $13.8 trillion by 2024, while the World Bank warned that the pandemic could push up to 150 million people into extreme poverty by 2021. These figures explain why disputes over the WHO pandemic agreement are not a matter of technical diplomacy, but a question of global security.

The world has already paid a heavy price for delayed decisions, weak coordination, border closures, competition for vaccines, and the absence of agreed rules in advance.

That is why the current debate in Geneva is not just another round of diplomatic wording. It is a question of whether the world will be able to act faster, more fairly and more effectively next time than it did during COVID-19. The pandemic became a stress test for the international system, and that test was passed with enormous losses. Borders were closed chaotically, states competed for medical equipment, supply chains collapsed, and access to vaccines reflected global inequality. This is why the discussion around the future WHO pandemic agreement matters far beyond the medical agenda.

Source: news-medical.ne

At first glance, it may seem that the world has already learned the lessons of COVID-19. In 2025, WHO member states adopted a pandemic agreement intended to form the basis of a new international architecture for future outbreaks. In practice, however, the agreement remains unfinished. Its key element — the Pathogen Access and Benefit-Sharing mechanism, known as PABS — has still not been agreed. As a result, the treaty is effectively stalled: without the PABS annex, it cannot fully function.

The essence of the dispute is straightforward in principle. To respond quickly to a new threat, countries must rapidly share samples of dangerous pathogens and genetic information about them. This enables scientists, laboratories and pharmaceutical companies to develop tests, vaccines and medicines more quickly. But this raises a central political question: if developing countries provide data about a new virus, will they later receive fair access to the medical products created from that data? This became one of the most contentious issues after COVID-19, when wealthier countries secured vaccines more quickly, while many poorer states waited months for supplies.

The problem is not only logistical but also political: it is about trust between states. Developing countries fear that in a future pandemic they could again become providers of information but not recipients of protection — identifying a new pathogen and enabling global response, only to find that vaccines, tests and medicines have already been secured by richer countries. For many in the Global South, COVID-19 demonstrated that in crises, solidarity quickly gives way to national interest.

This is why the PABS mechanism has become the main stumbling block. It is intended to define how countries will share pathogen data and what guarantees they will receive in return. On paper, it appears technical; in reality, it concerns the distribution of power, money, technology and access to life-saving medical products. For developed countries, the priority is preserving incentives for pharmaceutical companies, protecting intellectual property and avoiding excessive obligations. For developing countries, the priority is avoiding a repeat of the COVID-19 experience, when global systems failed to ensure equal access to vaccines.

This is the core dilemma: the world wants rapid scientific transparency, but is not ready to agree on fair access to the results of that transparency. Countries are expected to share virus data quickly, but many are not convinced they will receive vaccines, tests and medicines on time during a crisis. After COVID-19, this distrust is no longer abstract — it is historically grounded. The pandemic showed that in moments of global crisis, each country prioritises its own stockpiles, contracts and political interests.

The pandemic treaty was designed as a response to this problem. Its logic was to establish rules in advance rather than improvise during emergencies. But when discussions move from principles to binding obligations, states often revert to national self-interest. Everyone agrees the world must be better prepared for the next pandemic, but not everyone is ready to share resources, technologies and production capacity in advance.

The most painful lesson of COVID-19 was vaccine inequality. Wealthy countries secured large volumes of supply in advance, while many developing states faced delays. This was not only a moral issue but also a global health risk: as long as a virus circulates anywhere, it can mutate and re-emerge in new forms. Fair access to vaccines is therefore not charity, but a matter of global security.

Particularly sensitive is the question of what share of medical production manufacturers should allocate to the WHO in a future pandemic . Proposals have included reserving a portion of vaccines, diagnostics and medicines for international distribution. For supporters, this is a minimum safeguard against exclusion. For critics, it risks interfering with markets, contracts, intellectual property and national interests.

Source: asisonline

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