The Pandemic Agreement Impasse is an Opportunity, Not a Failure

Overview

This policy brief argues that the repeated failure to conclude negotiations on the WHO Pandemic Agreement, particularly its Pathogen Access and Benefit Sharing (PABS) provisions, should not be viewed as a failure of multilateralism but rather as evidence of it functioning correctly. States raising concerns about sovereignty, reciprocity, proportionality, and unresolved questions of fairness, evidence, and implementation are exercising legitimate diplomatic scrutiny rather than obstructing progress. The brief highlights a stark mismatch between proposed pandemic preparedness spending ($31 billion annually) and the actual historical burden of pandemics (roughly 8 million deaths over 100 years), suggesting resources could be misallocated away from more pressing endemic health priorities.

The document further contends that the Agreement would impose binding obligations for pathogen sharing and surveillance while leaving benefit distribution subject to political discretion and market power concentrated among manufacturers. It emphasizes structural inequities, such as demographic differences between Africa and Europe, that make uniform pandemic policies inappropriate, and questions the evidentiary basis for claims of escalating pandemic frequency. Ultimately, the brief calls for a slower, more deliberative negotiation process grounded in stronger evidence, genuine reciprocity, and national ownership, suggesting that premature agreements risk undermining institutional legitimacy and diverting resources from higher-burden health issues like tuberculosis, malaria, and undernutrition.

Key Findings

• Pandemic preparedness funding ($31 billion annually) is approximately 15 times larger than combined funding for the deadliest endemic diseases (TB, malaria, maternal/neonatal conditions, diarrhoeal diseases).
• Pandemics have caused roughly 8 million deaths over the last 100 years, a much lower burden than diseases like tuberculosis (1.25 million deaths/year) or undernutrition (2.45 million deaths/year).
• The Pandemic Agreement institutionalises binding obligations for pathogen sharing and surveillance while leaving benefit-sharing dependent on political discretion, manufacturing concentration, and market power.
• Evidence for claims of escalating pandemic frequency is weaker than preparedness narratives suggest once surveillance intensity and definitional changes are accounted for.
• The COVID-19 experience showed that equal access to pharmaceutical commodities does not guarantee equal public health outcomes across populations.
• Demographic differences (e.g., Africa's median age of 19 vs. Europe's 44) mean identical pandemic policies impose very different risks and costs, yet the preparedness architecture assumes uniform responses.
• The preparedness agenda prioritises surveillance, emergency declaration, and pharmaceutical deployment over broader determinants of health such as nutrition, sanitation, and health systems strengthening.