17MAY

Pandemic Agreement still unsigned after one year

3 min read

11:07UTC

WHO member states concluded the resumed 6th IGWG session on 1 May by agreeing to extend negotiations on the PABS annex, leaving the Pandemic Agreement inoperative one year after its adoption at WHA78 and scheduling the next substantive session for 6-17 July 2026.

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Key takeaway

One year after adoption, the Pandemic Agreement's PABS annex remains unresolved, with no vaccine-sharing mechanism in force.

WHO member states concluded the resumed 6th session of the IGWG (Intergovernmental Working Group on Pandemic Prevention, Preparedness and Response) on 1 May by agreeing to extend negotiations on the PABS (Pathogen Access and Benefit-Sharing) annex to the Pandemic Agreement. ¹ The Agreement was adopted at WHA78 in May 2025. One year on, it cannot be signed or ratified because the PABS annex, described by WHO as 'the last piece of the puzzle', remains unresolved. The 7th IGWG session is scheduled for 6-17 July 2026. WHA79, convening in Geneva 18-23 May, is expected to formally authorise continued negotiations through mid-2027, meaning the Agreement could remain inoperative for at least two full years post-adoption.

The structural tension behind PABS has resisted resolution since the treaty's initial draft: high-income countries want rapid, frictionless access to pathogen samples for vaccine development; low- and middle-income countries want guaranteed access to the resulting vaccines. The same tension disabled the Nagoya Protocol's application to pathogens under the Convention on Biological Diversity. No countries or blocs have publicly named themselves as the obstacle to consensus; WHO's characterisation that 'differences will be overcome' gives no indication of whether the gap is technical (sample-sharing definitions) or political (vaccine-access guarantees). NTI Bio and Resolve to Save Lives (founded by former CDC director Tom Frieden) have consistently argued PABS is the treaty's load-bearing arch.

The governance stasis lands in a week when the US dairy H5N1 picture is deteriorating and Andes hantavirus is tracking across six countries. The WHO R&D Blueprint Q1 2026 roadmaps represent the parallel preparedness track that is moving: published pathogen roadmaps for filoviruses, arenaviruses, and paramyxoviruses in the first quarter. The 7th IGWG session opens only in July 2026, with no interim deliverables agreed. The R&D Blueprint covers pathogen research prioritisation; it cannot substitute for the vaccine-sharing mechanism that PABS was designed to provide in a declared emergency.

Deep Analysis

In plain English

In May 2025, most of the world's countries agreed in principle to a new **Pandemic Agreement** at the **World Health Organisation**. The idea is to set legal rules for how countries share dangerous pathogen samples and how they get fair access to vaccines when a pandemic happens. But there is one unresolved part: the **PABS annex** (Pathogen Access and Benefit-Sharing). It is the section that says: if country A discovers a new virus and shares the sample with vaccine manufacturers in country B, what is country A guaranteed to get back in return? Rich and poor countries disagree on the terms. A year after the agreement was adopted, that section is still being negotiated. Without it, the whole agreement cannot be signed or come into legal force. The next round of talks is in July 2026. In the meantime, if a new pandemic started today, the rules for sample sharing would still be the old voluntary bilateral deals that left many poor countries waiting months for COVID vaccines.

Deep Analysis

Root Causes

The structural conflict underlying PABS negotiations has two components. First, origin countries (predominantly low-income, which historically contributed samples) and destination countries (predominantly high-income, which host vaccine manufacturers) have economically opposite interests: origin countries want guaranteed rapid access to finished vaccines; destination countries want rapid sample access without binding financial obligations.

Second, **NTI Bio** and **Resolve to Save Lives** have documented that the existing Pandemic Influenza Preparedness (PIP) Framework, the only prior benefit-sharing arrangement for pathogens, generated approximately $350 million for WHO's preparedness programmes between 2011 and 2020 but delivered zero guaranteed vaccine doses to contributing countries during the 2009 H1N1 emergency.

Negotiators from the Global South use PIP's failure as evidence that voluntary frameworks do not deliver; high-income country negotiators use PIP's operational complexity as evidence that mandatory frameworks create more friction than they solve.

What could happen next?

Risk
If H5N1 B3.13 acquires sustained human-to-human transmission before PABS is resolved, the sample-sharing and vaccine-access framework for a pandemic response would default to the bilateral deal-making model that disadvantaged low-income countries in 2020-2021.
Medium term · 0.72
Consequence
WHA79 (18-23 May 2026) is expected to authorise continued negotiations through mid-2027, effectively extending the Pandemic Agreement's ratification gap by at least another year.
Immediate · 0.85
Precedent
The PABS stall follows the Nagoya Protocol timeline; a 2027 resolution and 2028-2029 ratification window would mean the Pandemic Agreement does not enter force until roughly a decade after COVID-19 demonstrated its necessity.
Long term · 0.6

Source Landscape

This story draws on neutral-leaning sources from Switzerland

Switzerland

Primary parallel: The 2010 Nagoya Protocol on biodiversity benefit-sharing, adopted under the Convention on Biological Diversity, established the same structural precedent: genetic resources (biodiversity) in exchange for guaranteed benefit-sharing with source countries.

The Nagoya Protocol took four years to ratify after adoption (2014 entry into force) and has generated ongoing compliance disputes. PABS explicitly mirrors the Nagoya model applied to pathogen samples rather than biodiversity, which is why the same negotiating blocs are aligned in similar positions.

Counter-parallel: The International Health Regulations 2005 amendments, adopted at WHA77 in June 2024, moved faster because they contained no benefit-sharing component requiring financial flows to source countries. The IHR amendments are already in force; the Pandemic Agreement's PABS annex is the single element that adds the equity dimension the IHR lacks, which is also the single element that has stalled ratification.

Consensus view: Suerie Moon (Geneva Graduate Institute) and Lawrence Gostin (Georgetown University's O'Neill Institute) have both characterised PABS as the structural heart of the Pandemic Agreement: without it, sample sharing from a pandemic-origin country to vaccine manufacturers remains governed by bilateral deals, recreating the 2020-2021 COVID vaccine access gap that left low-income countries at the back of the queue while wealthier nations secured doses through advance purchase agreements.

Counter-view: Several high-income country negotiators, including delegations from the US (when present) and EU, have argued that PABS' proposed mandatory benefit-sharing obligations would create a legal deterrent to sample sharing by giving origin countries leverage to withhold samples until terms are agreed, which could delay early warning intelligence during the critical first weeks of a novel outbreak.

On this view, voluntary rapid sharing plus voluntary access commitments, the pre-PABS default, outperforms a mandatory system with high transaction costs.

Key tension: Whether mandatory benefit-sharing obligations accelerate or delay the early sample sharing that gives the world its best chance of producing a vaccine before an outbreak becomes a pandemic.

Sources:WHO

Mentions:World Health Organization →NTI Bio →Resolve to Save Lives →Geneva →H5N1 →WHO R&D Blueprint →Pathogen Access and Benefit-Sharing →Lawrence →WHO Pandemic Agreement →IGWG →WHA79 →Lawrence Gostin →Suerie Moon →Andes virus →CDC →IHR amendments →

First Reported In

Update #2 · B3.13 gets better at humans as testing ends

WHO· 12 May 2026

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Causes and effects

Caused by

WHO publishes three Q1 pathogen-family roadmaps

WHO R&D Blueprint roadmaps represent the preparedness track that IS moving; the PABS extension stasis is the governance track that is not.

Occurred 31 Mar 2026

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This Event

Pandemic Agreement still unsigned after one year

Without a resolved PABS annex, the Pandemic Agreement has no legal mechanism for rapid pathogen-sample sharing or equitable vaccine distribution, reverting any declared pandemic emergency to the bilateral deal-making that left low-income countries at the back of the COVID-19 vaccine queue.

Led to

No vaccine, no treatment, no MCM

PABS annex extension agreed 1 May leaves no resolved legal architecture for vaccine sharing even if Regeneron or Ridgeback produced Bundibugyo cross-reactivity data; MCM gap and treaty gap compound.

Occurred 17 May 2026

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Different Perspectives

CIDRAP / Michael Osterholm

CIDRAP's coverage framed the Bundibugyo outbreak against simultaneous H5N1 and Andes hantavirus pressures on the same federal response budget and noted that MCM development for neglected non-Zaire Ebola species is the unresolved gap in the post-2014 preparedness rebuild. The first Bundibugyo PHEIC arrives with that gap confirmed open.

Resolve to Save Lives / Tom Frieden

Frieden's 7-1-7 metric (outbreak detected within 7 days, reported within 1, responded to within 7) was violated on all three counts in Ituri: detection lagged by four-plus weeks, the WHO signal came five or more weeks after community deaths, and the response opened at 246 suspected cases rather than at index.

Uganda Ministry of Health / Diana Atwine

Permanent Secretary Atwine confirmed the Kampala index case as imported on 14 May and activated protocols rehearsed in Uganda's 2022 Sudan ebolavirus response, which contained 142 confirmed cases in 113 days without a licensed vaccine. A mobile laboratory at Bwera Hospital on the DRC border shortens cross-border confirmation to same-day.

DRC Ministry of Health

No formal public statement had been issued by the DRC Ministry of Health as of the 17 May WHO PHEIC declaration. WHO AFRO confirmed Kinshasa has activated national coordination mechanisms; the ministry's own communications channel has not produced named attribution or revised case counts.

US federal public-health bench / Jay Bhattacharya and Brian Christine

Jay Bhattacharya holds both the NIH Director and acting CDC Director roles simultaneously; Brian Christine, an Alabama urologist confirmed in October 2025, is the HHS Assistant Secretary for Health. The combination is the thinnest senior US public-health roster since 2014, and neither position has a confirmed CDC director, confirmed FDA commissioner, or confirmed ASPR head alongside it.

Imperial College London / Anne Cori and Neil Ferguson

Cori and Ferguson placed the case-fatality rate at 30 to 40 per cent and assessed the outbreak had likely gone undetected for weeks or months before the 5 May WHO signal. The four-week community-to-signal gap converts the INRB confirmation turnaround from a success story into evidence of an upstream surveillance failure.