WHO Nations Punt on Pandemic Pathogen Sharing, Buying Time but Not Solutions

The room in Geneva has been through this before. Diplomats representing the member states of the World Health Organization wrapped up the resumed sixth session of the Intergovernmental Working Group on the WHO Pandemic Agreement last week having agreed on one thing above all else: they need more time. The specific sticking point is the Pathogen Access and Benefit Sharing annex, known as PABS, a framework meant to govern how countries share dangerous pathogens with the global scientific community and, critically, how the benefits derived from that sharing flow back to the countries that handed over the samples in the first place.

On its surface, this looks like a procedural delay. Beneath it sits one of the most consequential and unresolved tensions in global health governance, one that COVID-19 exposed with brutal clarity and that negotiators have struggled to resolve ever since.

The logic of PABS is straightforward enough. When a novel pathogen emerges, often in a lower-income country, that country's scientists and health authorities collect and characterize samples. Those samples are then shared with laboratories in wealthier nations, where the scientific infrastructure exists to rapidly develop diagnostics, therapeutics, and vaccines. The problem, as countries in the Global South have argued for years, is that the benefits of that scientific work rarely return to the place where the pathogen was first found. Indonesia made this argument forcefully in 2007 when it briefly withheld H5N1 influenza samples from the WHO system, citing exactly this asymmetry. The PABS framework is supposed to fix that, but agreeing on the mechanics has proven extraordinarily difficult.

The core dispute involves what obligations pharmaceutical companies and research institutions in wealthy countries would take on in exchange for access to pathogen samples. Developing nations want binding commitments: guaranteed allocations of vaccines, technology transfer, and real-time access to products developed from their biological contributions. Wealthier nations and the pharmaceutical industry have resisted language that could be interpreted as mandatory licensing or that might slow the speed of product development during an emergency. The result is a negotiating impasse that has now stretched across multiple sessions of the working group.

What makes this particularly difficult from a systems perspective is that the incentives pulling in opposite directions are deeply structural. Pharmaceutical companies operate within intellectual property regimes that reward exclusivity. Governments in high-income countries are accountable to domestic constituencies who expect first access to vaccines their tax dollars helped fund. And lower-income countries, having watched wealthy nations hoover up COVID-19 vaccine supplies in 2020 and 2021, have every rational reason to demand enforceable guarantees rather than voluntary commitments.

The extension of negotiations is not simply a diplomatic inconvenience. There is a meaningful second-order consequence building quietly in the background. The longer the PABS framework remains unresolved, the greater the incentive for individual countries to develop their own bilateral pathogen-sharing arrangements outside the WHO system entirely. Some nations have already begun strengthening regional health security architectures, and the African Union's Africa CDC has been expanding its capacity to handle pathogen characterization domestically. If that trend accelerates, the WHO's role as the central nervous system of global pathogen surveillance could erode, not through any dramatic rupture but through a slow accumulation of workarounds.

A fragmented pathogen-sharing ecosystem would be genuinely dangerous. The speed with which scientists identified and sequenced SARS-CoV-2 in early 2020 depended on a relatively open, if imperfect, system of international data and sample sharing. A world in which countries calculate the geopolitical and economic value of each pathogen before deciding whether to share it is a world that responds more slowly to the next outbreak. The delay measured in weeks at the start of a pandemic can translate into millions of additional infections.

The WHO Pandemic Agreement itself, which was adopted in principle in May 2024 after years of negotiation, was celebrated as a landmark achievement. But the PABS annex was always the unfinished business embedded within that achievement, the part where the hardest trade-offs live. Agreeing to keep talking is not nothing. It signals that member states have not walked away, and that the political will to find a solution, however strained, has not entirely collapsed.

But political will has a half-life, and the next serious outbreak will not wait for a working group to finish its deliberations.