Vivianne Ihekweazu (Lead Writer)
The final Pathogen Access and Benefit-Sharing (PABS) negotiations must be the true test of global equity in health.
Sometimes, it is not immediately obvious that history is being made, but this time, it was. Amid enthusiastic applause, the new Pandemic Agreement, a legal instrument, was finally adopted by 194 Member States on 20th May 2025, at the 78th World Health Assembly.
It has been a demanding three-year journey, filled with late nights and tough negotiations. The process began in March 2021, when world leaders called for a new international agreement. It reflected the strength of multilateralism and the power of global co-operation to shape how the world prepares for and responds to pandemics.
COVID-19 exposed deep inequities
The COVID-19 pandemic exposed inequities in access to lifesaving tools, including vaccines, diagnostics, and medicines that left many countries, especially in Africa, very vulnerable. Meanwhile, wealthier countries, procured far more vaccines than they needed.
This undermined any collective effort to keep everyone safe and ensure equal access to essential resources. Determined to find better way, WHO Member States of the World Health Organization (WHO), established a dedicated Intergovernmental Negotiating Body (INB) to develop a new framework, within a timeframe never attempted before.
While the adoption of the Pandemic Agreement is a major milestone, this is by no means the end of the road. Rather, the start of a new journey. One of the most contentious issues during the negotiations, was the details of a new Pathogen Access and Benefit-Sharing (PABS) System.
COVID-19 revealed the failure of voluntary sharing principles in ensuring equitable and timely access to pandemic-related products. As a result, the Pandemic Agreement is not yet open for signature. Article 12, titled “Access and Benefit Sharing,” which outlines how pathogens are shared and how the resulting benefits distributed, must first be finalised and translated into a practical system, which will be outlined in an annex.
Making the agreement work
Although the principles of the agreement have been agreed, WHO Member States must now reconvene, through an Inter-Governmental Working Group (IGWG) to define what, how and when information on pathogens will be shared to support the development, and allocation of appropriate counter measures, such as diagnostics, medicines and vaccines.
If successful, then the world would solve one of the biggest failures of the COVID-19 pandemic. The inability of low- and middle-income countries (LMICs) to access the countermeasures they desperately needed. Many received vaccines too late, in limited quantities, or not at all, long after wealthier countries stockpiled far more than they required.
In an age of 24-hour news and social media, citizens in African countries watched this injustice unfold in real time. So, many countries from the “Global South” went into the Pandemic Treaty negotiations, echoing the sentiment of one of Nelson Mandela’s famous speeches “never, never and never again shall it be” that countries are left out of accessing the very products that save lives and protect health systems.
Africa’s united voice in the talks
This is why the African region approached the PABS negotiations prepared and united, working with the political leadership on the African continent, and coordination by a group of diplomats and health attaches in Geneva known as the Africa Group. African countries worked hard and joined forces to negotiate collectively, putting the shared interests of the continent above narrow and individual agendas. This unity was not automatic, as many country representatives were initially working unilaterally, pushing narrow positions and interests. It had to be built to serve the continent.
Image credit: Africa CDC
However, this was never going to be effective. The strengthening of collective positions occurred after Africa CDC convened health ministers in Addis Ababa and the health attachés followed up with convenings in Geneva to reach consensus on the many tricky issues. As they worked together, they grew in confidence and accepted that they could not win on all fronts. A hard lesson had been learnt, if COVID-19 taught us anything, it is that what benefits one African country ultimately benefits another. It is in the continent’s collective interest that strengthening our collective health security must become the norm, not the exception.
The world has a second chance to get this right, with Africa as strong and empowered participant. By speaking as a bloc, the African Group strengthened its negotiating power. It demonstrated what is possible when the continent stands together around a common purpose. The African Group’s position was rooted in solidarity, that no country should be expected to share pathogens and genetic data, which is critical to global health security, without guaranteed and equitable access to the benefits that result from them. This is what fairness and equity really means. The path forward must be clear; all Member States must now push to achieve an ambitious and legally binding PABS system that benefits the world. The solidarity shown in these negotiations should serve as a model for future global health diplomacy.
Why Pathogen Access Must Guarantee Product Access
At the heart of the PABS debate is a simple truth, you cannot ask countries to share pathogens and data during outbreaks, without also guaranteeing them access to the tools developed from those pathogens. This is especially important for Africa, which hosts rich biodiversity and bears a disproportionate burden of emerging infectious diseases. This is why the PABS system is so important and mutually beneficial for all. An ideal system will cover all pathogens with pandemic potential, clearly define benefit-sharing obligations, and ensure that these obligations are binding and time-sensitive.
Securing a Binding, Equitable PABS Deal
The adoption of the Pandemic Agreement should not lull us into complacency. In many ways, the hardest part is just beginning. The finalisation of the Annex that defines PABS, based on Article 12 will determine whether this agreement lives up to its promise.
For African countries, the task ahead is clear:
- Stay united: The strength of the African negotiating bloc lies in its solidarity. That unity must be preserved and reinforced as PABS discussions continue. But also stay connected to the world, At the heart of the Pandemic Agreement is global solidarity.
- Push for legal guarantees: Voluntary commitments are not enough. The PABS system must be backed by clear legal obligations that ensure benefits are not delayed or withheld.
- Champion regional manufacturing: Equity is also about building local capacity. Access must go hand-in-hand with investment in Africa’s ability to produce its own diagnostics, vaccines, and treatments.
African countries must continue to show leadership and demand fairness in order to ensure that the lessons from the last pandemic are not ignored. If we have learnt anything, it is this, that “diseases do not respect borders” and global health security will remain a hollow phrase until equity is hardwired into every agreement and every response to the future threats we face.