The Political Declaration on Pandemic Prevention, Preparedness and Response was not approved by consensus by the United Nations General Assembly, and is likely to be put to a vote at a later stage on the UN calendar. 

Objections by the United States and a few other states appeared to block a consensus agreement on the draft text at Friday’s high-profile UN High-Level Meeting (HLM) on pandemics, pushing the issue back to the General Assembly, where it could go to a vote before the close of the Assembly’s annual session in December. 

“The United States is not in a position to support this text in full,” said the US representative at the debate. “Critical issues remain unresolved. Whether it is the inclusion of divisive ideologies that lack definitional consensus or references to an unfinished negotiation on pathogen access and benefit sharing in an agreement that failed to achieve international consensus, the United States is not in a position to support this text,” she said.  

Several delegations had come expecting to adopt the text on Friday. Peru said it hoped the declaration would be adopted “this afternoon,” while Cabo Verde referred to the declaration “we are approving today.” The Netherlands said it “regrets that member states have not been able to reach agreement on a common political outcome.”

Closing the meeting, General Assembly President Khalilur Rahman said that “while there is broad support for the text, there continue to be some observations.” The document “will be considered further by the member states in the General Assembly,” he said. No date was given before the session closed for when this will occur.

Support from Africa and Caribbean

The declaration drew strong support from African nations, led by Burundi, which delivered the statement on behalf of the African group, and Cabo Verde, and from major Latin American and Caribbean countries including Brazil, Mexico and Haiti, which spoke for the Caribbean Community (CARICOM) at Friday’s debate. 

In Asia, developing countries like Bangladesh said they “welcome the political declaration and its vision and call for solidarity.” 

The European Union said it remains “fully committed” to the declaration’s “overarching objective” – signaling that the 27-member bloc would not oppose the declaration’s passage.

But the EU representative also expressed reservations, stating the text “falls short of our goals” and set out “explicit red lines.” Its statement took particular issue with language in the draft text that supported heavy reliance on international trade rules allowing countries to issue “compulsory licensing” in health emergencies, saying it could undermine intellectual property. Technology transfer must be “voluntary and on mutually agreed terms,” the EU said, emphasising the importance of such arrangements with low- and middle-income countries.

Italy went further, saying that it “had concerns regarding the political declaration,” noting that it “did not support he adoption of the WHO Pandemic Agreement,  nor the 2024 amendments to the International Health Regulations,” suggesting that the changes expand the WHO’s role beyond its constitutional mandate to a degree that impinges on national sovereignty.

Italy also objected to terms such as “infodemic management,” misinformation and disinformation, saying they lack an agreed definition. It added that references to financing, technology transfer and intellectual property were “non-binding.”

Other countries also registered reservations. India called the declaration non-binding and said it “must not prejudge” the ongoing PABS negotiations. Germany said it “would have hoped for a more balanced approach,” stressing voluntary technology transfer.

Venezuela, speaking for the Group of Friends in Defense of the UN Charter, said only that the group “takes note” of the declaration.

WHO urges rapid approval of pathogen access talks

WHO’s Director General Dr Tedros Adhanom Ghebreyesus, meanwhile, affirmed that the recent WHO agreements do not impinge on national sovereignty and urged member states to reach a rapid conclusion on the Pathogen and Benefit Sharing (PABS) annex to the WHO Pandemic Agreement, approved in 2025. 

A bitter standoff between developing countries and high-income European nations has stalled progress on the annex, which aims to hammer out a more precise, rules-based approach for ensuring immediate sharing of pathogen samples and genetic sequence data – but also guarantee benefits to developing countries that participate in sample sharing, from the drugs, diagnostics and vaccines thus produced.

“Today, I leave you with just one request, just one,” said Tedros, “Get PABS done as soon as possible. Further delays are not just delays in procedure or process. They are delays that cost all countries daily when the next pandemic arrives. 

“We can never say the world is ready enough. The threat evolves and so must we,” he added. “Is the world more ready than it was before COVID-19? Yes and no. And if you fulfil the commitments you’re making today, you will make it a yes.”

Tedros’ appeal was echoed by former New Zealand Prime Minister Helen Clark, co-chair of the Independent Panel, which issued a biting report in 2021 on shortcomings in global preparedness and response. She cited the recent outbreaks of hantavirus and the Ebola Bundibugyo virus as examples of heightened outbreak risks that the world faces today.

“We can and we must do better at anticipating and managing known risks before they become international emergencies.”

On the plus side, she noted how “good, updated International Health Regulations” had tightened countries’ reporting obligations to WHO, leading to a rapid WHO declaration of a public health emergency of international concern over the Bundibugyo outbreak within two days of its confirmation, with Africa CDC following a day later. 

“But we now know that the virus had been spreading for some time,” she added, noting that surveillance of emerging threats remains inadequate. 

Along with more pandemic finance, the world needs global coordination, she emphasised, urging rapid approval of the PABS annex. The 2025 WHO Pandemic Agreement cannot go to member state signature, ratification and implementation before the PABS annex is finalised, she underlined. 

“A path must be found through the current impasse in negotiations,” she said. “That path must support the fast sharing of pathogen samples and sequence information, and it must. and it must ensure guaranteed access to benefits. My call, like that of Dr Tedros, to leaders around the world is to please put your weight behind these negotiations.” 

Developing nations call for approval of PABS annex 

The PABS annex aims to set up an enforceable system for implementing a 20% set-aside of real-time health products to countries in need, as mandated in the overall Pandemic Agreement approved last year.  According to the agreement, 10% would be provided free of charge and 10% would be provided at non-profit prices.  

“Kenya supports rapid WHO access targeting at least 20% of real-time production, clear positions on sequence information, and enforceable arrangements that deliver benefits when they are most needed,” said the Kenyan delegate at the HLM, as one expression of developing country positions. 

“We must ensure that the rapid sharing of pathogens and scientific information is matched by the rapid, fair, and equitable sharing of the benefits arising from their use, including vaccines, diagnostics, and therapeutics, and that countries contributing pathogens and genomic information can meaningfully benefit from the products and technologies developed from them,” added Egypt.

Belgium told the meeting that the PABS talks had “stalled, with little progress since the 2025 World Health Assembly.” Estonia urged countries to reach a compromise no later than the World Health Assembly in May 2027. 

Pandemic Agreement Negotiator Warns Against Losing Momentum

US bilateral deals are elephant in the room of PABS negotiations

The elephant in the room holding up an agreement is, in fact,  the United States’ declared opposition to any multilateral pandemic accord, one former European negotiator told Health Policy Watch just ahead of Friday’s debate.  

Instead, the US is setting up bilateral deals with dozens of low-income nations whereby it would be assured of access to pathogen data as a part of donor assistance packages, but with no express guarantees of real-time products for pandemics and health emergencies. 

In its statement on Friday, the US said it “stands ready to work directly with responsible partners” to strengthen preparedness and “stop dangerous outbreaks at their source.”

Europe is therefore fearful that should it sign onto a PABS agreement that provides for strictly linked provisions on pathogen access and benefit sharing, its pharma industries will be hamstrung, in comparison to US-based manufacturing powerhouses that face no such financial or technical limitations. 

“That’s the elephant in the room holding up a PABS agreement,” the former negotiator said, on condition of anonymity. 

“The US has pursued specimen-sharing agreements with a number of countries, although the full extent and how it will practically interact with a future PABS system is unclear,” observed one Geneva-based NGO expert. “That potentially creates a competing pathway whereby pathogens/materials could reach US actors”  – while manufacturers participating in a PABS benefit-sharing system are left out in the cold. 

Other major powers weighed in on the declaration to varying degrees. While China backed WHO’s “leading and coordinating role” and called for progress in the pandemic agreement negotiations, it did not take a firm stance on whether it supports the declaration as written.

“At present, unilateralism is causing growing shocks. The health divide continues to widen, and the gap in health financing has become increasingly evident,” China’s delegate said.

The delegate called for countries to “advance the relevant negotiations and deliberations on the pandemic agreement,” and to “urge developed countries to genuinely fulfil their commitments by providing developing countries with technological and financial support, so that no country or no one is left behind.”

Russia also took the floor, but like China, elected not to state its position on the declaration. It cited its Covid-19 vaccine deliveries to 71 countries and its own Ebola vaccine, and argued that “bureaucratic barriers and politicization should not stand in the way of saving human lives.”

Civil society and industry response to HLM declaration  

Meanwhile, NGO access groups expressed disappointment at the delays in adoption of the Political Declaration – while pharma actors 

“We are disappointed that UN Member States are putting off adoption of the Political Declaration, as we risk losing momentum at a time when global cooperation has never been more crucial, leaving the world less prepared for and protected from the next pandemic,” said Rachel Cohen, senior advisor at the Geneva-based Drugs for Neglected Diseases initiative (DNDi). 

“Despite this setback, we have been encouraged over the last week to hear countries repeatedly recognise that research and development (R&D), including the goal of developing medical countermeasures within 100 days of an outbreak being identified, must be at the core of pandemic preparedness efforts and equitable access must be built into the R&D process by design. UN member states can and should move ahead, especially within regional and cross-regional coalitions and alliances, to put the commitments in the draft Declaration into action.  

Meanwhile, the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) affirmed its support for a multilateral agreement governing pathogen access saying: 

“We are calling for global frameworks that support rapid and effective action by facilitating the timely sharing of pathogen samples and scientific information, strengthening research and development, and enabling regulatory cooperation. They should also support practical measures such as day-zero financing and coordinated response mechanisms that allow partners to mobilise quickly when new threats emerge. The objective must be to accelerate collaboration and innovation, not create additional barriers or complexity during a crisis.”   

One Health approaches need more development

While many member states spoke about the importance of strengthening One Health approaches, also endorsed in the declaration text, there is little detail in the text about how to do that.

Prevention of pathogens from escaping the wild into human communities through deforestation, wild animal trade, water and sanitation and other pathways, civil society actors stressed.

“We particularly appreciate the Declaration’s endorsement of an integrated One Health approach, which recognises the interconnectedness of human, animal and environmental health and the need to address the drivers of disease emergence and pathogen spillover,” said a Pandemics and Animal Welfare (PAW) Working group in a joint statement to the HLM.

“At the same time, we note that, even though most emerging infectious diseases are zoonotic, references to animals remain limited throughout the Declaration, while animal welfare receives no explicit recognition.

“To strengthen prevention efforts, member states should place greater emphasis on addressing pandemic risks at their source. This requires a clear commitment to identifying and mitigating the practices and conditions that create opportunities for pathogen spillover, including biodiversity loss, habitat disruption, wildlife exploitation and trade, and animal production systems.”

Image Credits: Nature .