The negotiations on the Pathogen Access and Benefit Sharing System under the WHO Pandemic Agreement: State of Play as of September 2025
By Viviana Munoz Tellez, German Velasquez
The World Health Organization (WHO) Member States adopted a Pandemic Agreement in May 2025 but deferred negotiations on the critical Pathogen Access and Benefit Sharing System (PABS). Despite the tight timeline, the Intergovernmental Working Group (IGWG) has made minimal progress as of September 2025, with no draft text produced and formal negotiations yet to begin. The PABS system is essential for pandemic equity, balancing rapid pathogen sharing with equitable access to vaccines and treatments. But with the current approach to the IGWG process, without formal negotiations underway, Member States risk failing to finalize the PABS Annex by the March 2026 deadline.
This book presents reflections and research that highlight tensions in the negotiations on pandemic preparedness treaties and revisions to the International Health Regulations, underscoring the geopolitical divide between developed and developing countries. It advocates regional health initiatives as a response to the multilateral impasse and reflects on the erosion of foundational public health concepts such as “essential medicines”.
New pandemics are inevitable. How can we best prepare for them and, above all, how can we avoid the mistakes and injustices made during the COVID-19 pandemic?
How can equitable access to medicines and diagnostics be guaranteed when they are produced in a small number of countries? How can we explain the fact that current funding for cooperation in the field of health is in the hands of a small group of Northern countries and foundations from the North? How can the role of the World Health Organization be strengthened? WHO now plays only a minor role in coordinating public health policies. How is it that the concept of “essential medicines”, a major advance in public health policy, is being replaced by that of “medical countermeasures”, a term more in line with the private sectors?
Preparing for future pandemics forces us to ask ourselves: how can we safeguard the general interest, the defense of human rights and public health?
Negotiating Global Health Policies: Tensions and Dilemmas is essential reading for negotiators from the 194 member countries of the World Health Organization (WHO), the World Trade Organization (WTO), and the World Intellectual Property Organization (WIPO) who participate in international negotiations on health and development. Academics and students of medicine, health sciences, law, sociology and political science, as well as intergovernmental organizations and non-governmental organizations who work on access to medicines and global health issues, also would find the book of interest.
Author: Germán Velásquez is Special Adviser, Policy and Health of the South Centre in Geneva, Switzerland. Previously, he was Director of the Secretariat on Public Health, Innovation and Intellectual Property at WHO. He represented WHO at the WTO TRIPS Council from 2001 to 2010. He is the author and co-author of numerous publications on health economics and medicines, health insurance schemes, globalization, international trade agreements, intellectual property and access to medicines.
He obtained a Master’s degree in Economics and a PhD in Health Economics from Sorbonne University, Paris. In 2010, he received a Honoris Causa PhD on Public Health from the University of Caldas, Colombia and in 2015 he received another Honoris Causa PhD from the Faculty of Medicine of the Complutense University of Madrid, Spain.
Policy in Practice: Implementing Antimicrobial Stewardship Post-COVID-19
Q&A and Commentary
By Dr Rasha Abdelsalam Elshenawy
This report summarises the key questions and expert commentary for the South Centre, as well as the South Centre Policy Brief on lessons from the COVID-19 pandemic, to strengthen antimicrobial stewardship and provide practical recommendations discussed during the South Centre webinar on “Strengthening Antimicrobial Stewardship: Policy Insights from COVID-19 and Future Pandemic Preparedness.”
South Centre Statement to the Resumed Thirteenth Meeting of the Intergovernmental Negotiating Body to Draft and Negotiate a WHO Convention, Agreement or Other International Instrument of Pandemic Prevention, Preparedness and Response
7 April 2025
Negotiations resume for a WHO pandemic agreement, aiming to finalise the text in 5 days. Will Member States show the needed leadership and will to deliver an impactful outcome with equity at the core?
Strengthening Antimicrobial Stewardship Policy: Insights from COVID-19 and Future Pandemic Preparedness
South Centre Webinar
Date: 14 April 2025 Time: 12:00 PM – 1:00 PM CEST | 6:00 AM – 7:00 AM EDT | 3:30 PM – 4:30 PM IST Location: Virtual (Zoom)
In this one-hour webinar, we will explore how the COVID-19 pandemic impacted antimicrobial stewardship (AMS) programmes and what lessons can strengthen future pandemic preparedness, especially in low- and middle-income countries (LMICs).
Lessons from COVID-19: Strengthening Antimicrobial Stewardship Prior and During Pandemics
By Dr Rasha Abdelsalam Elshenawy
The COVID-19 pandemic has had a complex impact on the silent pandemic of antimicrobial resistance (AMR). While increased antibiotic misuse and disrupted antimicrobial stewardship (AMS) programs exacerbated AMR in some settings, heightened awareness and improved infection prevention measures implemented to control COVID-19 provided valuable lessons on sustaining these practices in the fight against AMR. This brief highlights lessons learned from the pandemic, such as the importance of access to antimicrobials and the urgent need for resilient and sustainable AMS integrated into pandemic preparedness, strengthening infection prevention and surveillance systems, enhancing access and use of diagnostics, and promoting a One Health approach. By leveraging these lessons, policymakers can build more resilient health systems, maintain the effectiveness of antimicrobials and be better prepared for future pandemics, particularly in developing countries. Immediate action is essential to protect public health and combat AMR effectively.
To prevent another COVID-19, the Pandemic Treaty must deliver real legal commitments on equity, technology transfer and benefit-sharing. Negotiations are falling short—consensus can’t mean dilution. A democratic vote is needed.
Las nuevas pandemias son inevitables. ¿Cómo podemos estar mejor preparados para ellas y, sobre todo, cómo podemos evitar los errores e injusticias cometidos durante la pandemia de COVID19? Actualmente se están llevando a cabo negociaciones para formular un tratado internacional vinculante sobre prevención y preparación que garantice respuestas más justas a futuras pandemias. Este libro pretende ser una contribución crítica a estos debates en curso.
¿Cómo garantizar un acceso equitativo a los medicamentos y diagnósticos cuando la mayoría de ellos se producen en un número reducido de países? ¿Cómo explicar que la financiación actual de la cooperación sanitaria esté en manos de un pequeño grupo de países y fundaciones del Norte? ¿Cómo reforzar el papel de la Organización Mundial de la Salud, que actualmente desempeña un papel secundario en la coordinación de las políticas de salud pública? ¿Por qué se ha sustituido el concepto de «medicamentos esenciales», gran avance de la política de salud pública, por el de «contramedidas médicas», término más acorde con el afán de lucro del sector privado?
Autor: Germán Velásquez, Asesor especial sobre políticas y salud, South Centre de Ginebra
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