Participation of South Centre Member Countries in the WHO GLASS: Progress and Gaps in AMR Surveillance and Stewardship Efforts
By Dr. Rasha Abdelsalam Elshenawy
This study highlights antimicrobial resistance (AMR) surveillance challenges in LMICs, focusing on the 55 South Centre Member States’ enrolment in the WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS). Despite progress since its 2016 launch, significant gaps persist: only 60 percent of South Centre Member States report AMR surveillance to GLASS, and just 38 percent report antimicrobial use (AMU) data to GLASS. The COVID-19 pandemic substantially disrupted surveillance activities, with rates declining from 2020-2021 compared to pre-COVID-19 pandemic levels. Digital infrastructure, such as mobile reporting tools, cloud-based systems, and interactive dashboards, offers significant opportunities to strengthen AMR surveillance in resource-limited settings. The study recommends a holistic and phased approach for South Centre Member States, including developing integrated national AMR action plans with realistic implementation timelines, investing in laboratory and workforce development, establishing interoperable digital infrastructure, and strengthening regional collaboration mechanisms. By systematically addressing core surveillance challenges while strategically incorporating digital innovations where appropriate, countries can develop resilient monitoring systems that support effective stewardship, protect national populations, and contribute to global health security by preserving antimicrobial effectiveness for future generations.
The GUIDE Framework for Evidence-based Antibiotic Prescribing
Strengthening Antimicrobial Stewardship for the Healthcare Workforce
By Dr. Rasha Abdelsalam Elshenawy
Antimicrobial resistance (AMR) poses a critical threat to global health security, with inappropriate antibiotic prescribing in hospitals driving the spread of resistant pathogens. This GUIDE Framework for Evidence-Based Antibiotic Prescribing provides a structured, five-step model designed to strengthen antimicrobial stewardship (AMS) and empower the healthcare workforce to make informed, proportionate prescribing decisions.
South Centre Statement to the Intergovernmental Working Group (IGWG) on the WHO Pandemic Agreement
3 November 2025
This statement was delivered at the opening of the Intergovernmental Working Group (IGWG) on the WHO Pandemic Agreement, third session, on 3 November 2025. The South Centre underscored that the first draft Bureau text helps to kick off text-based negotiations, but it does not meet the requirements for implementation of Article 12 of the Pandemic Agreement.
On September 24, 2025, two agreements were announced with generic drug manufacturers in India for the supply of generic lenacapavir at $40 (instead of the original $28,218) per patient per year. However, these generics can only be supplied to the countries included in Gilead’s voluntary license, excluding too many from accessing this price.
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.
New Amendments to the International Health Regulations: Strengthening Access to Health Products in Emergencies and Pandemics
By Viviana Munoz Tellez
The International Health Regulations amendments entered into force on September 19, 2025 across most World Health Organization (WHO) Member States. These updates don’t give WHO any new powers but help countries work better together to advance fair and timely access to health products such as vaccines, treatments and diagnostics needed to respond to health emergencies. The real challenge now is implementation and building the necessary capabilities to make these improvements function.
Working Document – Pathogen Access and Benefit Sharing System
3 September 2025
This document is a work in progress intended to assist in the understanding of the ongoing negotiations in the WHO | IGWG for the establishment of a Pathogen Access and Benefit Sharing System as an Annex of the Pandemic Agreement, as described in Article 12.
Community Based Surveillance for AMR Monitoring: Significance, Requirements and Feasibility in LMICS
By Afreenish Amir
Community based surveillance, in addition to clinical antimicrobial resistance (AMR) surveillance, plays an essential role in AMR and antimicrobial use trend monitoring. Various community-based AMR surveillance studies to monitor trends in AMR and use of antimicrobials have been conducted and shown its potential to facilitate evidence-based interventions and policy making for control of AMR. Many low and middle income countries (LMICs) lack the necessary systems and resources to establish effective surveillance systems. Specifically, the surveillance capacity at hospitals and other health facilities is limited, and the overall human resource capacity for community-level data collection, analysis, and multi-sectoral coordination is severely constrained. Prior to planning for community based AMR surveillance, a country should have established mechanisms to run the system efficiently, including strong governance and regulations, surveillance infrastructure, laboratory capacities, skilled human resources, data collection and management, funding and sustainability.
The World Health Organization and quadripartite partners have recommended advancing community based AMR surveillance in LMICs, and integrated AMR surveillance combining information from humans, animals and ecosystems, which seems a challenge in the current situation. Considering the significant gaps in systems, resources, and capacities, it is important to prioritize strengthening the country’s core capacities and addressing the underlying gaps in healthcare systems. Efforts should focus on enhancing the country’s core capacities, systems, and technical requirements while exploring the potential of advancing selective community based AMR surveillance interventions and systems in the future.
Statement by the South Centre to the Seventy-eighth World Health Assembly
Agenda Item 15: Antimicrobial Resistance
27 May 2025
The South Centre strongly encourages member States and the Director General to maintain antimicrobial resistance as a WHO priority, with adequate resources in headquarters and regional offices, and increased coherence as a cross cutting issue across various WHO programmes …
Statement by the South Centre to the Seventy-eighth World Health Assembly
Agenda Item 13.9: Global strategy for Women’s, Children’s and Adolescents’ Health
26 May 2025
We support the implementation of the Global Strategy 2016 – 2030, with increased and sustained financing, towards meeting the health needs and realizing the rights of all women, children and adolescents.
Key interventions include expanding immunization coverage, promoting breastfeeding, improving nutrition, advancing gender equality, and advancing sexual and reproductive health information and services for women and adolescents.
We strongly support the resolution regulating the digital marketing of breast-milk substitutes.
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