The pandemic treaty did not get finalised at the WHA 77 as per the original timeline. However, over the two and a half years of the drafting and negotiation process health and care workers and other civil society groups achieved significant victories because of the sustained advocacy efforts both at capital and Geneva levels. Please find below information on the outcomes of the WHA77 regarding the Pandemic Treaty, and other key information going forward. 

Final Outcomes from WHA 77 and its implications to the Pandemic Treaty 

1. The INB did not reach a consensus on a final full text of the Pandemic Treaty. The WHO DG presented a text to the WHA. The text was divided into parts. The sections highlighted in green are those that are agreed upon; sections highlighted in yellow are those in which member states were close to an agreement but remained contentious and disagreed on. The text also includes proposals to Articles suggested by countries.  

2. Agreed on and finalised articles include- Article 2: Objectives, Article 6: Preparedness, Readiness, and Health System Resilience, Article 7: Health and Care Workforce, Article 17: Whole-of-government and Whole-of-society Approaches, Article 18: Communication and Public Awareness, and a few other Articles dealing with the modalities of the treaty once it is adopted. 

3. The WHA 77 agreed to extend the INB, towards finalising the treaty by one more year. The INB must, therefore, present a finalised text to the next WHA, in May 2025. 

4. In the last hours of WHA77 Member States approved the amendments to the International Health Regulations (IHR). IHR are binding rules in place since 1969 and already went through several amendment process the last one in 2005. Member States proposed more than 300 amendment proposals. The approved ones include the recognition of equity as a principle in this instrument for the first time in its history; defines a pandemic emergency; include obligations on the access to health products; establishes a new coordinated financing mechanism, among other elements including strengthening transparency and timeliness of information. Please find the set of approved amendments in the end of this update. 

 What Does the INB Extension Mean? 

The extension means that member states will continue to negotiate for another year to reach agreements on topics that remain contentious. The INB's mandate remains the same. Regarding the articles agreed upon until last May, the WHA decision does not make clear whether they can be re-opened for discussions or not. Informally, delegates informed that this is unlikely, but not impossible. 

Transparency will remain an issue as member states decided that negotiations will continue behind closed doors and non-state actors' presence in the negotiation room will only be allowed in specific times. 

What Did Trade Unions and PSI Affiliates Achieve? 

As PSI, representing more than 30 million workers, the majority of them from the health and care sectors, our efforts were focussed on realising a treaty that secured the rights and interests of health and care workers as well as ensured that the treaty addressed the burning issue of global health inequity. Learning from the mistakes of the COVID-19 pandemic we advocated for provisions that prioritised the needs of people over profit, including an automatic trigger of patent waivers in the event of a pandemic, use of public finance for public health goods, accountability of big pharma, especially when using public finances among other demands. 

The final Article 7 includes the following important provisions that made their way in the text due to all your efforts: 

1. Countries need to ensure ‘decent work’ for all health and care workers (including 'other essential workers' (Para 2); 

2. Countries should prioritise the mental health and wellbeing of workers (Para 2);  

3. During times of a pandemic health and care workers will have priority access to all pandemic products (Para 2(a));  

4. Countries will work towards eliminating all forms of inequalities and disparities including barriers faced by women (Para 2(b));  

5. Countries will address harassment and violence faced by workers (Para 2(c));  

6. Governments will develop policies for work-related injury, disability or death during pandemic response (Para 2 (e));  

7. Any agreements on international migration of health workers should adhere to the WHO migration safeguards list and Global Code of Practice as well as other international guidelines. And should also ensure all rights are guaranteed to the migrants as well as secure interests of the sending countries’ health system. (Para 4); 

8. The Article also includes a provision to ensure rights of other essential workers are also guaranteed during a pandemic including their access to decent work. (Para 5); 

This is the result of the tireless work put in by all our affiliates. With the support of PSI, organised workers have been able to include several of our demands that address concerns of the health and care workforce in Article 7 of the treaty. It is important to note that all through 2023, and 2024 till INB8 the drafts of the treaty were severely lacking in several basic provisions that are required to sustain a strong, competent, and protected workforce. All your efforts to engage with governments and national delegates during the last few rounds of negotiations, made many countries raise their voices and backed several of our demands to realise the rights of the health and care workforce. 

What concerns remain? 

While agreement has now been reached on Article 7, that addresses the health and care workforce, as well as the Article on strengthening and building resilient health systems, other Articles that primarily address the equity provisions remain contentious. 

Although we advocated for it, social dialogue did not finally make it to the agreement. What has been included instead is that countries will be 'supporting individual and collective empowerment'. PSI observes that the language on this was better in some versions of the previous texts than the current finalised text. Previous versions of the draft included a provision that urged countries to 'support the meaningful representation, engagement, consultation, participation and empowerment of all health and care workers', which is a broader definition of social dialogue processes.  

The last provision under Article 7 addresses ‘other essential workers’. While we welcome the inclusion of a provision that broadens the scope of the treaty and covers other equally important essential workers and their interests during a pandemic, we are concerned that especially naming specific categories of essential workers (such as seafarers and transport workers is unfair to the other workers as it places unfair importance to only a few categories of workers.  

Where Did the INB Fail to Reach Consensus 

Articles 9, 10, 11 and 12 were somehow the core of the equity-related debate. That is because those articles talked about lifting intellectual property rights during health emergencies, diversifying production capacity, establishing technology transfer mechanisms without solely relying on voluntary measures. Article 12, specifically aims to create a WHO Pathogen Access and Benefit Sharing System (PABS). This was one of the most controversial articles throughout the INB and Member States were unable to reach any consensus on that.  

These articles clearly exposed the countries division in the discussion. From one side, developed countries pushing for voluntary measures to maintain privileges in accessing health products and controlling technology. From another, developing countries pushing for compulsory measures to enforce technology transfer and more equitable access to health products, as well as diversifying production capacity.  

Surveillance (Article 4) was another non-consensual and divided developing and developed countries, which pushed for more stronger measures, which could overwhelm developing countries systems.  

Next steps: what can trade unions do? 

The negotiations will likely continue to happen behind closed doors. It is therefore imperative that unions, especially those of health and care workers make their voices heard through any means possible. During the next phases of negotiations, we need to secure what we have managed to include in text. This is because it is not clear whether the agreed on articles will be revised or not. At the same time, it is important to keep gathering information on how countries see the next negotiations steps. 

• Set up a meeting with government officials to discuss: 

• How do they see the negotiations from here to May 2025 

• Whether they think "greened" articles will be revisited or not 

• The incorporation process of this instrument in each country 

PSI will organise consultations with affiliates and other partner organizations to evaluate the text, especially Article 7. 

Useful links 

Report by the Director-General submitted to the 77th WHA (with the outcome of the INB presented to the WHA) 

Approved resolution on the Pandemic Treaty: here  

International Health Regulations (2005) - document submitted to WHA 

Official news by WHO: World Health Assembly agreement reached on wide-ranging, decisive package of amendments to improve the International Health Regulations