On May 20, 2025, the 78th World Health Assembly (WHA78) adopted the Pandemic Agreement (PA) in Geneva, marking a historic moment. This was after three years of grueling negotiations by WHO Member States in the Intergovernmental Negotiating Body (INB). However, they could not reach a consensus on Article 12 of the Agreement on Pathogen Access and Benefit Sharing (PABS). The World Health Assembly then decided to continue negotiations in an Intergovernmental Working Group (IGWG) to address issues as an annex of the PA. The 79th World Health Assembly (WHA79) in May 2026 is expected to adopt the PABS annex to the PA, after the IGWG negotiations.

The PABS system aims to ensure sharing of pathogens with pandemic potential - including samples and genetic sequence data - while delivering fair and equitable benefits, such as vaccines, therapeutics, and diagnostics.

Between July 2025 and February 2026, the IGWG held five rounds of negotiations. A sixth round, which is scheduled to be the last before the WHA79, will take place in Geneva between 23 and 28 March. PSI raised some important concerns during the second round of IGWG negotiations in September, which remain even more pertinent at this crucial point in time. Addressing the IGWG, Bàbá Ayé, the PSI Health and Social Care Services Sector Officer, highlighted three key concerns:  

First is that the negotiations should not in any way lead to further inequality between the Global North and the Global South. And secondly that public services’ primacy should be safeguarded and the interests of corporations should not, overtly or covertly, be the driving force in determining pathogen access, and lastly, that health and care workers should be involved in decision-making regarding the PABS.   

Alas, these concerns have only deepened since then. Divisions between the Global South and the Global North countries, which have bio-pharmaceutical corporations, have grown larger. While governments of at least eighty-five countries, most of which are from the Global South seek to include measures that can promote equity in the distribution of health technologies in case of a next health emergency, a few countries in the Global North which are home to big pharma, are keen to maintain the same regulations and norms regime that led the world into a global context of vaccine apartheid during the COVID-19 pandemic.  

The Pathogen Access and Benefit Sharing (PABS) system envisaged in Article 12 of the PA should enable safe, transparent and accountable sharing of samples and data of pathogens with pandemic potential including their genetic sequence information, alongside the fair and equitable sharing of benefits arising from their use, including vaccines, therapeutics and diagnostics.  

The PABS system represents a crucial mechanism to operationalize equity in the Pandemic Agreement. This system regulates access to materials for health technology development and the benefits that countries/companies accessing these materials should offer to countries where the data originate, benefiting all of humankind. In simple terms, we need a system where those accessing the data (pathogen access part) make binding commitments to equitably share the technologies (benefit) that arise from it. This negotiation will determine whether we keep or discard the material conditions that led us straight into “vaccine apartheid,” thus ensuring a more concerted biomedical approach to curbing pandemics and health emergencies in general.

At this point of negotiations, it seems that countries are just discussing technicalities, but the issues go far beyond. This is about taking a political decision, that will determine whether the world will have a system that promotes equity in distributing health technologies or if we will continue to have a colonial and extractivist approach towards access to pathogens and other data and the distribution of the technologies that may be developed from such information. On top of this tense environment, the governments of wealthier and more powerful countries backing corporate interests are putting pressure on developing countries, using tactics such as bilateral agreements.  

PSI and its affiliates are following the negotiations and calling on governments to defend measures that will create a fair and equitable PABS system. PSI and civil society allies involved in the negotiations as relevant stakeholders, such as the Geneva Global Health Hub (G2H2), Third World Network (TWN) and Medicus Mundi International (MMI) have consistently defended the need for the PABS agreement to ensure equity and thus a more robust basis for pandemic preparedness, instead of pandering to what amounts to primacy of the interests of the biopharmaceutical industry. This aligns with the positions defended by the majority of Member States in the negotiations. Here are the major differences between the two contending views. 

The majoritarian position (backed by at least 85 countries):

• All individuals and entities seeking access to PABS sequence should be identified (registered and verified) and should accept a data access agreement (DAA). 

• A PABS Sequence Database owned and operated by the WHO and its member states, i.e., under public control and governed based on multilateralism. 

• Other databases should be WHO-recognised sequence databases, meaning that they would need to follow the criteria and norms established by the multilateral PABS system.  

• Databases must implement a system for user registration which entails the verification and acceptance of DAA 

• Positions consistent with existing models of pandemic prevention and preparedness, and the Pandemic Agreement’s text:  

• Art. 12.3 PA: “the development of a safe, accountable and transparent PABS System shall address traceability measures and open access to data.” 

• Art. 12.5(b) PA: “modalities, terms and conditions on access and benefit-sharing that provide legal certainty”. 

 The viewpoint of a few powerful countries backing corporations: 

• Oppose user identification (registration and verification). In favor of anonymous access. 

• Oppose the requirement for individuals and entities seeking sequence information to accept a Data Access Agreement. They rather call for recipients to be informed of the requirements of PABS, without this being binding.

• Opposes a WHO PABS sequence database. 

• Wants each Party to share sequence with their database of choice despite the fact that external databases – which are privately run and not accountable to the public/governments/citizenry: allow anonymous access; can change their models at any time; will not share user information with the WHO (so benefit sharing cannot be effective) and; could avoid contractual commitment from recipients of sequence information. 

• Claims user registration and DAA will affect interoperability – which is scientifically not true. 

Their position is inconsistent with Art. 12.3 and Art. 12.5(b) of Pandemic Agreement. And their claims that this position is in line with Open Access is false. It is not in line with the UNESCO Recommendation on Open Science and promotes an inequitable, extractive model. 

In plain terms, the majoritarian perspective seeks to include language in the agreement that would make sure that users accessing information on pathogens and other relevant data could be identified so that it would be possible to know who is responsible for sharing the benefits of the research that used that particular data.  

What happened during the 5th IGWG? 

The fifth meeting of the IGWG on the PABS Annex, as mentioned above, revealed deep divisions between developed and developing countries on critical issues. The North-South split centers on three main areas: database governance (governments of developing countries want a WHO-governed database while the EU and allies prefer arrangements with existing private databases like GISAID), user registration requirements (developing countries demand mandatory registration and Data Access Agreements while governments of developed countries advocate for anonymous access), and benefit-sharing mechanisms (particularly around contracts, intellectual property rights, and guaranteed access to vaccines, therapeutics and diagnostics).  

The negotiations happen inside a meeting room at the WHO headquarters in Geneva, where only the delegates of Member States are present. During long hours, they share their countries’ positions and the Bureau (representatives of Member States drawn from each of the six WHO Regional Organizations that conduct the negotiations with the assistance of WHO’s secretariat) tries to find a “middle-ground”. Once a part of the text reaches an initial consensus, it is highlighted yellow. If Member States agree that they reached a final reading of a particular article, then it becomes highlighted green. However, after six days of negotiations, the text remained heavily blank with little initial consensus. This situation caused concerns about running out of time before the May 2026 deadline when results must be presented to the World Health Assembly. A delegate told a PSI staff after 12 hours of work on the 5th day of negotiations that “we yellowed three just words today”.  

Along with civil society organizations, such as Medicus Mundi International (MMI), the Geneva Global Health Hub (G2H2), People’s Health Movement (PHM) and Third World Network (TWN), PSI has been stressing that we are risking maintaining an extractive status quo rather than addressing the inequities exposed and exacerbated during COVID-19. If developed countries continue to insist on their positions, we will continue to have anonymous data access, which is digital biopiracy.  

PSI and like-minded organizations, along with delegates from several developing nations, stressed that meaningful equity requires user registration, binding contracts with benefit-sharing obligations, track-and-trace mechanisms, and guaranteed access to medical countermeasures. Meanwhile, some developed countries argued for “pragmatism”, saying “stringent” requirements would discourage participation from researchers and manufacturers, undermining the system’s effectiveness.  

What to expect from the 6th IGWG? 

It is expected that the tensions between the North and the South will continue. It is also very likely that developed countries will increase pressure on developing countries, either via bilateral agreements or through direct engagement during the negotiations. It is however crucial to point out that the position of the developed countries is primarily in the interest of corporate interests and not that of the people in these countries. Diseases and pandemics do not know borders. Prioritising business interests inherently puts people everywhere at heightened risk.  

PSI will work with its affiliates to engage governments both in the global South and in the global North. And with our civil society allies, we will push for improvements in the text and for the inclusion of binding commitments from countries and the private sector. We need to go beyond the status quo; we need a fair and equitable, public-owned and transparent PABS system. As Pedro Villardi, the PSI health coordinator for the Inter-America region who represented PSI at the 5th IGWG stressed; the PABS system must be multilateral and based on “robust governance and accountability mechanisms” that put people over profit. That is the way to go for global pandemic preparedness.