AHF urges stronger global health equity measures in WHO pandemic agreement

With a new round of negotiations scheduled for the end of March in Geneva and with the May 2026 deadline approaching, the world’s countries continue to negotiate the rules that will define how vaccines, diagnostics and treatments will be distributed during future pandemics. Public health organisations warn that the European Union is blocking binding health equity commitments, which could allow the next health emergency to repeat the pattern observed during COVID-19: early access for wealthier countries and long delays for much of the rest of the world.At the headquarters of the World Health Organization (WHO), member states are negotiating the Annex on Access to Pathogens and Benefit-sharing (PABS), a key piece of the Pandemic Agreement adopted in May 2025. This mechanism seeks to establish rules to ensure that when countries share virus samples and scientific data that allow the development of vaccines, diagnostics and treatments, the benefits derived from that information are also distributed equitably.“The lesson of COVID is clear: when the rules are weak, inequality prevails. There can be no more VIP queue in the next pandemic,” Francisco Rubio, AHF’s advocacy director for Latin America and the Caribbean, is quoted in a release to the media.

“During COVID we saw how countries with more resources secured vaccines and medical technology, while millions of people in regions such as Latin America waited for access to basic life-saving tools. Health equity cannot depend on late donations; requires clear commitments.”

The release notes that the pandemic agreement cannot enter into force until this annex is finalised, so the outcome of the negotiations that continue during March and April will be decisive for its implementation.

PROPOSALS

During the fourth session of the WHO Intergovernmental Working Group held in December 2025, more than 80 developing countries proposed establishing mandatory standard contracts to regulate the use of pathogen samples and genetic data with pandemic potential. These contracts would include clear conditions for benefit-sharing, technology transfer, scientific cooperation, and equitable access to vaccines, diagnostics and treatments. Delegations from the European Union, particularly some member states such as Germany, opposed starting the negotiation of these contracts and promoted a model based on voluntary commitments from the pharmaceutical industry.

Under this proposal, some manufacturers could decide to give away about 20 per cent of their production of vaccines, treatments or diagnostics during a pandemic, of which only 10 per cent would be guaranteed as a donation, while the rest would be subject to commercial agreements. During the COVID-19 pandemic, international initiatives such as COVAX managed to distribute nearly 2,000,000,000 vaccine doses in 146 economies. Even so, global distribution remained profoundly unequal. In 2021, Latin America accounted for about eight per cent of the world’s population, but accounted for about 30 per cent of registered deaths from COVID-19.

Inequality was also reflected in advance purchases of vaccines. According to analyses published in The Lancet, high-income countries, representing just 16 per cent of the world’s population, secured at least 70 per cent of the vaccines available in 2021, leaving much of the world waiting for access to essential, life-saving tools. Various studies also estimate that more than 1,000,000 deaths in 2021 could have been avoided if vaccines had been distributed more equitably.

DIRECT IMPLICATIONS

For Latin America and the Caribbean, the outcome of these negotiations has direct implications. The region actively participates in global epidemiological surveillance networks and shares key scientific information when new diseases emerge, but during the pandemic many countries faced significant delays in securing vaccines and treatments. What is civil society asking for to avoid another health inequality? Among the main demands addressed to decision-makers in the European Union are:

1. Without equity, no agreement: The Pandemic Agreement cannot be ratified without Annex PABS, and this annex should not be adopted without binding health equity provisions.

2. Cooperation, not extraction: Those who benefit from the system must contribute to the system. Manufacturers, business persons and users should participate in mandatory profit-sharing mechanisms through binding contracts. This includes equitable access to vaccines, diagnostics and treatments; non-exclusive licences for manufacturers in developing countries during severe health emergencies; and annual financial contributions.

3. No registration, no access: The system must include user registration and traceability mechanisms that allow for knowing who is accessing pathogens and how they are used.

4. Meaningful civil society engagement: Transparency, accountability, and community engagement are key elements in protecting health equity.

5. Finalise the agreement with effective equity provisions: A weak annex risks repeating the inequalities seen during the COVID-19 pandemic.

6. Protect regional production: Without equitable benefit-sharing, efforts to develop regional production and strengthen health sovereignty in low- and middle-income countries could be limited.Negotiations on the PABS system will continue through 2026 and will define global rules for access to vaccines, diagnostics and treatments in future pandemics. For public health organisations, the current debate revolves around a central point: whether the new agreement will establish clear benefit-sharing obligations – including access to shared vaccines, diagnostics and treatments derived from pathogens – or whether those commitments will be subject to voluntary mechanisms.

AHF Jamaica is part of a global network known for its commitment to delivering advanced medical services and health advocacy, “regardless of ability to pay.” The organisation is encouraging broader public engagement on how Jamaica can secure fair access to pandemic-related medical tools under emerging global frameworks.