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Research Paper

The Missing Annex: Pathogen Sharing and the Unfinished WHO Pandemic Agreement

MER/26/D11 · Meridian Research Team ·

The Missing Annex: Pathogen Sharing and the Unfinished WHO Pandemic Agreement

The World Health Assembly adopted the WHO Pandemic Agreement in May 2025, but the treaty cannot be opened for signature until governments agree an annex setting out the Pathogen Access and Benefit-Sharing (PABS) System. That annex was not ready for the World Health Assembly in May 2026, and negotiators now return for a ninth round on 2–13 November 2026. This paper explains what the annex must do, what the official record shows about the remaining disagreements, and why the November round will decide whether the agreement can move towards signature before mid-2027.

Key points

  • The WHO Pandemic Agreement was adopted by consensus on 20 May 2025, after a committee vote of 124 in favour, none against and 11 abstentions [1; 2].
  • Under Article 31 it opens for signature only after the World Health Assembly adopts the PABS annex, and under Article 33 it enters into force 30 days after the sixtieth ratification [1].
  • The annex was not finished for the Seventy-ninth World Health Assembly, which on 22 May 2026 extended the negotiating mandate to the Eightieth Assembly in May 2027, or to an earlier special session in 2026 [3; 4].
  • The agreement sets a target of 20% of participating manufacturers' real-time production of pandemic products for WHO in a pandemic emergency, at least 10% of it donated; the draft annex still carries competing formulas for lesser emergencies [1; 4].
  • To make a special session in December 2026 possible, the working group would need to agree the text by 10 November 2026 [5].

1. The problem

According to WHO, negotiations on a pandemic treaty were launched in response to gaps and inequities identified in the national and global response to COVID-19 [2]. Two problems are linked: how quickly pathogen samples and genetic sequences are shared, and how fairly the vaccines, treatments and tests developed from them are distributed. The WHO Pandemic Agreement, negotiated under Article 19 of the WHO Constitution, is the second treaty of its kind after the Framework Convention on Tobacco Control [2]. It tries to address both problems through a single bargain.

That bargain is set out in Article 12, which establishes the PABS System. It pairs "the rapid and timely sharing" of pathogen materials and sequence information with, "on an equal footing", the fair and equitable sharing of the benefits arising from their use [1]. The detail, however, was left to a separate annex, and the agreement states that all elements of the system must come into operation simultaneously [1]. Without the annex, the treaty has no operating system for its central exchange, and it cannot be opened for signature [1].

2. The evidence

Adoption and the legal sequence. Resolution WHA78.1 adopted the agreement and created an open-ended Intergovernmental Working Group (IGWG) to draft and negotiate the annex "as a priority" and to report to the Seventy-ninth World Health Assembly [1]. The resolution notes that the agreement will open for signature, at WHO headquarters and later at United Nations Headquarters, only after the Assembly adopts the annex [1]. It enters into force on the thirtieth day after the sixtieth instrument of ratification is deposited [1; 2].

The benefit-sharing target. Article 12.6 provides that, in a pandemic emergency determined under the International Health Regulations (2005), each participating manufacturer shall make available to WHO, under legally binding contracts, "rapid access targeting 20%" of its real-time production of vaccines, therapeutics and diagnostics for the pathogen concerned. At least 10% is to be a donation and the remainder reserved at affordable prices, with distribution based on public-health risk and need [1]. Article 12.7 requires separate benefit-sharing provisions for a public health emergency of international concern (PHEIC) that is not a pandemic emergency, but sets no fixed share for that case [1].

The May 2026 deadline missed. The IGWG transmitted to the Assembly an on-screen draft of the annex, dated 30 April 2026, which it described as "not final agreed text" [4]. The draft states that the system rests on two pillars, sharing and benefit-sharing, and lists "annual monetary contributions" among the benefits, subject to further discussion [4]. For a PHEIC, one bracketed option would reserve at least 20% of real-time production for WHO, with 8% or 10% free of charge; an alternative formulation would add an obligation to grant WHO non-exclusive, royalty-free licences that could be sublicensed to manufacturers in developing countries [4]. On 22 May 2026, decision WHA79(7) told the IGWG to continue and to develop the legally binding contracts to be signed with WHO, and to submit the outcome to the Eightieth Assembly or, "as may be necessary", to a special session in 2026 with a single agenda item [3].

The negotiating calendar. The IGWG's updated timeline, adopted at its seventh meeting in July, lists the seventh (6–17 July) and eighth (14–18 September) meetings, informal talks on 5–9 October and a ninth meeting on 2–13 November 2026 [5]. It reserves the week of 14 December 2026 for a possible two-day special session of the Assembly. Because the Executive Board would have to call such a session by 13 November, the IGWG would need to decide by 10 November [5]. Further dates are reserved into July 2027 [5].

Where the talks stand. At the eighth meeting, a five-day session [7], negotiators worked on three parts of the draft, according to the official report: access to materials and sequence information, the definitions of terms, and governance. The report concludes only that "discussions to facilitate convergence on these items would continue" [6]. Reporting from the closed sessions by the Third World Network, a non-governmental organisation that follows the talks, describes convergence on four steps after a pathogen is detected (risk assessment, notification to WHO, sharing through designated entities and the use of persistent identifiers), but no agreement on whether Parties will share as a matter of legal obligation, and objections from certain countries to WHO's role in setting up laboratory networks and databases [8].

Political pressure. On 12 October 2026 the UN General Assembly adopted a political declaration on pandemic prevention, preparedness and response. WHO said member states "particularly highlighted the urgent need to conclude negotiations" on the annex, and the Director-General urged them to finish it so that the agreement can be opened for signature [9].

A smaller membership. The United States withdrew from WHO on 22 January 2026, according to a joint statement by its Secretaries of State and of Health and Human Services, which said that all US funding for, and staffing of, WHO initiatives had ceased [10]. WHO said it regretted the decision and hoped the United States would return [11].

3. Analysis

The following assessments are Meridian analysis based on the evidence above.

First, the annex is the treaty. Because signature depends on it and the system's elements must start together [1], any delay in the annex postpones the whole agreement. Even on the earliest path, adoption at a December special session would be followed by signature, national ratification procedures and a further 60 instruments before entry into force [1; 5].

Second, the hardest issues are about obligation, not principle. The official record shows agreement on the purpose of the system, but bracketed text remains on what manufacturers must provide in a PHEIC, how laboratories and databases are designated, and how benefits are guaranteed through contracts [4; 6]. These choices determine whether benefit-sharing is predictable or largely discretionary.

Third, the November deadline is tight by design. The 10 November decision point falls in the middle of the ninth meeting [5]. If agreement is not reached by then, the timeline points to further meetings and consideration at the Eightieth Assembly in May 2027 [3; 5]. That would be two years after the agreement was adopted.

Fourth, the system would start without the United States, which its government described as WHO's largest financial contributor [10]. Its absence from WHO [10; 11] does not prevent the annex from being adopted, but it may affect how many manufacturers based there choose to take part, and therefore how much production the 20% target would cover in practice.

4. Assessment

  • The WHO Pandemic Agreement remains an adopted text that no state can yet sign; its operation depends wholly on the PABS annex [1; 3].
  • The ninth IGWG meeting will show whether a special session in December 2026 is possible or whether the decision slips to May 2027 [5].
  • The credibility of the benefit-sharing promise will depend on contract terms and the PHEIC formula, not on the 20% headline [1; 4].
  • Indicators to watch: an IGWG decision by 10 November 2026; any Executive Board call for a special session by 13 November; a clean annex text without brackets; and the first signatures once the agreement opens.

References

  1. World Health Organization, Resolution WHA78.1, "WHO Pandemic Agreement", with the text of the agreement as annex, 20 May 2025. https://apps.who.int/gb/ebwha/pdf_files/WHA78/A78_R1-en.pdf (accessed 31 October 2026).
  2. World Health Organization, "World Health Assembly adopts historic Pandemic Agreement to make the world more equitable and safer from future pandemics", news release, 20 May 2025. https://www.who.int/news/item/20-05-2025-world-health-assembly-adopts-historic-pandemic-agreement-to-make-the-world-more-equitable-and-safer-from-future-pandemics (accessed 31 October 2026).
  3. World Health Organization, Decision WHA79(7), "Outcome of the open-ended Intergovernmental Working Group on the WHO Pandemic Agreement in relation to the drafting and negotiation of the Annex described in Article 12 of the WHO Pandemic Agreement", 22 May 2026. https://apps.who.int/gb/ebwha/pdf_files/WHA79/A79_(7)-en.pdf (accessed 31 October 2026).
  4. World Health Organization, "Open-ended Intergovernmental Working Group on the WHO Pandemic Agreement: Report by the Director-General", A79/8, 13 May 2026, with the on-screen draft PABS annex text as at 30 April 2026. https://apps.who.int/gb/ebwha/pdf_files/WHA79/A79_8-en.pdf (accessed 31 October 2026).
  5. World Health Organization, "Working modalities and updated timeline and deliverables of the open-ended Intergovernmental Working Group", A/IGWG/7/3 Rev.1, 7 July 2026. https://apps.who.int/gb/igwg/pdf_files/IGWG7/A_IGWG7_3Rev1-en.pdf (accessed 31 October 2026).
  6. World Health Organization, "Report of the meeting", eighth meeting of the IGWG, A/IGWG/8/4, 25 September 2026. https://apps.who.int/gb/igwg/pdf_files/IGWG8/A_IGWG8_4-en.pdf (accessed 31 October 2026).
  7. World Health Organization, "Member States advance negotiations on pathogen access and benefit-sharing ahead of UN General Assembly meeting on pandemics", news release, 18 September 2026. https://www.who.int/news/item/18-09-2026-member-states-advance-negotiations-on-pathogen-access-and-benefit-sharing-ahead-of-un-general-assembly-meeting-on-pandemics (accessed 31 October 2026).
  8. Third World Network, "WHO: WHO Member States proceed carefully with PABS negotiations", 4 October 2026. https://www.twn.my/title2/health.info/2026/hi261001.htm (accessed 31 October 2026).
  9. World Health Organization, "WHO welcomes adoption of United Nations political declaration on pandemic prevention, preparedness and response", news release, 12 October 2026. https://www.who.int/news/item/12-10-2026-who-welcomes-adoption-of-united-nations-political-declaration-on-pandemic-prevention-preparedness-and-response (accessed 31 October 2026).
  10. US Department of Health and Human Services, "Joint Statement by Secretary of State Rubio and Secretary of Health and Human Services Kennedy on the Termination of U.S. Membership in the World Health Organization (WHO)", 22 January 2026. https://www.hhs.gov/press-room/joint-statement-by-secretary-of-state-rubio-and-secretary-of-health-and-human-services-kennedy-on-the-termination-of-us-membership-in-the-world-health-organization-who.html (accessed 31 October 2026).
  11. World Health Organization, "WHO statement on notification of withdrawal of the United States", 24 January 2026. https://www.who.int/news/item/24-01-2026-who-statement-on-notification-of-withdrawal-of-the-united-states (accessed 31 October 2026).