Pandemic prevention, preparedness and response agreement

In light of the impact of the COVID-19 pandemic, and in particular the inequities witnessed in pandemic response, WHO’s 194 Member States decided to draft and negotiate an agreement, or other international instrument, to address pandemic prevention, preparedness and response. This was driven by the need to ensure communities, governments, and all sectors of society – within countries and globally – are better prepared and protected, to prevent and respond more equitably to future pandemics. The great loss of human life, disruption to households and societies at large, and impact on development are among the factors cited by governments to support the need for lasting action to prevent a repeat of such crises.

At the heart of the agreement is the need to ensure equity in access to the tools needed to prevent and prepare for pandemics (including technologies like vaccines, personal protective equipment, information and expertise) and access to health care for all people.

WHO Member States have adopted two other global legally binding agreements to protect and promote people’s health, pursuant to the provisions of the WHO Constitution itself: the WHO Framework Convention on Tobacco Control, and the International Health Regulations (2005).

WHO Member States develop and adopt such agreements to, among other things, increase collaboration and coordinated action in multiple areas that impact on the health and well-being of people in communities, countries and globally.

These international instruments represent a commitment by countries to address the health needs of their citizens, advance their health status, and strengthen the socio-economic status of their communities.

The process to negotiate the international agreement for pandemic prevention, preparedness and response was launched by the World Health Assembly – WHO’s highest decision-making body – through a special session held in December 2021, during the COVID-19 pandemic.

Article 19 of the WHO Constitution gives WHO’s Member States the authority to adopt conventions or agreements on any matter within WHO’s competence. The first instrument established under Article 19 was the WHO Framework Convention on Tobacco Control, which has made a significant and rapid contribution to protecting people from the harm caused by tobacco, since its entry into force in 2005.

WHO Member States established the Intergovernmental Negotiating Body (INB) to guide the Pandemic Agreement negotiation process. The INB held its first meeting on 24 February 2022. Thereafter, the INB process involved 13 formal rounds of meetings, nine of which were extended. Member States also held many informal and intersessional discussions on various aspects of the draft agreement and the negotiation process.

The INB was mandated to submit its final outcome to the Seventy-seventh World Health Assembly in May 2024. On 1 June 2024, recognizing that the INB had achieved progress and reached initial agreement on many provisions of the proposed WHO Pandemic Agreement, but that further work needed to be done to complete remaining elements, the Health Assembly decided to extend the INB’s mandate to finish its work as soon as possible, and submit its outcome for consideration by the Seventy-eighth World Health Assembly in May 2025, or earlier by a special session of the World Health Assembly if possible in 2024.

In the early hours of 16 April 2025, WHO Member States reached consensus on the proposed text of the WHO Pandemic Agreement, to be submitted for consideration and adoption by the Seventy-eight World Health Assembly. The closing session on 16 April can be watched here.

After a more than three-year process led by WHO’s Member States, the INB formally concluded its work with the presentation of the proposed WHO Pandemic Agreement for consideration and adoption by the Seventy-eighth World Health Assembly, which considered the draft text in Committee A on 19 May 2025 and adopted the instrument in Plenary on 20 May 2025.

In the resolution adopting the WHO Pandemic Agreement on 20 May 2025, the World Health Assembly established a new body – the Intergovernmental Working Group (IGWG) – to take forward the work to draft and negotiate the Annex on Pathogen Access and Benefit Sharing (PABS) described in Article 12 of the WHO Pandemic Agreement, and submit the outcome to the Seventy-ninth World Health Assembly for its consideration.

The IGWG was also tasked with facilitating, as necessary, activities related to the adoption of the PABS Annex and the opening for signature, ratification, acceptance, approval, accession or formal confirmation of the WHO Pandemic Agreement following the adoption of the Annex by the 79th World Health Assembly. The first organizational meeting of the IGWG will be held 9-10 July 2025.

In accordance with Article 31 of the WHO Pandemic Agreement, it shall be open for signature by Member States after the World Health Assembly adopts the PABS Annex, at the World Health Organization headquarters in Geneva, and thereafter at United Nations Headquarters in New York, on dates to be determined by the World Health Assembly.

In December 2021, WHO’s Member States requested the WHO Director-General to convene the meetings of the Intergovernmental Negotiating Body (INB) and support its work, including by facilitating the participation of other United Nations system bodies, non-state actors, and other relevant stakeholders in the process to the extent decided by the 194 Member States forming part of the negotiations.

WHO acted only as the Secretariat to the INB process, which was established by WHO’s Member States, who organized and led the drafting, discussion and negotiation process. In this sense, the WHO Secretariat’s role was to support countries – its Member States – as they negotiated and agreed the new international instrument. The WHO Secretariat did not determine the contents of the agreement, which was negotiated and agreed by WHO Member States.

The process for developing the WHO Pandemic Agreement was led by a Bureau comprising six members (two co-chairs and four vice-chairs) representing each of WHO’s six regions who were selected and appointed by WHO’s Member States. The Bureau was supported by the WHO Secretariat and, through its guiding of the INB process, provided extensive opportunities for engagement with a wide range of relevant stakeholders, including other United Nations system bodies, as well as non-State actors in official relations with WHO, to facilitate robust and inclusive participation in the proceedings. Throughout its three years of work, the INB sought inputs from relevant stakeholders, including through public hearings and other forms of consultation.

The INB process allowed various constituencies to be actively engaged through:

• written and oral inputs from Member States and relevant stakeholders on the successive iterations of the work, including the identification of the substantive elements, the Working Draft, the Conceptual Zero Draft, the Zero Draft, and subsequent drafts leading to the proposal that was agreed by the INB during the resumed session of its thirteenth meeting;
• regional consultations;
• informal, focused consultations and interactive dialogues on selected key issues, including with experts;
• public hearings for interested parties and stakeholders to express their views; and
• regular briefings and consultations at global level.

Subsidiary bodies of the World Health Assembly, such as the Intergovernmental Negotiating Body (INB) and the Intergovernmental Working Group (IGWG), operate based on the principles of inclusiveness, transparency, efficiency, Member State leadership and consensus. Public updates are provided at all relevant steps of processes. For the INB, the INB website is the main source of information. A similar is to be developed for the IGWG.

More information on the INB

The WHO Pandemic Agreement represents a global commitment by WHO countries to work together, as an international community of sovereign nations, to prevent, prepare for, and equitably respond to pandemics so that individuals, communities, countries do not witness a repeat of what happened during the COVID-19 pandemic.

Importantly, the Agreement establishes principles, priorities and targets for pandemic prevention, preparedness and response, with the aim to:

• build resilience to pandemics;
• support prevention, detection, and responses to outbreaks with pandemic potential;
• ensure equitable access to pandemic countermeasures; and
• support global coordination through a stronger and more accountable WHO.

The Pandemic Agreement complements other initiatives, actions and measures aimed at making the world safer from pandemics; this includes the International Health Regulations, and global systems and institutions working to equitably share health technologies, information and expertise.

The Agreement took the lessons learned from the COVID-19 pandemic and used them to build back better. Equity is a key driver, principle and outcome within the new Agreement.

The Agreement promotes political commitment at the highest level, through ensuring an all-of-government and whole-of-society approach within countries, and sustained and sufficient political and financial investment within and among countries.

Among other things, the Agreement addresses gaps, weaknesses and inequities in key areas that were witnessed during the COVID-19 pandemic including:

• prevention, preparedness and response arrangements;
• coordinated funding for pandemic prevention, preparedness and response; and
• mechanisms to increase equitable access to pandemic-related health products including vaccines, therapeutics and diagnostics.
  

Specific proposals on these matters and many others can be found in the text of the Agreement, as adopted by the World Health Assembly in resolution WHA78.1.

The International Health Regulations (2005) (the “IHR”) is a key international instrument on international health, rooted in the WHO Constitution. The IHR was established to prevent, protect against, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade.

The WHO Pandemic Agreement is designed to be coherent with, and complement, the IHR. The Health Assembly Special Session decision SSA2(5) of 2021, establishing the INB, noted the “need for coherence and complementarity between the process of developing the new instrument and the ongoing work […] regard to implementation and strengthening of the IHR (2005)”.

In May 2022, the World Health Assembly agreed to start a process to consider “targeted” amendments to the IHR. This work was led by a dedicated Member-State led working group process (the Working Group on Amendments to the International Health Regulations (2005)). The Working Group held its first meeting on 14–15 November 2022 and ended its work on 24 May 2024. A Drafting Group established by the Seventy-seventh World Health Assembly concluded the work initiated by the Working Group, after Member States agreed a package of amendments to the IHR.

Through decision WHA75(9) (2022), the World Health Assembly requested the above-mentioned Working Group “to coordinate with the process of the [INB], by means that include regular coordination between the two respective Bureaux and alignment of meeting schedules and workplans, as both the International Health Regulations (2005) and the new instrument are expected to play central roles in pandemic prevention, preparedness and response in the future.”

Recognizing how closely linked the two processes are, at WHA77 it was decided to create a single drafting group to take the two processes forward. That drafting group completed its work on the amendments to the IHR and recommended extension of the mandate of the INB process for taking forward the negotiations on the pandemic agreement.

The Coordinating Financial Mechanism, which has already been established under the International Health Regulations (2005), will also be used to support implementation of the WHO Pandemic Agreement. This will include strengthening and expanding capacities for pandemic prevention, preparedness and response, and helping make needed surge financing available, particularly in developing countries. A proposal will be developed, through the IGWG, to operationalize the Mechanism to support implementation of the Pandemic Agreement and IHR (2005).

The amendments to the International Health Regulations, agreed by the Seventy-seventh World Health Assembly on 1 June 2024, include the definition of a Pandemic Emergency, which represents the new highest level of alarm contained within the IHR and available for use by the WHO Director-General.

The Pandemic Emergency definition builds on the existing mechanisms of the IHR, including the determination of public health emergency of international concern.

A Pandemic Emergency aims to trigger a more effective international collaboration in response to events that are at risk of becoming, or have become, a pandemic.

Each and all of the six following criteria must be met for an “event” (which, according to the IHR, means a manifestation of disease or an occurrence that creates a potential for disease) to be determined a “Pandemic Emergency”.

These are:

1. it must be a Public Health Emergency of International Concern (PHEIC). A PHEIC means an extraordinary event which is determined (i) to constitute a public health risk to other States through the international spread of disease; and (ii) to potentially require a coordinated international response;
2. being of communicable disease nature;
3. having, or at risk of having, wide demographical spread.
4. exceeding, or is at high risk of exceeding, the capacity of health systems;
5. causing, or is at high risk of causing, substantial social and/or economic disruption etc.; and
6. requires rapid, equitable and enhanced coordinated international action etc.

None and no. The WHO Pandemic Agreement reaffirms the principle of sovereignty of States Parties in addressing public health matters, and that States have, in accordance with the Charter of the United Nations and the general principles of international law, the sovereign right to legislate and to implement legislation in pursuance of their health policies.

Article 22, paragraph 2, of the Pandemic Agreement goes onto say that "Nothing in the WHO Pandemic Agreement shall be interpreted as providing the Secretariat of the World Health Organization, including the Director-General of the World Health Organization, any authority to direct, order, alter or otherwise prescribe the national and/or domestic law, as appropriate, or policies of any Party, or to mandate or otherwise impose any requirements that Parties take specific actions, such as ban or accept travellers, impose vaccination mandates or therapeutic or diagnostic measures or implement lockdowns.”

A guiding principle, set out in Article 3 of the WHO Pandemic Agreement is the “full respect for the dignity, human rights and fundamental freedoms of persons.”

As with all international instruments, the WHO Pandemic Agreement was determined by sovereign governments for themselves. The agreement reaffirms “the principle of the sovereignty of States in addressing public health matters”.

Yes. The WHO Pandemic Agreement is open to the participation of all countries, who would be able to participate if they so wished. In line with the example provided by the WHO Framework Convention on Tobacco Control, the Accord is also open to regional economic integration organizations.

It is up to WHO Member States to decide on compliance mechanisms. It is a general principle of international law that once an international law instrument is in force, it is binding on the parties to it, and that parties to it undertake to implement it in good faith.