🟡 Policy Analysis
Member states of the World Health Organization failed to reach consensus on the Pathogen Access and Benefit Sharing (PABS) annex at the sixth negotiating session of the Intergovernmental Working Group in Geneva on March 23–28, 2026, according to analysis published in The Lancet Global Health. The stalled agreement threatens the implementation of the broader Pandemic Agreement adopted by WHO in May 2025, leaving the treaty unable to proceed to formal signature or ratification. Only one additional negotiating session has been scheduled for July 2026, placing significant pressure on diplomatic efforts before the 80th World Health Assembly.
Key takeaways
- PABS annex negotiations collapsed at the March 2026 WHO session, blocking ratification of the May 2025 Pandemic Agreement
- The deadlock reflects rising bilateralism, with wealthy nations pursuing separate pathogen-sharing deals rather than supporting multilateral frameworks
- Without agreement on the annex, the treaty cannot advance, threatening global pandemic preparedness coordination
The collapse of multilateral consensus
The failure to conclude PABS negotiations represents a critical setback for multilateral pandemic governance. According to The Lancet Global Health policy commentary, the annex—which governs how pathogen samples and genetic data are shared during disease outbreaks—has become a focal point of tension between high-income and lower-income nations. Without this mechanism, the broader Pandemic Agreement cannot be formally adopted, leaving the treaty in diplomatic limbo.
The June 2025 adoption of the agreement by WHO member states was intended to strengthen global coordination on pandemic prevention, preparedness, and response. However, the inability to finalize the PABS annex signals deeper fractures in international health cooperation.
Timeline of WHO Pandemic Agreement Negotiations
Key milestones and missed deadlines in pandemic governance talks, 2024–2026
Source: WHO / The Lancet Global Health | Georgian Medical Journal News
Bilateralism rises as multilateralism falters
The deadlock reflects a troubling shift toward bilateral arrangements between wealthy nations and pathogen-rich countries. According to the Lancet Global Health analysis, countries are increasingly pursuing direct deals with individual nations rather than supporting the equitable sharing framework envisioned by the WHO agreement. This trend undermines the principle of a unified global response to pandemics—a cornerstone of post-COVID-19 reform.
High-income nations and pharmaceutical producers have different incentives than developing countries with emerging pathogens, creating misaligned interests that bilateral negotiations cannot resolve. The fragmentation of pandemic governance into bilateral arrangements weakens collective preparedness and raises questions about data transparency and equitable vaccine distribution in future outbreaks.
The shift toward bilateralism in pandemic governance threatens the equitable, coordinated global response that WHO member states committed to in 2025.
— Commentary authors, The Lancet Global Health (2026)
Implications for global health preparedness
The stalled negotiations carry serious implications for pandemic readiness. Without a functioning PABS annex, countries lack a clear mechanism for sharing viral samples and genetic sequences during disease outbreaks—critical for developing diagnostics and vaccines quickly. The delay also signals to member states that WHO’s governance capacity may be insufficient to bridge fundamental disagreements on resource allocation and intellectual property.
Clinicians and public health officials depend on rapid, coordinated access to pathogen data and vaccine candidates. The diplomatic stalemate threatens these capacities, potentially slowing response times in future pandemics. For policymakers, the message is clear: multilateral institutions require political will and compromise to function effectively.
What this means
The path forward: negotiation or fragmentation?
With only one additional negotiating session scheduled before the World Health Assembly, diplomats face immense pressure to broker compromise. The core dispute—how to balance rapid pathogen sharing with intellectual property protection and benefit-sharing for developing nations—remains unresolved. Success will require concessions from all parties on data access, vaccine manufacturing capacity, and financial contributions to pandemic preparedness.
If negotiations fail in July 2026, the Pandemic Agreement will remain unsigned, and countries may formalize bilateral arrangements that bypass WHO altogether. This outcome would represent a significant retreat from the collaborative pandemic governance framework that emerged from the COVID-19 crisis. The international community now confronts a critical choice: invest in inclusive multilateralism, or accept a fragmented landscape where pandemic response depends on the bilateral relationships nations can negotiate individually.
Frequently asked questions
What is the PABS annex and why does it matter?
The Pathogen Access and Benefit Sharing annex governs how viral samples and genetic data are shared during outbreaks, and how benefits from resulting vaccines and treatments are distributed. Without it, the broader Pandemic Agreement cannot take effect, leaving no unified global framework for pandemic response.
Why are countries pursuing bilateral deals instead of supporting the WHO agreement?
Wealthy nations may secure faster access to pathogens and genetic data through direct bilateral agreements, while countries with emerging pathogens seek guarantees of vaccine equity and financial support. These competing interests are difficult to reconcile in multilateral forums, pushing nations toward bilateral arrangements.
What happens if negotiations fail in July 2026?
If the PABS annex is not finalized, the Pandemic Agreement will remain unsigned and countries will likely formalize bilateral arrangements. This fragmentation would weaken global pandemic preparedness and reduce the likelihood of rapid, coordinated responses to future outbreaks.
The stakes for global health governance have rarely been higher. As nations prepare for the July 2026 session, the question is whether multilateralism can survive the competing interests that derailed the March negotiations, or whether the post-COVID-19 reform agenda will dissolve into bilateral arrangements that prioritize individual nations over collective security. Read more about WHO health policy developments and global health initiatives on GMJ News.
Source: Commentary: PABS deferred: the rise of bilateralism and future of pandemic governance, The Lancet Global Health
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