On May 20 at the 78th World Health Assembly (WHA78), member nations of the World Health Organization (WHO) formally adopted the first-ever WHO Pandemic Agreement. The approval was carried by consensus at the plenary session, one day after a recorded vote in committee of 124 in favor, zero objections, and 11 abstentions. Fifty-nine nations were not present for the committee vote, including the United States.
The Agreement broadly mandates that its nation-state parties shall prevent and prepare for future pandemics in various ways. This includes improved surveillance, preventing disease transmission, strengthened healthcare systems including workforce development, and increased pathogen and disease research. It advocates a One Health approach that takes into account the multiple, intricate interactions between human health and the health of other species on the planet.
Despite frequent use of the word “shall,” the Agreement is watered down with qualifiers such as “subject to the availability of resources,” “as appropriate,” and “where and as feasible.” In addition, the Agreement itself, and its proponents, go to great pains to clarify that the Agreement in no way overrides or diminishes any party’s “national sovereignty.” The Agreement lacks enforcement mechanisms and specifies no penalties for failures to meet obligations.
The approval of the Agreement comes four years after 25 heads of government and WHO Director General Dr. Tedros Adhanom Ghebreyesus issued a call for improved global cooperation on pandemic preparedness and response. As noted by the WSWS at the time, these leaders’ call for a pandemic agreement was steeped in hypocrisy, false promises and imperialist agendas.
With such an inauspicious start, it is not surprising that last month’s approval is late and that the agreement itself is unfinished and watered down considerably. The original deadline for approval was last year’s WHA77, but progress on the agreement at the time was sabotaged by corporations who successfully pressured governments to eviscerate key provisions on the sharing of intellectual property.
It is no surprise, then, that the unfinished nature of the approved Agreement centers on these very issues, which remain unresolved. In particular, before the Agreement is opened for “signatures” by states, it requires the finalization of an annex called the Pathogen Access Benefits Sharing System Instrument (PABS Instrument) for approval at next year’s WHA79.
Specifically, the Agreement states:
The provisions governing the PABS System, including definitions of pathogens with pandemic potential and PABS Materials and Sequence Information, modalities, legal nature, terms and conditions, and operational dimensions, shall be developed and agreed in an instrument in accordance with Chapter III (hereinafter the “PABS Instrument”) as an annex.
The goal of the PABS Instrument is to share data and information on pathogens with pandemic potential in a timely, open and equitable manner across the world, to enable the development and implementation of response measures including drugs and vaccines. It also mandates global sharing of such measures, requiring “participating manufacturers” to provide “access” to the WHO of 20 percent of their production of vaccines and drugs during a pandemic emergency, with at least half of that amount as a donation and the other half at “reasonable prices.” The definition of “participating manufacturer” is left to the PABS Instrument itself.
The Agreement calls for the PABS Instrument to be finalized in time for approval at next year’s WHA79, scheduled for May 2026 in Geneva. Only then will the Agreement be opened for “signatures” or ratification by member states, and the Agreement subsequently goes into force 30 days after the 60th such signature. Thus the Agreement, announced with great fanfare last month, is over a year away from taking effect.
The 11 nations who abstained in the committee vote—including Russia, Italy, Poland, Iran, Egypt and Israel—were given the opportunity to express their reservations. The representative from Iran noted that “key concerns of developing countries were not addressed,” while decrying the “lack of binding commitments on unhindered access and equitable access to medical countermeasures, technology transfer and knowhow, and continued silence on negative impact of unilateral coercive measures on health systems.”
Notably absent from the entire meeting was a delegation from the United States. On his first day in office, January 20, 2025, Donald Trump issued an executive order initiating the process to withdraw the US from the WHO. As reported then by the WSWS, the withdrawal sabotages global public health efforts and increases the likelihood of future pandemics.
The US instead participated in WHA78 by sending a pre-recorded video of Trump’s anti-vaccine Health Secretary Robert F. Kennedy Jr. spewing a fascistic tirade, accusing the WHO of being unduly influenced by China, lacking transparency and accountability, and promoting political agendas over its core mission. Kennedy also repeated the thoroughly discredited Wuhan Lab Lie conspiracy theory on the origins of the COVID-19 pandemic.
Attempting to justify the US withdrawal from the WHO and non-participation at WHA78, Kennedy said the WHO “has doubled down with the Pandemic Agreement, which will lock in all of the dysfunctions of the WHO pandemic response.”
Kennedy also attempted to falsely portray the Trump administration as an adherent of global cooperation on health security. As extensively documented by the WSWS, Kennedy and the Trump administration are instead engaged in a massive assault on science and public health, of which the WHO withdrawal is but a part.
Kennedy urged delegates and dignitaries at WHA78 to join the Trump administration’s program for health instead, and said the US would look for global cooperation elsewhere, either in forming new entities or modifying existing ones, which he did not name specifically. He also contradicted himself, inviting the world to join the US in its shift of focus to chronic disease, while subsequently advocating for a supposed return to the core focus of global health as reducing infectious disease burden.
Following the WHO meeting, last week the US and Argentina announced the launching of an “alternative international health system” separate from the WHO, whose aim is to undermine science and public health while amplifying conspiracy theories.
With its withdrawal from the WHO, the US is also pulling its funding for the organization. Even though US GDP is approximately 26 percent of global GDP, it only provided roughly 15 percent of WHO funding. Despite the discrepancy, the Trump executive order cynically states, “the WHO continues to demand unfairly onerous payments from the United States, far out of proportion with other countries’ assessed payments.”
In the wake of the Pandemic Agreement approval, other nations have announced funding support. Member states also agreed at WHA78 to a 20 percent dues increase.
Chinese Vice Premier Liu Guozhong additionally announced that China will commit up to an extra $500 million in the next five years, saying, “all sides need to firmly support the WHO to play a central coordinating [sic] in global health governance, (and) support WHO to perform its duty in an independent, professional and science-based manner.”
China currently commits $200 million per year to WHO relative to the $700 million the US was set to contribute in 2024-2025 prior to its withdrawal. Thus the Chinese commitment falls well short of filling the void left by the US.
The international disarray evidenced by a late, watered-down and ultimately unfinished Pandemic Agreement, as well as the United States’ withdrawal from and attack on the WHO, stands as a glaring indictment of the global capitalist system and its entire ruling class. Despite championing the Agreement, Ghebreyesus himself shares considerable blame. Among other things, as pointed out by the WSWS, it was his WHO that prematurely ended the COVID-19 public health emergency of international concern in May 2023, and he himself has repeatedly referred to the ongoing COVID-19 pandemic in the past tense.
The previous administration of the US under President Joe Biden and the entire Democratic Party also are complicit in undermining global health responses to pandemics. It was his administration that adopted the anti-scientific “forever COVID” policy, dismantling all pandemic response measures and surveillance. The Biden administration also grossly mishandled the pandemic threat posed by the H5N1 avian influenza virus, which now looms ever larger under Trump and Kennedy.
As the crippled Pandemic Agreement limped over an artificial finish line, the newest SARS-CoV-2 variant, dubbed NB.1.8.1, burst onto the scene, a situation that places in stark relief the contrast between global threats and the capitalist response. The variant is already the dominant strain in China, Hong Kong and Taiwan, where it has caused significant spikes in infections and hospitalizations. So far, it has been found in several US states including California, New York, Ohio, Virginia and Washington.
The US Centers for Disease Control and Prevention has also found the NB.1.8.1 variant in travelers from multiple nations around the world besides China, including France, Spain, South Korea and Japan. Scientists are warning that it is only a matter of time until NB.1.8.1 becomes the dominant strain globally.
As the WSWS wrote previously on the Pandemic Agreement:
Capitalism’s response to the pandemic both in terms of death and illness and this massive rise in social inequality, as documented extensively by the World Socialist Web Site, is a great social crime. Turning to the institutions of capitalism and demanding that they change course is an exercise in folly. They have proven impervious as they stoke the fires of World War III and enable a deadly virus to tear through vulnerable populations ad infinitum.
The international working class must assimilate the lessons of the pandemic, above all the inability of capitalism to organize on a global scale to address the current pandemic and prevent future ones. Indeed, these immense global tasks fall to the working class itself, which must reorganize the world economy on its own terms to prioritize social needs, including public health, over corporate profits. This can only be achieved through an international socialist program, with the goal of ending capitalism and its contradictions and building a new society that protects and promotes health, resolves climate change, and ensures social equality.