Fernando Simón Soria
After 14 International Health Conferences (1851–1938), the International Health Regulations, the first in 1951 and the last in 2005, with a significant package of amendments approved at the World Health Assembly in 2024, with the experience of the COVID-19 pandemic and after more than three years of negotiations between all WHO member states, the first Pandemic Agreement was adopted at the 78th World Health Assembly on 20 May 2025. The COVID-19 pandemic highlighted significant shortcomings in the management of global health emergencies affecting the entire population.
The pandemic has shown us that the actions taken by states to protect their populations from health risks that transcend borders are not sufficient in the globalised world in which we live. Establishing global communication mechanisms, international coordination of non-pharmaceutical measures and research capabilities, vaccine development, treatments and diagnostic tests, and global production and access to these measures are the only guarantees for resolving pandemics and other emergencies with a major impact on public health. These actions require the commitment of states to implement national capacities in a coordinated manner that results in multilateral development, seeking balance and synergies between regions.
The Pandemic Agreement seeks to respond to these needs by improving global capacities for pandemic prevention, preparedness and response, in accordance with the fundamental principles of equity, solidarity, respect for dignity and human rights, and international humanitarian law, while guaranteeing the sovereign rights of states.
However, negotiating national commitments for global benefit is no easy task. States must commit to the principles of equity and solidarity, but we must also trust each other and be reliable in fulfilling our commitments. Despite everything, a historic agreement was reached, the potential of which will be seen in the coming years.
For the first time, we have opened a door to working together for global health security, understanding that this is the only possible path, but if we are not careful, that door could close. Once the Pandemic Agreement has been approved, its entry into force depends on the adoption, expected at the 2026 World Health Assembly, of an annex to the document detailing how the multilateral mechanism for ‘access to pathogens and the sharing of benefits’ generated will work. This mechanism aims to rationalise global inequalities between states in research, development and access to products generated from knowledge of pandemic risk pathogens and/or their genetic sequences during health emergencies.
The negotiations have been long and difficult, but they have shown that when there is a common goal, states can agree and make commitments for the global good, beyond national interests.
Despite what has been achieved, some people believe that an opportunity has been missed to establish a more ambitious agreement with greater commitments from states. Others believe that the Agreement somehow limits the ability of states to make their own decisions. Perhaps both statements are true, but the fact is that although the Pandemic Agreement is not perfect for everyone, it is good enough for all of us, and we have begun to walk together.