Pandemic Treaty Talks enter final stretch in Geneva as CSOs raise equity concerns

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Fresh tensions on pathogen access equity are surfacing as negotiators race against time to conclude critical talks on the World Health Organisation Pandemic Agreement in Geneva.

Activists and health experts are warning that unresolved equity gaps could undermine global preparedness for future health crises.

The negotiations, which resumed on April 27 and are expected to end on May 1, mark the final round of discussions before the agreement is presented at the upcoming World Health Assembly.

At the centre of the debate is the Pathogen Access and Benefit-Sharing (PABS) Annex, a key mechanism intended to govern how pathogen samples and genetic data are shared, and how resulting benefits, including vaccines, diagnostics, and treatments, are distributed.

Advocates say failure to secure a strong and binding annex risks repeating the inequities witnessed during the COVID-19 pandemic, when wealthier nations secured early access to vaccines while many developing countries waited months.

Henry Magala, Country Program Director at AIDS Healthcare Foundation, Uganda Cares, warned that the current draft still falls short of guaranteeing fairness for countries that contribute critical biological samples.

“One of the biggest gaps is that developing countries, which provide the biological samples used to develop vaccines, are not guaranteed fair access to the final products,” Magala said.

He noted that advocates are pushing for binding provisions that would require at least 20 percent of all vaccines produced during a pandemic to be reserved for developing countries, particularly those where outbreaks originate.

Another major sticking point is technology transfer. While several African countries have invested in vaccine manufacturing infrastructure, Magala emphasised that limited access to proprietary technology held by pharmaceutical firms continues to hinder local production.

“We have the infrastructure. What we need is technology transfer so we can produce vaccines locally and reduce dependency,” he said.

The issue of accountability is also under scrutiny, with campaigners calling for pharmaceutical companies to be formally registered and monitored under the agreement to ensure transparency in vaccine development and distribution.

Beyond access and production, financing remains a contentious issue. Proposals for a global pandemic fund suggest contributions based on countries’ economic strength, but concerns persist that low-income nations could struggle to meet such obligations.

“There is uncertainty about where funding will come from when the next pandemic hits. Without a clear financing mechanism, the world risks being caught unprepared again,” Magala noted.

Tibesigwa Diana, Regional Policy and Advocacy Manager at AHF Uganda Cares, described the ongoing session as a decisive moment for global health equity.

“This is likely the last opportunity to secure a fair deal. If equity is not embedded now, developing countries will continue to suffer the most during future pandemics,” she said.

Health advocates are now urging governments, including Uganda’s Ministry of Health and Members of Parliament, to actively engage in the negotiations and push for a more balanced outcome.

On his part, Anne Lumbasi, Senior Advisor at the Resilience Action Network Africa, recently underscored the global implications of inequitable access to health tools.

She said, “A pathogen anywhere is a threat everywhere. So, equitable access is not charity, it’s prevention.”

Lumbasi highlighted that African scientists played a critical role in sharing genomic data that helped track dangerous virus variants during COVID-19.

However, despite these contributions, the continent received less than three percent of global vaccine doses in the first year of rollout. “This was not a failure of science. It was a failure of equity,” she added.

Experts argue that the PABS system is designed to correct this imbalance by ensuring that countries contributing pathogen samples and sequence data receive fair benefits when medical countermeasures are developed.

Denis Joseph Bukenya, Executive Director of the Human Rights Research Documentation Centre, said the negotiations expose deeper structural inequalities in global health governance.

“The inverse benefit law highlights a systemic inequity in global health security. Low- and middle-income countries that quickly detect outbreaks and share pathogen samples are often the last to receive vaccines and treatments,” Bukenya said.

He added that while the Pandemic Agreement aims to establish a binding legal framework for preparedness and response, geopolitical realities continue to shape the negotiations.

“With the USA having withdrawn from WHO and prioritisation of national interest, power and capital are becoming more concentrated in nation states and some global corporations,” he said.