A world health deal is trapped in limbo
Delegates at the World Health Assembly in Geneva face stalled negotiations on the Pathogen Access and Benefit Sharing (PABS) annex of the Pandemic Agreement, with disputes over pathogen data sharing and benefit distribution threatening to delay the deal for another year. The impasse reflects deeper geopolitical tensions, as countries prioritize self-reliance and the WHO struggles with funding, authority, and political unity amid evolving global health challenges like AI governance and exclusionary membership practices.
Delegates will gather in Geneva next week for the World Health Assembly (WHA), marking one year since member states reached a landmark Pandemic Agreement. However, progress has stalled on the Pathogen Access and Benefit Sharing (PABS) annex, which requires rapid sharing of pathogen samples and data in exchange for vaccines, diagnostics, and therapeutics. Negotiations over PABS have dragged on for months, exposing a broader issue: distrust, unequal bargaining power, and a shift toward national self-reliance in global health strategy. The PABS dispute is not just a technical hurdle but a test of the WHO’s credibility in a polarized world. While countries frame health security through supply chains and stockpiles, cooperation remains fragile. Recent hantavirus outbreaks show that rapid information-sharing can work, but the WHO’s effectiveness is undermined by exclusionary practices, such as Taiwan’s absence from formal channels. Pathogens do not respect political boundaries, yet cooperation often does. Beyond PABS, two key developments at the WHA highlight power politics reshaping health governance. First, China’s upcoming seat on the WHO’s Executive Board—responsible for screening director-general candidates—will grant it procedural influence over the organization’s direction. This shift is significant amid U.S. retreat from multilateral health leadership, turning the WHA into a contested political arena. Second, member states are pushing to explicitly include artificial intelligence in the WHO’s renewed Global Strategy on Digital Health. Though classified as ‘soft law,’ such frameworks shape donor priorities and legitimize technological pathways, quietly influencing what is considered ‘modern’ policy. As the WHO navigates AI governance alongside pandemic preparedness, its ability to deliver depends on predictable financing, real authority, and unity when it matters most. The PABS impasse and these broader trends reveal a global health system strained by geopolitical rivalry. Without resolution, the WHO’s capacity to address future outbreaks—or emerging technologies like AI—will remain compromised by political divisions and unequal influence.
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