Historic WHO Pandemic Agreement Adopted Amid U.S. Withdrawal

On May 20, 2025, the World Health Organization (WHO) adopted the first-ever legally binding Pandemic Agreement during its 78th World Health Assembly in Geneva. This landmark accord, approved by 124 countries with 11 abstentions, aims to bolster global collaboration in preventing, preparing for, and responding to future pandemics. Notably, the United States, having withdrawn from the WHO earlier this year, did not participate in the agreement.

The Pandemic Agreement introduces key measures such as equitable access to vaccines, therapeutics, and diagnostics, and establishes a Pathogen Access and Benefit Sharing (PABS) system. While hailed as a significant step forward, the absence of the U.S.—a major player in global health—raises questions about the agreement's effectiveness and the future of international health cooperation.

The adoption of the Pandemic Agreement follows over three years of intensive negotiations initiated in response to the COVID-19 pandemic's devastating impacts. The agreement aims to strengthen global collaboration in preventing, preparing for, and responding to future pandemics. Key components include equitable access to vaccines, therapeutics, and diagnostics, as well as the establishment of a Pathogen Access and Benefit Sharing (PABS) system. The agreement was approved by 124 countries, with 11 abstentions, and no objections. Notably, the United States, which had withdrawn from WHO negotiations under the Trump administration, did not participate in the agreement.

The agreement emphasizes the importance of equitable and timely access to vaccines, therapeutics, and diagnostics during pandemics. Pharmaceutical manufacturers participating in the Pathogen Access and Benefit Sharing (PABS) system are expected to allocate 20% of their real-time production of these health products to the WHO. This allocation is intended for distribution based on public health risk and need, with particular attention to developing countries.

The PABS system is designed to facilitate the rapid sharing of pathogen data and ensure that benefits derived from this data, such as vaccines and treatments, are distributed equitably. The specifics of this system are to be finalized by May 2026.

The agreement explicitly states that it does not grant the WHO authority to direct or impose national laws or policies. It respects the sovereignty of member states in making public health decisions.

The agreement was approved by 124 countries, with 11 abstentions, including Poland, Israel, Italy, Russia, Slovakia, and Iran. Notably, the United States, which had withdrawn from WHO negotiations under the Trump administration in January 2025, did not participate in the agreement.

In January 2025, President Donald Trump announced the withdrawal of the United States from the WHO, citing concerns over the organization's handling of the COVID-19 pandemic and perceived political influences. This decision led to the cessation of U.S. funding, which had constituted approximately 15% of the WHO's budget. The withdrawal has raised concerns about the WHO's capacity to manage global health initiatives without U.S. support.

WHO Director-General Dr. Tedros Adhanom Ghebreyesus hailed the agreement as a "victory for public health, science, and multilateral action," emphasizing its role in better protecting the world from future pandemic threats.

The European Commission welcomed the adoption of the agreement, highlighting its role in strengthening global health security and emphasizing the importance of international cooperation.

Human Rights Watch acknowledged the agreement as a step forward but criticized its lack of enforcement mechanisms and concrete funding obligations. They expressed concerns that the agreement might not effectively address the inequitable distribution of health resources observed during the COVID-19 pandemic.

The adoption of the Pandemic Agreement signifies a collective commitment to improving global health security and addressing the disparities highlighted by the COVID-19 pandemic. By focusing on equitable access to health products and fostering international collaboration, the agreement aims to prevent future pandemics from disproportionately affecting vulnerable populations. However, the absence of the United States from the agreement raises questions about the effectiveness of global health initiatives without the participation of one of the world's largest economies and contributors to global health funding.

The Pandemic Agreement marks a historic step in global health collaboration. The absence of the U.S. underscores challenges in achieving truly global cooperation. Future developments will determine the agreement's impact on global health security.