Despite all odds and challenges, the World Health Assembly (WHA) finally adopted the Pandemic Agreement on Tuesday after 11 rounds of negotiations spanning three challenging years. The agreement aims to bolster the world’s ability to better prepare for the next pandemic — where the question is not “if,” but “when.” This marks a health milestone for the WHO, whose leadership was widely criticized for its slow and ineffective response to the COVID-19 pandemic.
The agreement covers a range of issues: protecting health and care workers, ensuring equitable sharing of pandemic-related products, bolstering health systems, improving risk communications, and addressing animal-to-human transmission through enhanced surveillance and response capabilities. In many ways, the agreement offers a glimmer of hope for a rules-based legal order, renewing faith in multilateralism amid an increasingly divided world.
While the agreement represents a meaningful affirmation in global health cooperation, it faces several implementation challenges that need to be addressed. Most notably, it lacks robust enforcement mechanisms to ensure member states fulfill their obligations, creating potential gaps in its accountability. Additionally, crucial details of the “Pathogen Access and Benefit-Sharing System” (PABS system) remain to be discussed, with a 12-month timeline set for finalizing these essential details.
This uncertainty looms over whether countries would eventually ratify this landmark agreement. The PABS system, in particular, has emerged as a significant source of debate among WHO member states. The core of this contention lies in the challenging negotiations over equitable distribution mechanisms — specifically, how to balance the sharing of pandemic-related medical products with the provision of pathogen samples and genomic sequencing data, both of which are fundamental components for developing effective vaccines and medical countermeasures.
Furthermore, the US’ withdrawal from the WHO — home to world-leading health systems and epidemiological expertise, and a major financial contributor to the WHO’s US$6.8 billion budget — creates additional uncertainties in the world’s pandemic prevention, preparedness and response.
Despite Taiwan being denied participation in the WHA for the ninth consecutive year, and the legal and political barriers to formal WHO engagement remaining insurmountably high, several provisions of the Pandemic Agreement are still relevant to the nation. These include combating misinformation and disinformation, protecting health workers from stigmatization and ensuring their safety during emergencies, and incorporating a one-health approach — addressing animal-to-human transmission — into Taiwan’s pandemic preparedness, prevention and response. It should be noted that after the 2005 SARS outbreak, Taiwan revamped its legal architecture based on the 2005 International Health Regulations, another legal instrument addressing international infectious disease control under the WHO. Taiwan’s strategic internalization of international health norms enhanced its whole-of-government approach and bolstered its capability to respond during the COVID-19 pandemic.
While Taiwan’s COVID-19 response was widely recognized and praised, continuing to build resilience and trust through coordinated, open communication among the government, private sectors and the public remains essential. In light of the Pandemic Agreement’s strategic shift toward improving health systems, Taiwan has an opportunity to align its regulatory framework for pandemic preparedness with the agreement. This can be achieved by implementing more participatory and inclusive public policymaking processes that place human rights considerations at their core. Moreover, as the agreement emphasizes the need for geographically diverse manufacturing capacities to ensure global health security, Taiwan can scale up its vaccine research, development and production capabilities so it could support domestic and international needs during future health emergencies and contribute meaningfully to global health security.
Lee Tsung-ling is a professor at Taipei Medical University, with an expertise in global health law and governance.
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