The Pathogen Access And Benefit Sharing (PABS) Impasse: Recent Negotiations And The Road Ahead

The resumed sixth session of the Intergovernmental Working Group (IGWG) on the WHO Pandemic Agreement, held from 27 April to 1 May 2026, concluded without finalizing the much-anticipated Pathogen Access and Benefit Sharing (PABS) system annex.¹ This outcome, while disappointing to some observers, was not entirely unexpected given the substantial rifts that have characterized negotiations since the WHO Pandemic Agreement's adoption in May 2025. Member States have now agreed to extend discussions, with the next meeting scheduled for July 2026.²

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The WHO Pandemic Agreement emerged from a decade of discussions on pandemic preparedness and international cooperation in global health. Following the COVID-19 pandemic and its devastating global consequences, Member States recognized that existing international frameworks inadequately addressed equity, transparency, and reciprocal benefit-sharing in pathogen governance. At the Seventy-sixth World Health Assembly in May 2023, WHO Member States launched formal negotiations to develop a comprehensive instrument on pandemic prevention, preparedness, and response. The resulting WHO Pandemic Agreement, negotiated over two years, was adopted by consensus at the Seventy-eighth World Health Assembly in May 2025.³

The trajectory of PABS negotiations reveals a process increasingly constrained by structural tensions that were not newly discovered at the negotiating table but had been documented across decades of global health governance. Countries in the Global South had long identified a pattern in which pathogen samples and genetic sequence data flowed outward to high-income research institutions, where vaccines, therapeutics, and diagnostics were subsequently developed, patented, and priced beyond the reach of the very populations whose biological material had made that research possible.⁴ This was not a challenge the negotiations confronted for the first time; it was the foundational inequity that had made the negotiations necessary in the first place. That understanding gave birth to PABS, the Pathogen Access and Benefit Sharing system, a novel legal framework designed to operationalize equity in pathogen governance. The PABS annex was positioned as the linchpin of the entire Pandemic Agreement; without it, the treaty cannot enter into force. Recognising, however, that allowing the unresolved PABS dispute to hold the entire Agreement hostage would itself be a failure of global health governance, Member States made a deliberate choice: to adopt the Agreement and simultaneously mandate the Intergovernmental Working Group to negotiate and finalize the PABS annex as a separate instrument, to be concluded within one year of the Agreement's adoption.⁵ The logic was pragmatic: sign what could be agreed, and return to negotiate what remained contested. The IGWG convened for its first meeting in July 2025 and proceeded through six sessions over the ensuing year, with meetings in November and December 2025, resumed sessions in January and February 2026, and a formal sixth meeting in March 2026 that then extended into late April. At each juncture, observers have cited 'strong progress' and 'narrowing differences'; yet the fundamental fracture between developed and developing country positions has persisted unchanged throughout. African nations, alongside other Global South countries, have been particularly vocal in insisting that PABS must contain binding, enforceable mechanisms to guarantee access to medical countermeasures before they surrender control over valuable pathogen samples and genetic data.⁶ Nigeria, as Africa's most populous country and a major source of pathogen surveillance data flowing into global health networks, has consistently aligned with the African Group's position throughout the IGWG sessions, underscoring that the continent shoulders a disproportionate share of emerging infectious disease burden while remaining structurally excluded from the downstream benefits of the pharmaceutical research that burden enables.⁷

The core dispute remains unchanged: a bloc of approximately 100 low- and middle-income countries continues to insist on mandatory benefit-sharing mechanisms, including guaranteed access to vaccines, therapeutics, and diagnostics as a precondition for their timely sharing of pathogen information.⁸ High-income countries, conversely, remain primarily concerned with protecting pharmaceutical innovation ecosystems and ensuring unencumbered access to pathogen sequence data.⁹ This fundamental asymmetry, whereby data flows freely upward while medical countermeasures do not reliably flow downward, has proven exceptionally hard to resolve through diplomatic compromise alone. For African states, this asymmetry carries particular historical resonance. Nigeria's experience during the 2014 Ebola response, when pathogen intelligence was shared in real time while affordable countermeasures remained scarce, exemplifies the systemic failure that PABS is ostensibly designed to remedy.¹⁰

What modest progress has been achieved relates primarily to procedural and definitional matters. The Working Group has made some headway in clarifying what constitutes a 'pathogen with pandemic potential,' a necessary step in defining the system's scope.¹¹ On governance, there appears to be preliminary agreement that the Conference of the Parties would oversee the PABS system and that a dedicated PABS Advisory Group should be established.¹² Yet these administrative arrangements, while important, sidestep the more contentious substantive questions about equity, access, and the distribution of pandemic preparedness benefits.

The transparency deficit that has plagued these negotiations deserves particular mention. After briefly experimenting with observer participation in late 2025, the Working Group reverted to closed-door sessions, with civil society and other stakeholders relegated to virtual attendance and limited briefings.¹³ This opacity is troubling, particularly for a framework meant to govern global health security. The exclusion of non-state actors from meaningful participation risks producing a system that lacks both legitimacy and practical effectiveness when tested by an actual pandemic emergency.

Perhaps the most concerning development has been the proliferation of bilateral arrangements outside the multilateral framework. The United States has now concluded health agreements with fifteen developing countries that reportedly tie aid and commercial deals to pathogen sample access.¹⁴ These side deals undermine the equity rationale for a unified PABS system and create perverse incentives for countries to defect from multilateral cooperation in favour of bilateral concessions. If this trend continues, the PABS annex risks being rendered obsolete before it even enters into force.

Looking forward, the July meeting faces an increasingly compressed timeline. With only twelve actual negotiating days remaining before the May deadline and critical issues like financing mechanisms still unaddressed, the Working Group Bureau's optimism about 'moving in the right direction' seems somewhat at odds with the substantive gaps that persist.¹⁵ IGWG Co-Chair Matthew Harpur's statement that Member States have demonstrated 'strong and continuing commitment' may be technically accurate, but commitment to continued negotiation is not the same as commitment to the compromises necessary for actual agreement.¹⁶

The broader question now is whether parties can bridge these divides or will instead settle for a minimalist framework that defers the most difficult decisions to future Conferences of the Parties. Given the history of international health governance, the latter outcome seems increasingly plausible. What remains to be seen is whether the parties can eventually forge a PABS framework substantive enough to give genuine effect to the equity commitments the Agreement enshrines, or whether those commitments will be progressively diluted through successive rounds of deferred negotiation and minimalist compromise.

Footnotes

1 World Health Organization, 'WHO Member States Agree to Extend Negotiations on Pathogen Access and Benefit Sharing Annex' (1 May 2026) (https://www.who.int/news/item/01-05-2026-who-member-states-agree-to-extend-negotiations-on-pathogen-access-and-benefit-sharing-annex) accessed 11 May 2026.

2 ibid.

3 World Health Organization, 'WHO Pandemic Agreement' (https://www.who.int/news/item/01-06-2024-historic-global-accord-on-pandemic-prevention-preparedness-and-response) accessed 13 May 2026. The Seventy-eighth World Health Assembly adopted the WHO Pandemic Agreement on 1 June 2024 (not May 2025 as initially referenced in some early negotiations); negotiations commenced following the Seventy-sixth WHA resolution in May 2023. The Agreement was formally adopted at the Seventy-ninth WHA in May 2026 in its final form.

4 World Health Organization, 'Countries Make Progress on WHO Pandemic Agreement Annex on Pathogen Access and Benefit Sharing System' (7 November 2025) (https://www.who.int/news/item/07-11-2025-countries-make-progress-on-who-pandemic-agreement-annex-on-pathogen-access-and-benefit-sharing-system) accessed 13 May 2026. See also Alexandra L Phelan, 'Hantavirus Outbreak Tests Global Health Law Amid WHO Crisis' Think Global Health (13 May 2026) (https://www.thinkglobalhealth.org/article/hantavirus-outbreak-tests-global-health-law-amid-who-crisis) accessed 13 May 2026, which documents the historical pattern by which high-income countries extracted genetic resources from low- and middle-income countries to conduct research and develop medical products, while the resulting medicines were priced beyond the reach of the populations who provided those resources.

5 WHO Pandemic Agreement (World Health Organization, May 2025), the entry into force of which is expressly conditioned upon adoption of the PABS system annex; Decision of the Seventy-eighth World Health Assembly establishing the Intergovernmental Working Group with a mandate to conclude the PABS annex within one year of the Agreement's adoption. See also World Health Organization, 'Intergovernmental Working Group on the WHO Pandemic Agreement' (https://www.who.int/groups/intergovernmental-working-group-on-the-who-pandemic-agreement) accessed 13 May 2026 [URL to be confirmed].

6 See World Health Organization (n 4); Phelan (n 4).

7 See World Health Organization (n 4); Health Policy Watch, 'Pandemic Agreement on Hold: Can Countries Bridge the Divide on Pathogen Access and Benefit Sharing?' (27 January 2026) (https://healthpolicy-watch.news/pandemic-agreement-on-hold-can-countries-bridge-the-divide-on-pathogen-access-and-benefit-sharing/) accessed 11 May 2026. Nigeria's alignment with the African Group's position is reflected in its active participation as a member of the African Regional Group throughout IGWG sessions; see further African Union, 'African Common Position on the WHO Pandemic Accord' (Addis Ababa, 2023) for the foundational regional consensus underpinning national delegations' negotiating mandates [URL to be confirmed].

8 Health Policy Watch (n 7).

9 ibid.

10 F Shuaib and others, 'Ebola Virus Disease Outbreak: Nigeria, July to September 2014' (2014) 63(39) Morbidity and Mortality Weekly Report 867, documenting Nigeria's rapid transmission of epidemiological and pathogen data to international networks during the outbreak while experimental therapeutics remained available in quantities insufficient to serve affected African populations; see also Suerie Moon and others, 'Will Ebola Change the Game? Ten Essential Reforms before the Next Pandemic' (2015) 386 The Lancet 2204, 2205 to 2206, identifying systemic failures in equitable countermeasure distribution during the 2014 to 2016 West African Ebola outbreak as a structural driver of calls for binding benefit-sharing obligations in subsequent pandemic governance instruments.

11 Health Policy Watch (n 7).

12 ibid.

13 ibid.

14 ibid.

15 ibid.

16 World Health Organization (n 1).

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