After Covid

Green light for WHO pandemic plan but Italy abstains even with guarantees of full sovereignty

In the Agreement approved after three years of negotiations, the full autonomy of states on procurement and lockdown decisions is maintained, but rapid and targeted access to 20 per cent of their products is demanded from the companies that will join

by Barbara Gobbi

20 May 2025

epa12118575 Tedros Adhanom Ghebreyesus, Director General of the World Health Organization (WHO), applauds the approval of the WHO Pandemic Agreement, aimed at avoiding a repeat of the mistakes made during the COVID-19 crisis, during the 78th World Health Assembly (WHA78) at the European headquarters of the United Nations in Geneva, Switzerland, 20 May 2025. The WHO Pandemic Agreement will be considered for final adoption by the Assembly on 20 May during the plenary session. The Assembly is being held from 19 to 27 May, with this year's theme being 'One World for Health.' EPA/MAGALI GIRARDIN

3' min read

3' min read

Green light after three years of negotiations on the World Health Organisation's Pandemic Plan: governments adopted it at a plenary session of the World Health Assembly following the approval of the Plan Agreement on 19 May with 124 votes in favour, 11 abstentions including Italy, and no votes against.

It is a somewhat historic date, not least because it came at a time of great weakness for the World Health Organisation following Trump's abandonment by the United States and in a context of a general crisis of authority for the bodies that report to the United Nations. The WHO pandemic agreement is the second international legal agreement negotiated under Article 19 of the Organisation's Constitution: before that there had been the Framework Convention on Tobacco Control, which was adopted in 2003 and came into force in 2005.

Italy abstained

It did not vote against but abstained, along with Russia, Bulgaria, Jamaica, Poland, Israel, Iran, Romania, Guatemala, Slovakia and Paraguay. If not a sign of opposition (zero 'no' votes), it was a sign of distancing, which our country had made no secret of: Health Minister Orazio Schillaci himself had contested the risk of 'outsourcing the management of a possible next pandemic' right from the start.

Tedros: a safer world

For DG Tedros Adhanom Ghebreyesus, "today the world is safer thanks to the leadership, collaboration and commitment of our Member States in adopting the historic WHO Pandemic Agreement. It is a victory for public health, science and multilateral action. It will ensure that, collectively, we can better protect the world from future pandemic threats. It is also a recognition by the international community that our citizens, our societies and our economies must not be left vulnerable to suffer losses again like those suffered during Covid-19".

"Since the height of the Covid-19 pandemic, governments around the world have acted with great determination, dedication and urgency, exercising their national sovereignty, to negotiate this historic Accord," said Teodoro Herbosa, Secretary Department of Health of the Philippines and President of this year's World Health Assembly. "Now we must all act with the same urgency to implement its critical elements, including systems to ensure equitable access to pandemic-related life-saving health commodities.

Sovereignty remains with the states

The Plan sets out principles, approaches and tools for improved international coordination to strengthen the global health architecture for pandemic prevention, preparedness and response. A strategy that includes equitable and timely access to vaccines, therapies and diagnostic tools. With regard to national sovereignty, it states that 'nothing in the WHO Pandemic Agreement shall be construed as conferring on the WHO Secretariat, including the Director-General, any authority to direct, order, modify or otherwise prescribe the national and/or domestic legislation, as appropriate, or policies of any Party, or to mandate or otherwise impose any requirement for Parties to take specific actions, such as prohibiting or accepting travellers, imposing vaccination mandates or therapeutic or diagnostic measures, or implementing lockdowns'.

In force with 60 ratifications

The resolution on the WHO pandemic agreement, adopted by the World Health Assembly, sets out preparatory measures for the implementation of the agreement. These include the initiation of a process to draft and negotiate a Pathogen Access and Benefit Sharing Scheme (PABS) through an Intergovernmental Working Group (IGWG). The outcome of this process will be considered at next year's World Health Assembly.

Once the Assembly has adopted the PABS Annex, the WHO Pandemic Agreement will be open for signature and consideration for ratification, including by national legislative bodies. After 60 ratifications, the Agreement will enter into force.

The protection of poor countries

In addition, the member states also instructed the IGWG to initiate measures to enable the establishment of the Financial Coordination Mechanism for Pandemic Prevention, Preparedness and Response and the Global Supply Chain and Logistics Network (GSCL) to 'improve, facilitate and work towards removing barriers and ensuring equitable, timely, rapid, safe and affordable access to pandemic-related health commodities for countries in need during public health emergencies of international concern, including pandemic emergencies, and for the prevention of such emergencies'.

Pharma's contribution

Under the agreement, pharmaceutical companies participating in the PABS system will play a key role in equitable and timely access to pandemic-related health products by providing WHO with 'rapid access to 20 per cent of their real-time production of safe, quality and effective vaccines, therapies and diagnostics for the pathogen causing the pandemic emergency'. Distribution of these products to countries will be made on the basis of risk and public health needs, with particular attention to the needs of developing countries.