Global health

WHO pandemic plan, here's why Italy abstained (along with ten other countries)

A choice under the banner of 'sovereignty', the one reiterated by the Ministry of Health to explain the rejection of the 35-article document, which, however, puts clear stakes in the way of interference in the autonomy of individual states

by Barbara Gobbi

21 May 2025

Tedros Adhanom Ghebreyesus, direttore generale dell’Organizzazione Mondiale della Sanità (OMS), interviene sull’adozione dell’Accordo OMS sulle Pandemie, volto a evitare il ripetersi degli errori commessi durante la crisi COVID-19, durante la 78a Assemblea Mondiale della Sanità (WHA78) presso la sede europea delle Nazioni Unite a Ginevra, Svizzera, il 20 maggio 2025

5' min read

5' min read

The key word is 'sovereignty': it is to this concept that Italy, represented by Health Minister Orazio Schillaci, has traced the decision to abstain on the World Health Organisation's pandemic plan in the vote in Geneva for the 78th WHO Assembly. A document that had been proposed three years ago, with the world still dramatically shaken by the Covid earthquake, and that we too had advocated. But the final yes - due to the change at the top of the country and the new course imposed by the reinterpretation of the management of the pandemic - did not come, despite the many adjustments to the text.

A political choice

After multiple revisions and negotiations, the 35-article document, which received 124 votes in favour and no votes against but 11 abstentions, including ours in good company with Russia, Iran, Singapore, Romania and Bulgaria, and which aims to put in place a network of preventive security in view of a probable new pandemic, sees the instances of cession of sovereignty, which Italy continues to claim, decisively muffled. 'And which is the only possible explanation,' ministerial sources observe, 'for the failure to vote in favour. Therefore, a strictly political choice'.

Analysing the Plan, in fact, it is evident how the WHO led by Director General Tedros Adhanom Ghebreyesus - grappling with its own survival at a time of extreme crisis, including the financial crisis - in order to get the go-ahead has decidedly chosen the path of diplomacy and discretion over the borders of the member states. Respect for sovereignty, indeed: The Organisation has made it clear 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 make mandatory or otherwise impose any requirement for Parties to take specific actions, such as banning or accepting travellers, imposing vaccination mandates or therapeutic or diagnostic measures, or implementing lockdowns".

The Statement of Italy

And yet, with a choice that appears asynchronous to these declarations, our country, while reporting the WHO statements, has persisted in its all-out defence of self-protection: 'With today's abstention, Italy intends to reaffirm its position on the need to reaffirm the sovereignty of states in addressing public health issues. We appreciate," the statement reads, "that this principle has been included in the text of the Pandemic Agreement. We also welcome the fact that, in announcing the conclusion of the negotiations, the WHO specified that the Pandemic Agreement does not authorise the WHO to direct, order, modify or prescribe national laws or policies, nor to require states to take specific measures, such as banning or accepting travellers, imposing vaccinations or therapeutic or diagnostic measures, or implementing lockdowns. We also believe that the Agreement must be implemented in full respect of the principles of proportionality and protection of fundamental rights, including the protection of personal data and individual freedoms".

The "unfinished business"

The conclusion: 'With these principles in mind, Italy hopes to continue to work with the other WHO member states to define outstanding issues that, in our opinion, merit further investigation'. What the outstanding issues are, the Ministry of Health does not make clear. What is certain is that the choice of abstention has had the effect of polarising the political world: on the one hand, Senator Marco Lisei, president of the Covid Commission, according to whom 'Italy, even on the front of health prophylaxis strategies, has finally returned to playing a role no longer as a gregarious but as a protagonist in the international forum, and this episode proves it'. The Fratelli d'Italia senator admits that 'The text has now improved, thanks also to Italy's interventions, but still not enough. It was right to abstain, also in view of the upcoming appointments and negotiations'. On the other side, there is the voice of the opposition: 'The choice to abstain on the global pandemic plan promoted by the WHO is very serious. The Meloni government decides to isolate the country to follow the denialist and anti-scientific sirens. No lesson from Covid, rather a closure in the face of the reasons of science and the need to coordinate strategies, resources and research at a global level,' said Chiara Braga, leader of the PD group in the Chamber of Deputies. While even former Minister Beatrice Lorenzin, vice-president of the PD senators, speaks of an 'incomprehensible and anti-historical choice' and Andrea Quartini, group leader of the 5 Star Movement in the Social Affairs Commission at the Chamber of Deputies and Coordinator of the M5S Health and Social Inclusion Political Committee, goes so far as to say that 'Schillaci should distance himself from sovereignism or leave'.

Scientists lined up for yes

On the other hand, the science front is united. 'I would have preferred our country not to be on the same side as countries like Iran, Russia and Israel,' reported infectivologist Matteo Bassetti. While former president of the Istituto Superiore di Sanità Walter Ricciardi recalls that Italy's abstention is surprising because our country had been among the promoters of the pandemic treaty three years ago. "This change of step has no scientific or public health explanation, but evidently it is a political choice, just look at the bad company of the countries Italy voted with. Countries that do not have the common good at heart but care more about the political sensitivities of their sovereignist and populist voters'. Virologist Fabrizio Pregliasco also declared himself 'somewhat incredulous and astonished'. 'I agree we need to specify it better,' is the remark, 'but to reaffirm the sovereignty of a nation in a context in which Covid has shown us that we must work together seems to me a not very clear element.'
For Giovanni Rezza, extraordinary professor of Hygiene and Public Health at the Vita-Salute San Raffaele University in Milan, the WHO pandemic agreement 'is certainly an important novelty even if, compared to the originally proposed treaty, it is much less ambitious. The very definition of 'agreement' is much softer than that of 'treaty'. Also weighing on the agreement is the coldness of some countries, including ours, and the uncertainty over the possible accession of the United States'. Rezza emphasised that the salient point of the agreement 'is represented by the PABS, a sort of exchange or compensation mechanism on the basis of which resource-poor countries - among other things, at greater risk with regard to the emergence of new pandemic viruses - would favour the availability of biological samples quickly in exchange for access to a quota of drugs and vaccines yet to be defined'.

The WHO on the upswing in funding

In this context, the WHO, which after Trump's US exit seemed moribund, is rearing its head again: the Pandemic Plan is in itself a success as the second international legal agreement negotiated under Article 19 of the Organisation's Constitution, after the Framework Convention on Tobacco Control that came into force in 2005 after being adopted in 2003.
And there is very good news on the funding front: at the 78th Assembly, world leaders including states and philanthropic bodies pledged at least another $170 million for the WHO. Fundraising for the WHO's global health strategy, the Fourteenth General Programme of Work, which aims to 'save an additional 40 million lives over the next four years', continues.

In addition, Member States approved a 20 per cent increase in membership fees, approving the Organisation's 2026-27 budget of USD 4.2 billion. This is the second 20 per cent increase in fixed dues, following the one agreed as part of the 2024-2025 budget. "This increase," they note from the Organisation, "comes at a time when governments are facing financial constraints and economic difficulties, demonstrating Member States' fundamental support for global health solidarity and the crucial role of the WHO.