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Background：

Expert reaction:

【李崇菱 Tsung-Ling Lee】 【蔡奉真 Feng-Jen Tsai】【李柏翰 Po-Han Lee 、林先和 Hsien-Ho Lin】

2025/05/20
Tsung-Ling Lee

Professor, Graduate Institute of Health and Biotechnology Law, Taipei Medical University, Taiwan. 

Q1：Why is this agreement important? If adopted, how will the agreement help the global prevention, preparedness and response to future pandemics?

The Pandemic Agreement marks a crucial advancement for global health law after three difficult years of international negotiations by World Health Organization (WHO) member states. However, while the treaty succeeds in reaffirming multilateralism as a foundation for international health cooperation and represents a positive step toward preventing future pandemics—where the question is "when," not "if"—it now faces significant hurdles ahead due to the absence of the US, after President Trump announced the US withdrawal from the WHO following his inauguration in January, and rising international divisions that threaten to undermine global solidarity.

The Pandemic Agreement complements the amended 2005 International Health Regulations by addressing critical areas—from zoonotic virus transmission to health worker protection. Drawing on lessons from the COVID-19 response, the agreement aims to future-proof global health by shifting prevention strategies toward strengthening health systems. However, the US withdrawal from WHO overshadows this global health milestone. As both a major financial contributor—providing approximately one-fifth of WHO's $6.8 billion budget—and home to world-leading health systems and epidemiological expertise, the current US absence in global health governance creates significant uncertainties for the future of the world's pandemic prevention, preparedness and response systems.

The Pandemic Agreement also seeks to introduce a "Pathogen Access and Benefit-Sharing System," where pathogen samples and genomic sequencing data—scientific information needed to develop vaccines—are exchanged for equitable sharing of medical products. This system is an amicable attempt to address the health inequalities witnessed during the COVID-19 pandemic. However, as countries needed more time to iron out these details through further negotiations on a separate Annex, this means the agreement won't be ratified until the Annex is formalized in one year, with current deadline for adoption in May 2026.

Q2：What are the possible consequences if the agreement fails to pass? How will it affect the global response to the pandemic in the future?

If countries were to reject the Pandemic Agreement—although this is unlikely but remains probable if the Annex is not adopted—it could have significant consequences for global health, especially considering the rise of emerging zoonotic diseases with unknown origins and transmission pathways that are likely to arise in the years to come.

While countries can take legal reforms individually to safeguard against future pandemics, the COVID-19 pandemic made clear that our interconnected global economy demands international health collaboration to build a more resilient world to prepare for common challenges. Without shared commitments to exchange scientific data and strategically strengthen health systems, the world risks greater health vulnerabilities and eroding trust between nations—an outcome that would harm everyone.

Q3：What do you think is the most important part of the current agreement, especially related to Taiwan?

Several provisions of the Pandemic Agreement are relevant to Taiwan: combating misinformation and disinformation, protecting health and care workers from stigmatization and ensuring their safety during health emergencies, and integrating a one-health approach (addressing animal-to-human transmission) into Taiwan's pandemic preparedness, prevention, and response. While Taiwan's COVID-19 response earned global recognition, it remains essential to continue building resilience and trust through coordinated, open communication among government, private sectors, and the public and engagement with WHO.

While Taiwan is not a WHO member state and cannot legally become a state party to the Pandemic Agreement, Taiwan can update its regulatory framework for pandemic preparedness in line with the Pandemic Agreement by implementing more inclusive public policymaking processes. As the Pandemic Agreement emphasizes the need for geographically diverse manufacturing capacities, Taiwan can also expand its vaccine research, development, and production capabilities to support both domestic and international needs.

2025/05/20
Feng-Jen Tsai

Professor, Ph.D. Program in Global Health and Health Security, Taipei Medical University, Taiwan.

The Pandemic Treaty represents a significant advancement in global cooperation mechanisms for the prevention and control of large-scale infectious disease outbreaks, following the International Health Regulations (2005). The treaty establishes the Pathogen Access and Benefit-Sharing System (PABS System), which expands upon the previous framework that was limited to avian influenza virus and benefit sharing, now extending its scope to all diseases with the potential to cause global pandemics.

The creation of this system effectively addresses the institutional gaps exposed during the COVID-19 pandemic, when the absence of a clear international agreement hindered the timely and equitable sharing of critical information, vaccines, and medical resources. In the event of future outbreaks of emerging infectious diseases, the World Health Organization (WHO) will be able to utilize this treaty to promote transparent information exchange and to secure contributions of vaccines and other essential countermeasures from participating companies. This will help ensure fair global distribution of pandemic-related resources and further strengthen the international public health response system.

Although several proactive measures were removed from the final text compared to the original draft, the treaty nonetheless lays a crucial foundation for future international collaboration in pandemic prevention and response, marking a key milestone in global health governance.

Taiwan, home to numerous outstanding companies in vaccine development and infectious disease response, demonstrated rapid and effective governmental action during the COVID-19 crisis. Looking forward, Taiwan can contribute meaningfully to global pandemic preparedness and response by actively participating in the PABS system, thereby supporting the enhancement of global health security.

2025/05/21
Po-Han Lee and Hsien-Ho Lin

Po-Han Lee, Associate Professor, Global Health Program & Institute of Health Policy and Management, National Taiwan University, Taiwan. 

Hsien-Ho Lin, Professor and Director of  Global Health Program & Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taiwan. 

The WHO Pandemic Agreement is a pivotal step towards a more resilient global health system. The treaty, together with the WHO Framework Convention on Tobacco Control (WHO-FCTC), contributes to the evolving global health legal architecture and, through interacting with the recently revised International Health Regulations (IHR), will help shape the governance of pandemic prevention, preparedness, and response. Its adoption shall promote timely information sharing and coordinated responses grounded in scientific evidence and human rights.

While reaffirming sovereign rights, it advances equity (across individuals, communities, and countries), global solidarity, and the One Health approach. It commits parties to transparency and accountability, recognising differential capacities and vulnerabilities among regions and countries. At stake is not only future pandemic readiness but also the legitimacy and effectiveness of multilateralism in health, especially considering the Trump administration’s withdrawal of the US from global governance frameworks.

The Agreement significantly expands expectations around pandemic surveillance and data sharing, marking a shift toward globally integrated and transparent systems. Parties are required to build interoperable surveillance capacities, incorporate the One Health approach, and share pathogen-related information—including genomic sequences—rapidly and equitably. The establishment of the Pathogen Access and Benefit-Sharing (PABS) System introduces binding commitments not only for data contribution but also for reciprocal access to vaccines, diagnostics, and therapeutics.

While these mechanisms promote early detection and collective risk mitigation, they also raise geopolitical questions for entities outside the WHO system. Without formal inclusion, jurisdictions like Taiwan risk being excluded from key data flows and benefit-sharing frameworks, despite their contributions to global health security. As such, the Agreement highlights the urgency of developing alternative access channels or parallel partnerships that preserve transparency, safeguard equitable information exchange, and ensure that high-functioning surveillance actors remain integrated in global pandemic response efforts. To maximize the effectiveness of response efforts, securing equitable access to medical countermeasures is essential.

To enhance global preparedness and response to pandemics, equitable access to and supply of pandemic countermeasures remains a critical concern, posing significant challenges to global health systems, pharmaceutical logistics, and international policy coordination. The experience of "vaccine nationalism" and unequal access to personal protective equipment during the COVID-19 pandemic underscores the urgent need for a more equitable and resilient global supply chain.

The proposed Pandemic Agreement recognizes the importance of international cooperation in mitigating supply chain disruptions, such as export bans, stockpiling, and production bottlenecks. Crucially, the treaty must guarantee that all countries—regardless of income level or political status—have timely and fair access to life-saving countermeasures. Failure to do so would leave significant gaps in global biosecurity and undermine the collective response to future health emergencies.

To safeguard the continuity of supply for critical medical countermeasures, the WHO, through the treaty, should prioritize the diversification of manufacturing hubs. Leveraging regional and local production capacities across all states will reduce dependency on a limited number of suppliers and facilitate faster access to essential tools during outbreaks. Furthermore, the Agreement should establish frameworks to integrate these manufacturing hubs into pre-arranged agreements and financing mechanisms. In this context, Taiwan’s capabilities in manufacturing place it in a strong position to offer valuable support to global efforts aimed at ensuring the timely and equitable supply and distribution of pandemic countermeasures.

Though not recognised as a “state” under the UN system, Taiwan can still positively contribute to implementing the Pandemic Agreement through non-state channels. Taiwan’s IHR-designated focal point already facilitates technical exchange, while professional bodies, individual experts, and civil society actors may engage through partnerships and multi-stakeholder platforms.

Taiwan may also pursue bilateral collaborations with like-minded governments to advance the Agreement’s aims and/or unilaterally incorporate treaty provisions into its domestic laws and policies, as demonstrated in its alignment with the WHO FCTC. The Agreement’s procedural features, including dispute settlement mechanisms—such as diplomatic channels and recourse to the Permanent Court of Arbitration—may also allow for more inclusive engagement.

Taiwan’s proactive legal reforms and commitment to transparency and accountability should illustrate how non-member actors can support global health norms. Its experience will offer a model of human rights-based, evidence-informed pandemic governance aligned with multilateral objectives.

Reference:

WHO member states approve pandemic treaty: World Health Assembly adopts historic Pandemic Agreement to make the world more equitable and safer from future pandemics