An extra week of negotiations to complete an international agreement on handling future pandemics kicked off in Geneva on Monday, with sharp divisions holding up an accord.
Wealthy countries and developing nations are at loggerheads in the talks at the World Health Organization over how the pandemic treaty, adopted last year, will work in practice.
The agreement's Pathogen Access and Benefit-Sharing (PABS) system deals with sharing access to pathogens with pandemic potential, then sharing benefits derived from them such as vaccines, tests and treatments.
"The world cannot afford to lose this opportunity and risk being unprepared for the next pandemic," WHO chief Tedros Adhanom Ghebreyesus said at the start of the talks.
"It will not be perfect; no agreement ever is. But it can be fair; it can be functional," he told negotiators.
In May 2025, WHO members adopted a landmark agreement on tackling future health crises, after more than three years of negotiations sparked by the shock of Covid-19.
The accord aims to prevent a repeat of the disjointed international response that surrounded the coronavirus crisis, by improving global coordination, surveillance and access to vaccines.
PABS, the heart of the treaty, was left out to get the bulk of the deal over the line.
- 'Blame is shared' -
"Developing countries are voicing their mistrust, fearing they will share their viruses without any guarantees of equitable access to vaccines in the event of a crisis," WHO chief scientist Sylvie Briand told AFP.
Other countries are asking whether the pharmaceutical industry has the capacity and motivation to contribute to a pandemic agreement "without a guarantee of return on investment", she said.
Countries have until Friday to negotiate PABS so it can be approved during the World Health Assembly of WHO member states, which opens on May 18.
"Progress has been slow" and finding compromise "will be very hard", though the European Union was now "making an effort to demonstrate some flexibility", said Jean Karydakis, a diplomat at Brazil's mission in Geneva.
The pathogen sharing clauses are considered crucial by developing states, particularly in Africa, where many countries felt cut adrift in the scramble for Covid-19 vaccines.
While NGOs have criticized wealthy nations' obduracy, a western diplomat, speaking on condition of anonymity, said there were also "excessive demands from some developing countries", and thus "the blame is shared" for the deadlock.
- Anonymous access? -
The treaty already says participating pharmaceutical companies should make available 20 percent of their production of vaccines, tests and treatments to the WHO for redistribution -- with at least half as a donation and the rest "at affordable prices".
However, the terms and conditions remain to be defined, as does access to health data and tools outside pandemics.
NGOs and developing countries want to impose mandatory rules for laboratories to ensure poor countries receive vaccines.
"During the Ebola outbreaks, samples from African patients led to treatments developed without such obligations," said Olena Zarytska of the medical charity Doctors Without Borders (MSF).
The result, she said, was limited supplies in Africa and stockpiles in the United States, which under President Donald Trump has withdrawn from the WHO.
Developing countries also want a user registration and tracking system for the PABS database, while developed countries, "basically Germany, Norway and Switzerland, advocate for maintaining anonymous access", said K. M. Gopakumar, senior researcher with the Third World Network.
Anonymous access would make it "impossible" to track who is using pathogen information and whether they are sharing the benefits, 100 non-governmental organizations, including Oxfam, said in a joint letter to the WHO.
"In practice, this means that genetic resources originating in developing countries can be accessed, commercialized, and exploited with complete impunity," the letter said.
