Pathogens without payback: when sharing isn’t caring, PgII

Key Highlights:

• The WHO Pandemic Agreement (WPA), adopted in May 2025, lacks the crucial Pathogen Access and Benefit-Sharing (PABS) Annex.
• Low and Middle-Income Countries (LMICs) share pathogens for research but don't always benefit from resulting VTDs, exemplified by COVID-19 vaccine inequity.
• The COVAX initiative delivered only a fifth of promised doses by mid-2021, and the WHO's Technology Access Pool failed.
• The Ebola drug, Inmazeb, was unaffordable for those in affected regions who provided samples for its development.
• The U.S. requires some African nations to share pathogens for 25 years in exchange for five years of funding with limited product access commitments.
• PABS seeks to mandate pharmaceutical manufacturers to provide 20% of real-time VTD production to the WHO during pandemics.

Detailed Insights:

• LMICs are expected to share biological materials and genomic data with the world through the WHO, but developed countries aren't obligated to reciprocate with fair access to clinical products.
• The COVID-19 pandemic highlighted vaccine apartheid, with high-income countries hoarding over half of global vaccine supplies despite representing a small percentage of the world's population.
• Subsequent mutations of COVID-19 resulted in an estimated 1.3 million preventable deaths and $28 trillion in global economic losses.
• PABS aims to legally link sample-sharing to guaranteed benefits, including technology transfer, capacity building, and broader production in developing countries through licenses.
• Developed countries, particularly the EU, oppose binding obligations on benefit-sharing, intellectual property, and data traceability, favoring voluntary mechanisms.
• PABS proponents advocate for mandatory user registration for pathogen sequence data to ensure greater accountability, while the EU argues this impedes data system openness.
• A potential middle ground involves a tiered system with lower obligations during normal times, stronger commitments during pandemics, and a global fund to support poorer countries.

Key Concepts Involved:

• Pathogen Access and Benefit-Sharing (PABS): A framework ensuring fair sharing of benefits derived from pathogen samples, including access to vaccines and therapeutics.
• Vaccines, Therapeutics, and Diagnostics (VTDs): Medical products crucial for preventing, treating, and diagnosing diseases.
• COVAX: A global initiative aimed at equitable access to COVID-19 vaccines, particularly for low- and middle-income countries.
• Public Health Emergency of International Concern (PHEIC): A formal declaration by the WHO of an event that constitutes a public health risk to other states through the international spread of disease.