In the event of a pandemic, the exchange of viral specimens and genetic information is crucial for the rapid development of vaccines, diagnostic tools and treatments.
But how are the benefits of these scientific advancements distributed?
This is the core question being debated at the World Health Organization (WHO).
Negotiators are meeting in Geneva to finalize the terms of the Pathogen Access and Benefit‑Sharing (PABS) instrument.
The PABS instrument is an annex to the World Health Organization’s Pandemic Agreement, which was adopted in May 2025.
The current round of negotiations, scheduled from 2 November to 13 November, constitutes the ninth meeting to discuss the terms of the PABS agreement.
The Pandemic Allocation and Benefit System (PABS) has been described as the core of the equity bargain in pandemic response.
The issue stems from a failure of global solidarity during the COVID‑19 pandemic. High‑income countries hoarded vaccines, delaying roll‑outs and causing unprecedented socio‑economic distress in developing nations.
Without the PABS annex, the Pandemic Agreement cannot move forward to signature and ratification.
The PA and PABS together seek to eliminate the lingering ambiguity and inequities in the global pandemic response by negotiating a legally binding instrument collectively through the World Health Organization.
Even if the Pandemic Alert and Response System (PABS) is fully implemented, its ability to achieve its stated objectives will not be known until it is put to the test during the next pandemic.
However, the manner in which the regulations are being drafted carries significant implications for reducing reliance on concentrated supply chains and for health sovereignty throughout South and Southeast Asia.
Global negotiations at the World Health Organization and throughout the United Nations system are characterised by deep structural power asymmetries, giving decision‑making advantages to those with economic leverage and resources to influence global rule‑making.
Yet the collective bargaining power of developing countries has historically led to several breakthroughs.
The climate negotiations highlighted these options by reaffirming the principle of “Common But Differentiated Responsibilities” and by establishing the Loss and Damage Fund at the 27th Conference of the Parties (COP27).
The PA raises a similar political question – can developing countries exert collective influence over the rules governing pandemic preparedness?
In South and Southeast Asia, the issue is made more complex by the clash between each country's domestic priorities and its ambition to shape global rules.
Countries such as Indonesia, Malaysia, the Philippines, Thailand, Bangladesh and India made varying contributions through a cross‑regional coalition known as the “Group for Equity.” The group, whose membership spans Latin America, Africa and Asia, is bound together by the overarching principle of “equity,” distinguishing it from more regionally focused blocs such as the European Union, the Caribbean Community and the Africa Group.
Although the Equity Group shared this common principle, in reality, members’ priorities were split on different provisions, including PABS.
This offered an opportunity for more vocal countries to take the lead on particular provisions.
During recent PABS negotiations, Indonesia, speaking on behalf of the Equity Group, said that “PABS was never meant to be ‘only’ about equitable access to medical countermeasures.”
"The initiative should help developing countries build local production, strengthen technological capacity, and boost their overall readiness when the next crisis arrives," a spokesperson said. Despite a history of technical cooperation on infectious diseases and pandemics, nations in South and Southeast Asia have struggled to convert that collaboration into a unified regional negotiating position.
In Southeast Asia, the “ASEAN Way” of consensus facilitates stronger functional problem‑solving through technical coordination—such as that provided by the ASEAN Center for Public Health Emergencies and Emerging Diseases and the ASEAN BioDiaspora Virtual Center—while limiting political consensus‑building among its member states.
In South Asia, SAARC’s political deadlock has restricted broader engagement.
However, health remains an important tool to facilitate continuity in cooperation.
The SAARC Tuberculosis Centre, for example, has achieved greater success than initiatives in other sectors, including security and counter‑terrorism.
The third factor constraining a regional stance is the composition of the World Health Organization’s regional offices, where numerous pre‑negotiation consultations and initial consensus‑building activities take place.
Pakistan and Afghanistan are classified under the World Health Organization’s Eastern Mediterranean Region (EMRO). India, Bangladesh, Myanmar and Thailand are placed in the South‑East Asia Region (SEARO), while Indonesia, Singapore and the Philippines belong to the Western Pacific Region (WPRO).
By design, building a regional political consensus that can be turned into common negotiating positions is more complicated in South and Southeast Asia than in other regions that exhibit a stronger regional identity in global forums.
However, global rules will directly impact regional pandemic preparedness, with major implications for health sovereignty.
This reality necessitates strengthening political and diplomatic influence within negotiations.
In South and Southeast Asia, where institutional contexts differ, incorporating diplomatic capacity‑building alongside regional technical exchanges could provide an initial step.
Countries possessing robust health‑diplomacy capabilities, such as Thailand, have already launched regional training programmes. These initiatives involve partners including Bhutan and Sri Lanka.
These can be expanded further to region-wide efforts helping negotiators with skills of strategic framing and agenda building.
Cooperation habits already extend beyond bilateral government engagement and are reinforced by a coalition of actors, including non‑governmental organisations, donors, scientific institutes and technical bodies.
The Asia Pathogen Genomics Initiative links governments, scientific institutions and other stakeholders throughout South and Southeast Asia on the sensitive issue of genomic surveillance.
The political imperative is to expand cooperation on contentious provisions—such as access and benefit sharing—and to forge links between technical networks and negotiators.
With the pressing necessity to secure an agreement on the PABS framework, nations now face a narrow window to advance the non‑negotiable elements required for a functional instrument.
Countries across South and Southeast Asia have felt firsthand both the repercussions of unequal access and the advantages that technical cooperation can provide.
The next step involves linking existing technical capacity with diplomatic efforts that determine which parties can obtain the tools needed to respond.
Absent such a linkage, nations may supply pathogen samples and related data for global pandemic‑preparedness initiatives while lacking equitable access to the vaccines, diagnostics and treatments that are subsequently developed from those resources.
Why it matters
The WHO pandemic negotiations directly dictate whether developing countries like Bangladesh will secure equitable access to vaccines and health countermeasures during future global health crises.