TWN Info Service on Health Issues (Apr25/06)
11 April 2025
Third World Network

Health: New proposal guts certainty of vaccine and medicine supply commitments for pandemics

Geneva, 11 April (TWN) – At an informal session held at midnight on Wednesday (9 April), Ambassador Tovar da Silva Nunes of Brazil presented an alternative proposal on manufacturers’ benefit-sharing commitments under the Pathogen Access and Benefit-Sharing (PABS) system.

The proposal, related to paragraph 6 of Article 12 of the Pandemic Agreement under negotiation at the World Health Organization (WHO), reduces the certainty of each manufacturer meeting its commitment to supply a minimum of 20% of vaccines, therapeutics, and diagnostics (VTDs) to the WHO during a pandemic emergency.

While setting 20% of real-time production as a target for each manufacturer benefitting from the PABS system, the proposed paragraph only provides certainty that a minimum of 10% of production will be provided as a donation to WHO. There is no certainty as to how much each manufacturer will contribute for the remaining percentage.  

The resumed 13^th Intergovernmental Negotiating Body (INB) to negotiate a Pandemic Agreement (PA) is meeting in Geneva from 7 to 11 April. Ambassador Tovar from Brazil is Co-chair of the negotiations.

Article 12 of the draft PA addresses the PABS system. Paragraph 6 is on supply commitments of VTDs to WHO during a pandemic emergency, that manufacturers participating in the PABS system have to undertake when accessing materials and sequences of pathogens with pandemic potential shared by governments with the PABS system.

The original proposal by the Africa Group, co-sponsored by the Group of Equity, called for the donation of at least 20% of real-time production of VTDs during a pandemic. In stark contrast, the new proposal offers significantly less.

The informal session followed a small-group discussion that lasted over 2 hours to draft the new proposal to accommodate objections from Japan, South Korea, the United Kingdom and Switzerland that refused to commit to supplying 20% of real-time production of VTDs to WHO during a pandemic emergency. China followed suit wanting greater flexibility for its manufacturers in making commitments.

While the new proposal marks an improvement over earlier drafts from developed countries that called for even lower commitments, it nonetheless significantly reduces the volume of supplies that manufacturers would provide to the WHO on a priority basis during a pandemic, undermining the Organization’s ability to ensure equitable access for countries in need.

The inability to obtain preferential access to vaccine supplies was one of the key reasons for COVAX’s failure to provide timely access to many developing countries that were involved. Instead, manufacturers prioritised access needs in rich countries.  

[COVAX was the multilateral mechanism intended for equitable global access to COVID-19 vaccines launched in 2020 and which closed on 31 December 2023 to disappointment.]

The draft text prepared for the resumed 13^th INB states: 

“Each participating manufacturer shall make available to WHO, pursuant to legally binding contracts signed with WHO, rapid access to 20% of their production of safe, quality and effective vaccines, therapeutics, and diagnostics for the pathogen causing the pandemic emergency, with flexibility, provided that a threshold of at least 10% of their real time production is made available to WHO as a donation free-of-charge and the remaining percentage to fulfill the 20% commitment at affordable/production prices or reserved for WHO.”

The new proposal presented by Ambassador Tovar during the informal midnight session reads:

“Each participating manufacturer shall make available to WHO, pursuant to legally binding contracts signed with WHO, rapid access to a target of  20% of their real time production of safe, quality and effective vaccines, therapeutics and diagnostics for the pathogen causing pandemic emergency, provided that a threshold of at least 10% of their real time production is made available to WHO as a donation, and the remaining percentage, with flexibility based on the nature and capacity of each participating manufacturer, is reserved at affordable  prices to  WHO.”

This text only proposes a target of 20% of real-time production. Concretely it only requires a firm commitment of 10% of real-time production to be made available to WHO as a donation. The remaining percentage is uncertain and will vary from manufacturer to manufacturer. This means, the supplies provided to WHO can be as low as 11%, a significant reduction from commitments that have been reflected in the draft text for many months and that was expected by many developing country delegations. It is also significantly less than what was proposed by the Africa Group.

It falls short of the minimum required for WHO to mount an effective response during a pandemic emergency.

In an intervention, on the first day of the INB, Gavi – The Vaccine Alliance stressed that “allocation of 20% of real time production is the bare minimum for PABS as a system to address the needs of lower-income countries”.

The benefit-sharing commitment under paragraph 6 has over time been gradually weakened.

Complicit in the weakening of this provision is the WHO Director-General Dr. Tedros Adhanom Ghebreyesus who has placed constant pressure on the Africa Group to concede to demands of the developed countries that are interested in protecting profits of their manufacturers over the lives in the developing world, according to sources familiar with the negotiations.

Following the resumed 12^th INB session (2-6 December 2024) the draft text mentioned manufacturers providing a commitment of 20% of real time production of VTDs as benefit sharing for receiving access to PABS materials and digital sequence information. The text also reflected options for meeting the 20% real-time production commitment.

Several months later, in the draft text presented to the 13^th INB session (17-21 February 2025), that commitment remained at 20% but “real-time production” was omitted from the text. There was a commitment to provide only 10% of production in “real-time” to WHO free-of-charge. The remaining percentage was to be provided “at affordable/production prices or reserved for WHO”. There was no commitment to supply the remaining percentage in real time. The then proposed Bureau text was as follows:

“Each participating manufacturer shall make available to WHO, pursuant to legally binding contracts signed with WHO, rapid access to 20% of their production of safe, quality and effective vaccines, therapeutics, and diagnostics for the pathogen causing the pandemic emergency, with flexibility, provided that a threshold of at least 10% of their real time production is made available to WHO free-of-charge and the remaining percentage to fulfil commitment at affordable/production prices or reserved for WHO.”

A similar text was presented to the current resumed 13^th INB session, the only change being the replacement of “free-of charge” with “donation”.

The new proposal now sets a target of 20% of real-time production to be supplied by each manufacturer using the PABS system. While 10% is clearly designated as a donation to the WHO, there remains significant uncertainty over whether the majority of manufacturers will also commit to providing the remaining 10% at affordable prices or will instead exploit the caveat “with flexibility based on the nature and capacity of each participating manufacturer” and commit to much less, raising concerns about WHO’s ability to secure sufficient supplies during a pandemic.

This proposal is expected to be discussed by WHO Members on Friday (11 April), the final day of perhaps the last INB session before the pandemic agreement is presented to the World Health Assembly in May.