A treaty was adopted in May 2025 and cannot yet be signed. Not because anyone has withdrawn, and not because of a drafting error — but because the Agreement itself says it stays closed until one missing annex is finished. That annex is the whole argument.
On 25 September 2026, at the UN High-Level Meeting on Pandemic Prevention, Preparedness and Response in New York, India was represented by Union Health Secretary Punya Salila Srivastava. Her central demand concerned the WHO Pandemic Agreement, adopted by the World Health Assembly on 20 May 2025 after more than three years of negotiation: that its credibility depends on a fair Pathogen Access and Benefit Sharing (PABS) system.
Why the Agreement is not open for signature
Article 12 of the Agreement provides for a Pathogen Access and Benefit Sharing system, to be set out in an Annex. The Agreement does not open for signature until that Annex is adopted, and the Annex is still being negotiated through an Intergovernmental Working Group.
This is an unusual arrangement and worth understanding, because it tells you where the real disagreement lies. Member states were able to agree on surveillance, health systems strengthening, workforce, regulatory cooperation and a great deal else. They were not able to agree on the one provision governing who gets what when a new pathogen appears — so they adopted everything else and parked that question in an annex, with the treaty held closed until it is settled.
India's specific position at the meeting follows directly. Srivastava stated that the political declaration should not prejudge the ongoing PABS negotiations, and should be implemented according to national circumstances and capacities. In diplomatic terms that is a defensive move: it prevents a political statement agreed at the UN from being used later to settle, by implication, a question still open in the technical negotiation.
What PABS is actually about
The problem is easiest to see through an example.
A new influenza variant emerges in a country. Its laboratories isolate the virus, sequence it, and share the sample and the genetic sequence with the international system — which is exactly what the world needs them to do, quickly, because surveillance depends on it. Pharmaceutical firms in other countries use that material to develop a vaccine. The vaccine is manufactured, and it is sold first to the governments that can pay most.
The country that supplied the pathogen may be at the back of the queue for the product derived from it.
This is not hypothetical. It happened during the 2007 H5N1 episode, when Indonesia stopped sharing virus samples on precisely this argument, and it happened again in the distribution of COVID-19 vaccines. The incentive problem is stark: if sharing a pathogen brings no assurance of access to what is developed from it, a country facing an outbreak has a reason to delay — and delayed sharing harms everyone, including that country.
PABS is the mechanism intended to close that loop. The principle is that access to pathogens is matched by access to benefits — vaccines, diagnostics, therapeutics and the technologies to make them. Srivastava's formulation was that countries contributing pathogens and biological resources must receive timely access to those products while respecting national sovereignty.
The structural parallel is exact, and it is the most useful thing a candidate can carry from this. The Nagoya Protocol under the Convention on Biological Diversity established the same bargain for genetic resources generally: prior informed consent, mutually agreed terms and equitable benefit-sharing. We set that framework out in our explainers on who owns traditional knowledge and on benefit-sharing over a chilli seed. PABS is that logic applied to pathogens — and the reason it is contested is that pathogens move faster than negotiations, and the commercial stakes in a pandemic are enormous.
The two instruments, kept apart
Examinations reliably confuse these, and the distinction is simple once stated.
The International Health Regulations (IHR), in their current form dating to 2005, are the existing binding legal instrument on how states detect, assess, notify and respond to public health events of international concern. They are what obliges a country to report an outbreak, and they contain the mechanism by which the WHO Director-General declares a Public Health Emergency of International Concern (PHEIC). Amendments to the IHR were adopted at the World Health Assembly in 2024, strengthening those provisions.
The Pandemic Agreement is a new, separate treaty, adopted in 2025, addressing what the IHR largely do not: equity in access to countermeasures, technology transfer, local manufacturing capacity, and the pathogen-sharing bargain.
So: IHR govern notification and response; the Pandemic Agreement governs equity and access. Amended in 2024 and adopted in 2025 respectively. WHO Director-General Tedros Adhanom Ghebreyesus referred to both at the meeting, and pressed for the PABS negotiations to conclude, warning that delay could affect the world's ability to respond to the next pandemic.
India's position and the record behind it
India argued from a specific record. During COVID-19 it supplied 300 million vaccine doses to around 100 countries and two UN entities, and provided medical assistance to over 150 countries — invoked under the framing "One Earth, One Health" and India's identification with the Global South.
Three further elements of the Indian intervention are worth noting because each is a recurring theme in Indian positions at multilateral forums.
Digital public infrastructure as a global public good. Srivastava cited the role digital systems played in surveillance, vaccination, risk communication, supply chains and continuity of services during the pandemic. This is consistent with India's broader effort to present its DPI stack as an exportable model rather than a domestic achievement.
National responsibility first, international assistance complementing it. She stressed that preparedness must be rooted in national health systems, development plans and domestic financing, with external assistance supplementary. This is a deliberate position: it resists the framing in which developing countries are treated primarily as recipients.
One Health, with qualifications. She called for its implementation "as appropriate, in accordance with domestic law, international law and national circumstances." The qualifying language matters. One Health — the approach treating human, animal and environmental health as one system, which we set out in our explainer on One Health and zoonotic diseases — is scientifically uncontroversial. What is contested is whether international commitments under it could create obligations reaching into agriculture, livestock and trade, and India's phrasing is designed to keep that discretion national.
UN Deputy Secretary-General Amina Mohammed cautioned against complacency and stressed community-based systems for early detection — the point our piece on the molecular virology community and platform technologies develops on the research side.
What preparedness costs, and why it lapses
The structural difficulty behind this entire negotiation deserves stating, because it is the strongest available material for a descriptive answer.
Pandemic preparedness is a public good with a timing problem. Its benefits are diffuse, shared internationally, and realised only when an outbreak occurs — possibly decades later, possibly during someone else's term of office. Its costs are immediate, national and visible. Laboratory networks, stockpiles, surveillance systems and trained epidemiologists must be funded continuously in years when nothing happens, and in such years they look like expenditure without return.
The predictable consequence is that preparedness is funded intensely after a crisis and allowed to erode as memory fades. This happened after SARS in 2003, after H1N1 in 2009, and after Ebola in 2014. The UN meeting's own purpose — renewing political attention five years after COVID-19 — is an acknowledgement that the pattern is repeating.
An honest assessment therefore holds that the Pandemic Agreement's significance lies less in any single provision than in creating a standing obligation that survives the fading of political attention. Whether it does will depend on whether the PABS annex is concluded at all — and, as of this meeting, it has not been.
🔑 Revision block
- The meeting: UN High-Level Meeting on Pandemic Prevention, Preparedness and Response, New York, 25 September 2026
- India represented by: Union Health Secretary Punya Salila Srivastava
- WHO Pandemic Agreement: adopted by the 78th World Health Assembly on 20 May 2025, after more than three years of negotiation
- Article 12: provides for a Pathogen Access and Benefit Sharing (PABS) system, set out in an Annex
- Critical procedural fact: the Agreement does not open for signature until the PABS Annex is adopted; it is being negotiated in an Intergovernmental Working Group
- India's demand: countries contributing pathogens and biological resources must receive timely access to vaccines, diagnostics, therapeutics and technologies, respecting national sovereignty
- India's procedural point: the political declaration should not prejudge the PABS negotiations
- The precedent: Indonesia's withholding of H5N1 samples in 2007, and COVID-19 vaccine distribution
- Structural parallel: the Nagoya Protocol under the Convention on Biological Diversity — prior informed consent, mutually agreed terms, equitable benefit-sharing
- International Health Regulations (IHR), 2005: the existing binding instrument on detection, assessment, notification and response; contains the PHEIC mechanism; amendments adopted at the World Health Assembly in 2024
- The distinction: IHR govern notification and response; the Pandemic Agreement governs equity and access
- India's COVID record cited: 300 million vaccine doses to around 100 countries and two UN entities; medical assistance to over 150 countries; framing "One Earth, One Health"
- Other Indian positions: digital public infrastructure as a global public good; preparedness rooted in domestic financing with international assistance complementary; One Health implemented in accordance with national circumstances
- Others present: WHO Director-General Tedros Adhanom Ghebreyesus; UN Deputy Secretary-General Amina Mohammed
- The structural problem: preparedness is a public good with immediate national costs and diffuse, delayed, international benefits — so funding erodes between crises
🎯 Practice MCQs
Q1. The WHO Pandemic Agreement was adopted by the World Health Assembly in: (a) May 2023 (b) May 2024 (c) December 2025 (d) May 2025
→ (d) — by the 78th World Health Assembly.
Q2. The Pandemic Agreement is not yet open for signature because: (a) Insufficient states have ratified it (b) The Annex on Pathogen Access and Benefit Sharing, provided for in Article 12, has not been adopted (c) The World Health Assembly has not met since adoption (d) It requires UN Security Council endorsement
→ (b) — it is being negotiated in an Intergovernmental Working Group.
Q3. PABS is intended to ensure that: (a) Pathogens are stored only in designated laboratories (b) Pharmaceutical patents are waived during pandemics (c) Countries supplying pathogens receive timely access to the products developed from them (d) All countries contribute equally to WHO funding
→ (c)
Q4. The International Health Regulations in their current form date to: (a) 1969 (b) 2005 (c) 2011 (d) 2019
→ (b) — with amendments adopted at the World Health Assembly in 2024.
Q5. The mechanism by which the WHO Director-General declares a Public Health Emergency of International Concern is contained in: (a) The WHO Constitution (b) The Pandemic Agreement (c) The International Health Regulations (d) The Nagoya Protocol
→ (c)
Q6. The structural parallel to PABS in international environmental law is: (a) The Montreal Protocol (b) The Basel Convention (c) The Ramsar Convention (d) The Nagoya Protocol under the Convention on Biological Diversity
→ (d) — prior informed consent, mutually agreed terms and equitable benefit-sharing.
Q7. In 2007, which country withheld virus samples on the argument that it received no assured access to resulting vaccines? (a) Indonesia (b) Brazil (c) Nigeria (d) Vietnam
→ (a) — during the H5N1 episode.
Q8. During COVID-19, India supplied approximately how many vaccine doses to other countries? (a) 100 million (b) 300 million (c) 500 million (d) 50 million
→ (b) — to around 100 countries and two UN entities.
Q9. Pandemic preparedness tends to be under-funded between crises because: (a) It is prohibited by international law to stockpile vaccines (b) Its costs are immediate and national while its benefits are diffuse, delayed and shared internationally (c) WHO does not permit national spending on it (d) Preparedness measures expire after one year
→ (b)
Q10. Consider the following statements: 1. The IHR and the Pandemic Agreement are the same instrument under different names. 2. India argued that the political declaration should not prejudge the PABS negotiations. Which is/are correct? (a) 1 only (b) 2 only (c) Both 1 and 2 (d) Neither 1 nor 2
→ (b) — the IHR govern notification and response; the Agreement governs equity and access.
📋 How this gets asked (PYQ pattern)
Global health governance has become a standing topic in the CDS and OTA international relations section since 2020, and it rewards precise institutional knowledge.
The instrument question is the discriminating one: separating the IHR (2005, amended 2024) from the Pandemic Agreement (2025). One governs notification and response; the other governs equity and access. Candidates who treat them as a single thing lose the mark, and the question is asked in exactly that form.
The acronym question covers PABS, PHEIC, IHR and the WHA. Expanding each correctly is often the whole question, and PABS is new enough that it is a likely inclusion this cycle.
The body question asks how the WHO is structured: the World Health Assembly as the decision-making body, the Executive Board, the Director-General, and the six regional offices — India being in the South-East Asia Region, with the regional office at New Delhi.
The linkage question is where a strong candidate gains ground: connecting PABS to the Nagoya Protocol and the CBD. The same bargain — access in exchange for benefit-sharing — appears in biodiversity, in traditional knowledge and now in pathogens, and recognising the pattern is worth more than memorising any one of them.
For the descriptive paper, the best available structure is the incentive problem: a country that shares a pathogen quickly serves the world but may gain nothing for itself, so the system must make sharing rational rather than merely virtuous. An answer that frames the negotiation that way, and notes that the treaty has been deliberately held closed until the question is resolved, is explaining the diplomacy rather than describing the document.
Preparing for CDS or OTA? International instruments are best learnt in pairs — what each one covers, and what the other one does not. Build the base with our CDS/OTA general studies notes, follow the daily CDS/OTA current affairs, and prepare with our faculty in the upcoming Cavalier courses in Delhi.
✍️ Written by Hitendra Deswal — Economy & international relations faculty at The Cavalier. Reviewed by the Cavalier Faculty Desk.