Endorsed: No Treaty Without Equity

Open Letter to the WHO Director General of the World Health Organization

Tedros Adhanom Ghebreyesus

Director General

World Health Organization

Dear Dr Tedros,

We, the undersigned civil society organizations, are reaching out to you to underscore our grave concerns regarding the negotiation process of the Intergovernmental Negotiating Body (INB) for the Pandemic Agreement.

The resumed 9th session of the INB is the last round of negotiation prior to the 77th World Health Assembly (WHA). The INB Bureau and the WHO Secretariat are pushing hard for acceptance of the draft Pandemic Agreement as proposed by the Bureau and the Secretariat with minimal changes, at the resumed session, setting the stage for its adoption at the 77th WHA. While we acknowledge the importance of adopting a Pandemic Agreement earliest possible, such an Agreement must contain concrete measures and mechanisms that change the status quo, operationalize equity and foster international solidarity for pandemic prevention, preparedness and response (PPPR).

In 2021, in calling for a pandemic treaty, the proponents including yourself saidTogether, we must be better prepared to predict, prevent, detect, assess and effectively respond to pandemics in a highly coordinated fashion. The COVID-19 pandemic has been a stark and painful reminder that nobody is safe until everyone is safe…. We are, therefore, committed to ensuring universal and equitable access to safe, efficacious and affordable vaccines, medicines and diagnostics for this and future pandemics[…] To make this commitment a reality, we must be guided by solidarity, fairness, transparency, inclusiveness and equity.

The draft Pandemic Agreement put forth by the Bureau and the WHO Secretariat starkly falls short of meeting these essential standards. Instead of ushering in a new era of equity and cooperation, the draft text perpetuates the status quo, entrenching discretionary, voluntary measures and maintaining inequitable access as the norm for addressing PPPR.

The absence of meaningful mechanisms that concretely deliver tangible financial support and facilitate technology transfer, especially enabling the sharing of proprietary technology and know-how with developing countries, to diversify production, is glaring. Equally disheartening is the absence of any provision ensuring swift and sufficient access to essential health products crucial for developing countries to respond to health emergencies including a pandemic. The draft text exacerbates inequity by its imposition of burdensome surveillance obligations which have been demanded by developed countries, without any corresponding commitment by developed countries to provide developing countries with the necessary financial and technological assistance or guarantees of equitable access.

In terms of process, the approach adopted is egregiously unfair. A mere 8 days have been allocated for 194 WHO Members to negotiate and reach consensus on a completely new draft text spanning 20 pages. During a briefing on April 19th, the Bureau made it clear that no new textual insertions or deletions would be permitted to the Bureau’s text. Instead, to change the proposed text, Members would have to express their concern with the Bureau’s text and then WHO Secretariat or Bureau will propose how the concern could be addressed through minor changes in the text. If such proposed change is acceptable to all, only then the text will be changed. If not, the unbalanced, highly inequitable text, unilaterally determined by the Bureau and Secretariat stands as the default option.  Effectively, this approach leaves WHO Members with a binary choice of accepting a text that unfairly addresses developing countries’ interests and is unfit for PPPR or rejecting the proposed draft text.

It is also crucial to acknowledge that the INB process has been marred by severe flaws and chaos. Since the publication of the Zero Draft, Member States-led text-based negotiations have systematically been avoided. The draft text has continuously shifted, with entirely new versions issued by the Bureau almost every session, based on unilateral decisions by the Bureau and WHO Secretariat dictating what remains and what is removed from the text. This process stands in stark contrast to the WGIHR process, which embodies a member-driven negotiation approach wherein the revised text reflects the diverse views of Member States.

For the resumed INB session, the Bureau is also proposing multiple informal negotiations, that will be organised on an ad hoc basis, without advance notice. Such an approach prejudices smaller developing country delegations, and suggests a non-transparent, non-inclusive, undemocratic chaotic process will be pursued at INB9 in clear violation of the UN principles and guidelines on international negotiations (A/RES/53/101).

The approach taken by the Bureau and WHO Secretariat can be seen as coercive, effectively pressuring Member States into accepting a deeply unbalanced legal instrument. This instrument does little more than legitimize an inequitable regime for pandemic prevention, preparedness, and response (PPPR).

We therefore call on you to take measures:

  • To refrain from advocating or pressuring Member States to accept the draft Pandemic Agreement as proposed by the Bureau and WHO Secretariat;
  • To ensure that resumed INB9 allows for effective Member State-led text-based negotiations i.e. to allow Member states to insert and delete text into the proposed draft text and to continue negotiations among Member States until they reach consensus. The role of the Bureau and the Co-chairs should be limited to moderating the negotiations, and from time to time suggesting text to bridge differences between Members. However at no time should Members be negotiating with the Bureau and the Secretariat, and neither should the Bureau and Secretariat text be considered the default text.  
  • There should also be advance notice and clarity on the type, timings and topics of the formal and informal meetings that will be held. Multiple parallel informal or formal working groups should be avoided.


António Guterres, Secretary General of the United Nations

Volker Türk High Commissioner for Human Rights

Dennis Francis, President of the United Nations General Assembly

Livingstone Sewanyana, Independent Expert on the promotion of a democratic and equitable international order

Tlaleng Mofokeng, UN Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health

For the full list of signatories, click here.