Negotiators are currently convened in Geneva for the ninth round of discussions regarding the Pathogen Access and Benefit-Sharing (PABS) instrument, an annex to the World Health Organization (WHO) Pandemic Agreement. This meeting, running from November 2 to 13, aims to finalize terms that could significantly alter the landscape of global health sovereignty. The PABS annex is considered the core of the equity bargain within the Pandemic Agreement, which was initially adopted in May 2025.
The current negotiations are heavily influenced by the lessons of the COVID-19 pandemic, where vaccine hoarding by high-income nations led to delayed roll-outs and severe socio-economic distress across developing regions. Without the successful adoption of the PABS annex, the broader Pandemic Agreement faces significant hurdles to signature and ratification. The primary goal of these instruments is to resolve long-standing inequities in the global response to pandemics through a legally binding framework.
For South and Southeast Asia, the stakes involve reducing dependency on concentrated supply chains and asserting greater control over health resources. Despite a history of technical cooperation, these regions have struggled to establish a unified negotiating position. Challenges include the "ASEAN Way" of consensus-building, which prioritizes technical coordination but often limits political alignment among Southeast Asian states. In South Asia, political deadlocks within SAARC have similarly hindered broader regional engagement, though health initiatives like the SAARC Tuberculosis Center have maintained some continuity.
The structural composition of WHO regional offices further complicates the formation of a cohesive regional identity. Countries are dispersed across different WHO regions: Pakistan and Afghanistan are in the Eastern Mediterranean Region (EMRO); India, Bangladesh, Myanmar, and Thailand are in the South-East Asia Region (SEARO); and Indonesia, Singapore, and the Philippines fall under the Western Pacific Region (WPRO).
Indonesia, acting on behalf of the Equity Group, has emphasized that PABS must extend beyond equitable access to medical countermeasures. The nation argues that the instrument should actively support developing countries in building local production capabilities and strengthening technological infrastructure. To improve their influence, experts suggest that South and Southeast Asian nations should integrate diplomatic capacity building with existing technical exchanges. Initiatives like the Asia Pathogen Genomics Initiative already foster cooperation between governments and scientific bodies, providing a foundation that could be leveraged to bridge the gap between technical networks and global diplomatic negotiators.
Ultimately, the current window for negotiation represents a critical opportunity for these regions to secure non-negotiable terms for an effective instrument. Failure to connect technical capacity to diplomatic strategy may result in nations providing vital pathogen samples and data to the global community without obtaining guaranteed, equitable access to the resulting vaccines, diagnostics, and treatments.
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Global negotiations at the WHO and in the broader United Nations system are shaped by deep structural power asymmetries, such that decision-making advantages those with economic leverage and resources to influence global rule-making. Yet the collective bargaining power of developing countries has historically led to se
