Institutional innovations and implementation challenges of the World Health Organization Pandemic Agreement

Against the backdrop of profound transformations in the global public health risk landscape, Member States of the World Health Organization collectively spearheaded the legislative process for the Pandemic Agreement to build a more resilient global health governance architecture, enhance international cooperation mechanisms, and tangibly safeguard public health security. Following 13 formal negotiation rounds and multiple informal consultations conducted by the Intergovernmental Negotiating Body (INB) – duly elected by Member States – the Agreement was adopted by the 78th World Health Assembly on 20 May 2025. The Pandemic Agreement systematically addresses critical aspects such as health product research and development, localized production, technology transfer, equitable access, and sustainable financing. This is achieved primarily through establishing two core mechanisms: the Pathogen Access and Benefit-Sharing (PABS) System and a Global Supply Chain and Logistics Network, thereby striving to overcome the challenges of global health equity. However, the current text of the Pandemic Agreement still faces hurdles in areas like mechanism development and coordination with existing international multilateral rules. Looking ahead, it is imperative to refine the Pathogen Access and Benefit-Sharing mechanism and enhance the coherence between the Pandemic Agreement and international multilateral rules. This is essential to achieve a leapfrog development in global health governance, moving from institutional design to practical efficacy.