Pandemic Agreement Costs Could Exceed $115 Billion Annually, Report Finds

GENEVA, 25 June 2026 — A new report from the International Health Reform Panel (IHRP) argues that the repeated stalling of negotiations over the WHO Pandemic Agreement should be read as a sign of unresolved political substance, not as a breakdown that needs to be hurried past.

The report, The Pandemic Agreement at an Impasse: Proportionality, Political Incentives, and the Future of Global Health Governance, is published by Garrett Wallace Brown, Roger Bate and David Bell, and lands ahead of the next intergovernmental Working Group for the Pandemic Agreement in July and the United Nations high level meeting on pandemics scheduled for September 2026.

The authors place the Pathogen Access and Benefit Sharing annex, known as PABS, at the centre of the dispute. Countries are asked to commit to sharing pathogens, genomic data and surveillance capacity on terms that can be measured and enforced. What they receive in exchange, including vaccines, therapeutics and technology transfer, depends on manufacturing concentration and political discretion in producer countries, and remains uncertain in timing and affordability. The report traces this pattern back to Indonesia’s 2007 dispute over sharing H5N1 virus samples, arguing that the same questions about who controls and benefits from biological material have shaped pandemic diplomacy for nearly two decades.

The report also challenges the financial case being put to negotiators. Existing estimates put preparedness costs above 31 billion dollars a year, and the report sets out how proposals tied to 0.1 to 0.2 per cent of GDP could push total spending past 115 billion dollars annually, a figure far above current funding for malaria, tuberculosis and malnutrition, conditions that together cause considerably more deaths each year.

The authors argue that many of the projections used to justify this scale of spending do not separate the direct toll of a pathogen from the economic damage caused by policy responses such as lockdowns, and treat rising detection of outbreaks as proof of rising severity, a distinction they consider central to any honest assessment of risk.

A further section of the report examines the institutional and commercial incentives that keep the preparedness agenda moving forward once it becomes established, including expanded mandates for international bodies, political reward for governments seen to act on future threats, and steady demand for manufacturers of vaccines and diagnostics. The authors are careful to note that none of this requires bad faith on the part of any actor, only that these incentives consistently favour expansion of the system over reassessment of its underlying assumptions.

The report gives particular attention to the role of the Africa Group and allied delegations in slowing the talks, treating their position as a considered political response rather than obstruction. Their argument, as the report documents through statements made during negotiations, is that the agreement asks lower income countries to take on firm obligations while leaving the benefits dependent on decisions made elsewhere.

“The question facing negotiators is not whether international cooperation on pandemics matters,” said Professor Garrett Wallace Brown of the University of Leeds. “It is whether this particular agreement, in its current form, is proportionate to the evidence and fair to the countries being asked to carry the greatest share of the obligation.”

David Bell added: “Treating delay as failure puts pressure on negotiators to close gaps with language rather than substance. Our analysis suggests the gaps are real, and that resolving them properly will take longer than the current timetable allows.”

The full report, including detailed costings and a review of the political economy shaping the talks, is available from the IHRP here.