The WHO Pandemic Agreement, and What Pakistan Must Legislate

On 20th May 2025 the Seventy-eighth World Health Assembly adopted the WHO Pandemic Agreement by consensus, the day after Committee A had carried it by 124 votes in favour, none against and eleven abstentions, of which Pakistan was not one. Professor Lawrence O. Gostin, Sam Halabi and Alexandra Finch wrote of it in JAMA on 27th May 2025 under the title the Agreement gives to its own second chapter, “The World Together Equitably”, and recorded that the United States, having given notice of withdrawal from the World Health Organization, would neither be a party to it nor take the benefits of participation.

Fifteen months later no State is a party to it, for the plain reason that no State can yet sign it.

An agreement that cannot yet be signed

Article 31.2 of the Agreement provides that it shall be open for signature only after the Health Assembly adopts the Annex described in Article 12.2, and Article 33.1 that it enters into force on the thirtieth day following deposit of the sixtieth instrument of ratification or accession. That Annex, the “PABS Instrument”, is not written. On 1st May 2026 Member States agreed to extend the negotiations; the seventh meeting of the Intergovernmental Working Group sat from 6th to 17th July 2026, the eighth is fixed for 14th to 18th September 2026, and the outcome is to be presented to the World Health Assembly of May 2027, or earlier to a special session.

Since the treaty cannot be signed therefore Pakistan is not late, and that is the whole of the opportunity. The interval between now and the sixtieth ratification is the only period in which the domestic statute can be built at leisure rather than in the week after a determination at Geneva, and it is precisely such intervals that Pakistan has not used: this State has been bound by the International Health Regulations (2005) since 15th June 2007 and has still not enacted the public health emergency law which the Honourable Supreme Court of Pakistan pressed for on 8th June 2020, when the Attorney General accepted before the Apex Court that no such law had been made at the national level.

What the Agreement actually asks of a statute book

Read the operative provisions and one formula recurs. Article 4.2 requires comprehensive multisectoral national pandemic prevention and surveillance plans, Article 5.3 requires One Health measures and Article 6.2 requires health system functions, each of them “in accordance with national and/or domestic law”; Article 15.2 urges a national multisectoral coordination mechanism and Article 15.4 national pandemic plans; Article 21 requires periodic reports to the Conference of the Parties.

Every substantive obligation is therefore referred back to the domestic statute book, and a State whose statute book is empty in this field converts each of those obligations into nothing at all. That is not a drafting flaw at Geneva. It is the necessary consequence of Article 3.1, whose first guiding principle is the sovereign right of States to legislate within their jurisdiction, and of Article 22.2, which states that nothing in the Agreement gives the Secretariat or the Director-General any authority to direct, order, alter or prescribe the domestic law or policies of any Party, or to require that a Party ban travellers, impose vaccination mandates or implement lockdowns.

Hence the objection heard loudest against this treaty, that it transfers power to Geneva, is answered by its own text; and the harder truth, which the objectors do not reach, is that it transfers no power to Islamabad either. Whatever Pakistan is to be able to do in the next pandemic, Parliament must give it the power to do.

The measure of the gap

The second Joint External Evaluation of Pakistan’s International Health Regulations (2005) core capacities was conducted from 15th to 24th May 2023 and published by the World Health Organization in 2025. The overall score was 43 per cent, expressed as 121 out of 280. Response capacity was the lowest at 36 per cent; points of entry and other IHR-related hazards scored highest at 54 per cent; and prevention capacity scored 43 per cent, exactly what it had scored in 2016.

Indicator P1.1, legal instruments, was scored 2 out of 5, “limited capacity”, on the finding that the instruments have been only partially mapped and that no formal assessment has been conducted; the evaluators added that the process for enacting laws is lengthy, that expediting the public health response bill is a priority, and that legislation on immunisation, tuberculosis, HIV and other communicable diseases is still unaddressed.

Twenty per cent of something, to a State that can receive it

Article 12.6(a) is the provision on which the equity claim of the whole treaty rests: in the event of a pandemic emergency determined under Article 12 of the International Health Regulations (2005), each participating manufacturer shall make available to the World Health Organization, under legally binding contracts, rapid access targeting 20 per cent of its real-time production of vaccines, therapeutics and diagnostics for the pathogen concerned, of which a minimum threshold of 10 per cent is a donation and the remainder is reserved at affordable prices; Article 12.6(b) directs distribution on the basis of public health risk and need, with particular attention to developing countries.

A benefit allocated is not a benefit received. To take delivery under Article 12.6 a State needs a lawful consignee, an emergency footing on which to accept and deploy an unregistered product, a power of emergency authorisation in the regulator, a rule of priority for who is treated first, and a compensation scheme for injury; Pakistan holds none of these in statute. The Drug Regulatory Authority of Pakistan is moving in the right direction, its Central Drugs Laboratory at Karachi having secured World Health Organization prequalification in April 2026 and the Authority being directed towards WHO Maturity Level 3 by early 2027, but a regulator’s maturity is not a legislature’s grant of power.

The same holds on the production side, on which Articles 10 and 11 turn. The Federal Minister for Health, Mr Syed Mustafa Kamal, announced Pakistan’s first National Vaccine Policy at the beginning of May 2026, anchored on buyback guarantees meant to make local vaccine manufacture commercially viable, and stated on the same occasion that about 85 per cent of pharmaceutical raw materials are imported. A buyback guarantee is a promise of procurement; it is not a licensing regime, a technology transfer framework or a liability rule.

The sharing side, and a collision worth avoiding now

The system is called Pathogen Access and Benefit-Sharing, and access comes first. Article 12.5(e) requires the PABS Instrument to be implemented consistently with national law on biosafety, biosecurity, export control of pathogens and data protection, and Article 12.5(d)(ii) requires each Party to align its own access and benefit sharing measures so that measures contrary to or duplicative of the Instrument fall away once the system comes into operation. Pakistan has no data protection statute in field, and its access rules for biological materials are scattered across import policy, the biosafety rules of 2005 and institutional practice.

I have drafted, for the Ministry of National Health Services, Regulations and Coordination, provisions which declare the genomic data of citizens a protected national asset and prohibit its storage outside Pakistan. I hold to those provisions, and I say plainly that they must be drawn to bind human genomic data and not “PABS Materials and Sequence Information”. Since a pathogen sequence shared with the World Health Organization is the price of the 20 per cent therefore any residency rule which sweeps up viral sequence data would leave Pakistan claiming the benefit while withholding the sample, which is the one posture the Agreement exists to make impossible. That distinction belongs in the definition clause, not in a later clarification.

Who legislates, when the subject is devolved

Entry 3 of Part I of the Federal Legislative List in the Fourth Schedule to the Constitution of the Islamic Republic of Pakistan, 1973 gives the Federation “External affairs; the implementing of treaties and agreements”, and Entry 32 “International treaties, conventions and agreements and International arbitration”. Public health appears nowhere in that List. Hence the Federation may bind Pakistan while the Provinces must perform, which after the Eighteenth Amendment is a structural mismatch and not a matter of political will.

There are three constitutional routes through it: a resolution of two or more Provincial Assemblies under Article 144 authorising Parliament to legislate; endorsement by the Council of Common Interests under Article 154; and directions to a Province under Article 149(4). The Draft National Health Security and Infectious Disease Contingency Act 2026 takes the second, extending to the whole of Pakistan including the Islamabad Capital Territory at once and to the four Provinces on and from endorsement by the Council of Common Interests. Whichever route is taken, it must be taken before ratification, because a Federation which ratifies and then discovers that it cannot perform has handed the Provinces a veto they never asked for.

What is to be done

In the light of the above, it is urgently required that the implementing Bill be laid before Parliament alongside, and not after, the instrument of ratification. That Bill must define “Public Health Emergency” and “Pandemic Emergency” in terms which track Article 1 and Article 12 of the International Health Regulations (2005), and name the officer who declares; it must designate a national authority for the “PABS System” with an express power to share “PABS Materials and Sequence Information” and a definition which separates that information from the genomic data of citizens; it must give a named authority power to receive, store, authorise and distribute the products allocated under Article 12.6, with a statutory rule of priority and a compensation scheme; it must place the national multisectoral coordination mechanism urged by Article 15.2 on a statutory footing, since the alternative is another National Command and Operation Centre created by a letter of the Prime Minister’s Office; and it must require the report to the Conference of the Parties under Article 21 to be laid before Parliament in the same session in which it is transmitted to Geneva.

The Annex will be finished, at the World Health Assembly of May 2027 or at a special session before it, and the sixtieth instrument of ratification will in due course be deposited. The only question that will then concern this country is the one it failed to answer during the times of COVID-19: whether Pakistan arrives at that moment holding a statute, or holding only a signature.