The treaty enters into force only after 60 countries ratify it. While the goal is to finalize the PABS annex by the 79. World Health Assembly 2026, many experts say one year is not enough. “The timeline is very ambitious… but if we need more time, we should take it to reach a good result,” Valentina says. “Our goal is a system that works and can make a real difference.”

Meanwhile, the withdrawal of the U.S. from WHO during the final stages of negotiations casts a shadow over the pandemic agreement. Once the largest funder of global health and a major player in biomedical innovation, its absence could pose a threat to the agreement’s universality and future implementation, especially in areas like funding, pharmaceutical cooperation, and global coordination.

Yet as Melissa of MSF points out, implementation ultimately lies at the national level: “Each of our countries has a responsibility to implement… whether the US is doing that or not.” At the same time, she acknowledges the “massive gap” left in political and financial support for WHO, calling it a “very big challenge.” Valentina echoes this sentiment, describing the U.S. exit as “very unfortunate,” noting that their expertise was missed and their absence increased pressure on other member states, particularly the EU. Still, she remains hopeful: "We showed that we were capable of achieving a good result […] and they could [re]join at a later stage.”

The Real Test: Implementation and Accountability

With the agreement adopted, the focus shifts to implementation – a word Melissa from MSF repeats often.

First, countries must translate the treaty into national policy. It is not self-executing: its principles must be reflected in domestic legislation, budgets, and operational plans. “That [implementation] is also something that we urge governments to start thinking about now. Not wait until the PABS is negotiated, [or] until the 60 countries have ratified,” urges Melissa.

Second, civil society must stay engaged – as watchdogs and partners. Groups like MSF played a critical role during negotiations. That role continues. “For the implementation, which is the real test or the second test, we need civil society organizations to ensure that governments are actually going to put the words into actions,” says Melissa.

Valentina explains that for Germany, implementation will go through the usual parliamentary procedure. Success will depend on the outcome of the PABS negotiations, political will and once again global solidarity. “That [implementation] will be crucial,” she reflects.

According to Dr Oliver Morgan, the WHO Hub for Pandemic and Epidemic Intelligence plays a central role in supporting the implementation of the Pandemic Agreement by advancing collaborative surveillance and strengthening global capacities.

Through initiatives like the Collaboratory and the Epidemic Intelligence from Open Sources (EIOS), the Hub facilitates real-time data sharing, outbreak analysis, and early warning systems across 105 countries, all grounded in a One Health approach. It also strengthens national public health agencies and leads the International Pathogen Surveillance Network (IPSN), which connects 344 active partners across 99 countries to improve genomic surveillance and promote equity in data access.

As Member States work toward finalizing the PABS annex, the Hub contributes practical expertise and helps build technical trust, including through targeted funding for low- and middle-income countries. With over 2,500 partners engaged in 2024, the WHO Hub has become a cornerstone of global collaboration and a key platform for strengthening Germany’s leadership as a multilateral actor in global health security.

Conclusion: A New Chapter, Not the Final Page

The Pandemic Agreement marks a new chapter in global health, but it is just the beginning. It signals renewed commitment to multilateralism, preparedness, and equity. Its true promise, however, will depend on what happens next: the PABS annex, and the implementation of financing, logistics, and legal frameworks.

If the global community can deliver, this agreement could be a turning point – aligning science, sovereignty, and solidarity to better protect humanity.

Ultimately, the Pandemic Agreement will be judged by one question: When the next pandemic hits, will outcomes be more equitable than in 2020?

• Will a nurse in Ghana get vaccinated at the same time as a nurse in Germany?
• Will researchers in Asia freely share a virus sample knowing their communities will have equal access to any cure?
• Will global surveillance detect a threat before it spirals out of control?

The agreement offers hope. But fulfilling that hope will take vigilance, resources, and the political courage to put global interests above narrow ones.