States agree on landmark pandemic treaty with key implications for LRGs

Five years after the COVID-19 pandemic shook the world, and following more than three years of intensive negotiations at the World Health Organization (WHO), States have reached a historic agreement on a new international treaty to better prevent, prepare for, and respond to future pandemics. The agreement is set to be formally adopted at the upcoming World Health Assembly in Geneva next May. The GCH has engaged from the beginning and advocated for the whole-of-government approach to make sure that LRGs will have a more structured role in future national and international efforts.

The 32-page agreement places equity at its heart, defining it as “a goal, principle and outcome of pandemic prevention, preparedness and response, striving in this context for the absence of unfair, avoidable or remediable differences among and between individuals, communities and countries” (Art. 3.4).

Negotiations have been long and complex, reflecting differing perspectives between developed and developing countries, especially on how to realize equity in practical terms (see key issues in negotiations below). These discussions took place in a challenging global geopolitical context, with increased international instability since early 2025. That States were able to reach consensus on a multilateral treaty is a remarkable achievement, paving the way for stronger global cooperation in facing future pandemics.

While local and regional governments (LRGs) were largely excluded from the negotiation table, the implementation of the treaty will heavily rely on their engagement. Article 17 of the new treaty recognizes this, encouraging States “to apply whole-of-government and whole-of-society approaches at national level, including […] to empower and enable community ownership, and contribution to, community readiness for and resilience to pandemic prevention, preparedness and response.”

To be effective, many of the treaty’s core provisions will require strong involvement from LRGs—particularly in the areas of pandemic prevention and surveillance (Art. 4), health system preparedness and resilience (Art. 6), healthcare capacity (Art. 7), communication and public awareness (Art. 18), and sustainable financing (Art. 20). While the agreement itself does not explicitly reference LRGs, Article 17 provides a crucial entry point for advocacy and engagement. The Global Cities Hub (GCH) encourages LRGs to use this opportunity to assert their essential role in pandemic prevention, preparation and response efforts.

Key Issues in the negotiations

1. Strengthening pandemic prevention and surveillance (Art. 4)

Some countries proposed an annex to detail specific prevention and detection measures at the community level, hoping for a stronger early containment strategy. This annex became a bargaining point, but consensus was ultimately reached to leave implementation details to the treaty’s governing body, the Conference of the Parties (CoP), which will be entrusted to develop guidelines to implement this Art. 4.

2. Technology Transfer for the production of pandemic-related health products (Art. 11)

At the core of equity discussions was the issue of technology transfer—sharing intellectual property, know-how and technology enabling developing countries to produce vaccines, diagnostics, and treatments during pandemics. While many countries and NGOs argued for effective technology transfer mechanisms, others, particularly those hosting major pharmaceutical industries, insisted such transfers remain voluntary, even during emergencies. The final agreement reached a compromise, thanks to shared understanding of the term “as mutually agreed”.

3. Pathogen Access and Benefit-Sharing System (PABS) (Art. 12)

The treaty also introduces the Pathogen Access and Benefit-Sharing System (PABS), aimed at ensuring both the rapid sharing of pathogen data and the fair distribution of the benefits that result. Under Article 12.6(a), manufacturers participating in the system will provide WHO with access to 20% of real-time production of relevant medical products during a pandemic—10% as donations and 10% at affordable prices, so that WHO may redistribute these to countries who need it in times of emergencies. While the principles have been agreed, key operational details of the PABS System—including definitions, terms, and legal modalities—will have to be negotiated in a separate annex to the treaty.

Looking Ahead: The Role of Cities and Regions

While much attention has been focused on diplomatic negotiations, the ultimate success of the pandemic treaty will depend on how it is implemented on the ground. Cities and regions have been on the frontlines of COVID-19, and their experience, expertise, and leadership are indispensable in building resilient health systems. The GCH urges LRGs to seize the opportunity presented by Article 17 and advocate for their involvement in national and international efforts.

This treaty marks a critical step forward in global health governance. Now, it is time to translate commitments into action—with local and regional governments at the center of the response.