The WHO Pandemic Treaty and the Question Nobody Has Answered: What Does Global Health Justice Actually Require?
The WHO Pandemic Treaty and the Question Nobody Has Answered: What Does Global Health Justice Actually Require?
In May 2025, the World Health Assembly adopted the Pandemic Agreement — the first binding international instrument on pandemic prevention, preparedness, and response since the International Health Regulations were revised in 2005. The agreement took three years of contentious negotiation, with the most difficult provisions centring on exactly the issues that the COVID-19 pandemic made visible: who gets access to vaccines and treatments when supply is scarce; what wealthy nations owe to low-income countries in a health emergency; and whether solidarity is a legal duty or merely a political aspiration.
At the same time, antimicrobial resistance continues to exact a growing toll on global health systems. The WHO’s most recent AMR assessment estimates that drug-resistant infections now cause over 1.27 million deaths annually. Both challenges demand the same thing: a principled basis for international health cooperation that goes beyond political rhetoric.
From Aspiration to Framework
Justice, Solidarity, and Global Health: From Globalisation to Collaboration by Peter West-Oram (Routledge, April 2026) develops a coherent philosophical account of what justice and solidarity actually require in global health — not as an abstract moral ideal, but as a practical framework for designing obligations, institutions, and policies that can be enforced and sustained.
The argument matters because the Pandemic Agreement, AMR action plans, and climate-health agendas all need principled foundations to work. For public health professionals, hospital ethics committees, global health policy researchers, and university libraries, it is the ethical reference work the field has been missing.
Key Organisations Working on Global Health Justice
WHO — World Health Organization
The primary intergovernmental body for global health governance. Administered the Pandemic Agreement negotiations and leads global coordination on AMR, vaccine equity, and health emergency preparedness.
WHO — Global Action Plan on Antimicrobial Resistance
The WHO’s coordinating framework for the international response to AMR, working through the One Health approach across human health, animal health, and environmental sectors.
Wellcome Trust — Infectious Disease and AMR
One of the world’s largest biomedical research funders, with major programmes on AMR, pandemic preparedness, and global health equity.
MSF Access (formerly MSF Access Campaign)
Médecins Sans Frontières’ advocacy arm, focused on access to medicines, vaccines, and diagnostics in low-income settings. A key voice in pandemic treaty negotiations on intellectual property and equitable access.
Gavi — The Vaccine Alliance
The public-private partnership financing vaccination programmes in lower-income countries. Gavi’s COVAX facility exposed the structural gaps in global vaccine equity during COVID-19, directly informing the Pandemic Agreement’s access provisions.
Q&A
Q: What did the WHO Pandemic Agreement adopt in 2025?
The WHO Pandemic Agreement was adopted by the World Health Assembly on 20 May 2025 — the first binding international instrument on pandemic prevention, preparedness, and response since the IHR were revised in 2005. Key provisions cover pathogen access and benefit sharing, equitable access to vaccines, and governance structures for international cooperation during health emergencies.
Q: What is the difference between global health solidarity and charity?
Charity is voluntary and can be withdrawn. Solidarity entails recognised obligations grounded in shared vulnerability — obligations not contingent on the goodwill of wealthier actors. A global health system built on solidarity obligations can, in principle, be designed to be durable and enforceable.
Q: How does antimicrobial resistance illustrate the need for global health solidarity?
AMR is caused by antibiotic misuse anywhere and its consequences spread everywhere. Controlling it requires coordinated global action: shared surveillance, equitable access to new antibiotics, and collective stewardship of existing treatments. No single country acting alone can solve it.
Q: What were the main failures of global health solidarity during COVID-19?
Wealthy nations hoarded vaccines while COVAX was underfunded; export restrictions blocked supply chains; IP protections blocked technology transfer; and international coordination collapsed under national political pressure. As of early 2021, over 70% of vaccines had been administered in high-income countries while less than 5% of people in low-income countries had received a dose.
Q: How does climate change intersect with global health justice?
Climate change disproportionately affects health in low- and middle-income countries — through heat, flooding, vector-borne diseases, and food insecurity — despite those populations having contributed least to historical emissions. West-Oram’s framework argues that climate-health justice requires the same solidaristic obligations as pandemic justice.
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