Global pandemic accord talks: What’s been achieved so far?

The 12th round of negotiations towards a global accord on handling future pandemics ended Friday without a final agreement, with rich and poor nations still wrangling over how to make it work.

Here is an overview of where the talks are at, what has been agreed, and what is holding up the process.

 What has happened so far? 

The Covid-19 pandemic killed millions of people, crippled health systems and crashed economies. It exposed glaring deficiencies in the world's handling of the crisis.

In December 2021, countries therefore decided to draft a new accord on pandemic prevention, preparedness and response. Negotiations began in February 2022.

In June 2024 at the annual World Health Assembly -- the WHO's top decision-making body -- countries gave themselves until the next assembly in May 2025 to conclude and adopt the agreement -- and to get it done by the end of 2024 if possible.

On Monday, countries decided they were unable to finish this year.

  Who is negotiating? 

The World Health Organization's 194 member states must formulate the agreement, not the WHO itself.

The talks are held at the WHO's headquarters in Geneva.

  What has been approved? 

Countries are in agreement on the broad scope of what they want -- it is just the details which are in contention.

Of the draft text's 35 articles, 17 have been fully approved by member states, while 12 are mostly approved.

However, some of those are simple procedural paragraphs. The outstanding sections are the toughest: the core aspects of the agreement.

  What is still in contention? 

 Article 4: Pandemic prevention and surveillance

This would commit countries to strengthening capacities and developing national plans for  areas including stopping diseases spreading from animals to humans, and community-level detection and control.

But smaller countries would need money to ramp up their capacities.

 Article 5: One Health approach

Relating to the interconnection between the health of people, animals and the environment, none of this section has been fully approved.

 Article 11: Transfer of technology and know-how for the production of pandemic-related health products

Designed to diversify production, wealthier countries want this done on voluntary and mutually agreed terms; others want this mandated.

 Article 12: Pathogen Access and Benefit-Sharing System

PABS is the heart of the agreement. Countries would share data on emerging pathogens, and, in return, the benefits derived from them would also be shared, namely vaccines, tests and treatments.

Countries are squabbling over the percentages of production that would be made available free of charge for distribution in poorer nations, and a further chunk at cost prices.

 Article 13: Supply chain and logistics

This establishes the Global Supply Chain and Logistics Network to facilitate equitable, timely and affordable access to pandemic-related health products.

The article is largely approved, but a battle is raging over one word: whether access should also be "unhindered".

 Who's saying what -

 Tanzania, for 48 African countries: "Although we had such slow progress... the remaining issues are not many, but crucial and delicate.

It is our sincere hope that our meeting in December may resolve the remaining issues... and deliver this long-awaited treaty, which, in our opinion, is already overdue."

 Philippines, for the 35-country Equity Group: "Much work needs to be done to achieve consensus on key articles that operationalise equity.

"The group is committed to adopting a consequential pandemic agreement by May 2025."

 Indonesia: "Without true equity, this agreement will fail to bring the transformative change our world desperately needs."

 Eswatini: "The sky has not fallen in and there is a great hope that the negotiations will be finalised."

WHO emergencies director Michael Ryan: "I sense an acceleration of common will to reach an agreement. Time is not on our side, but if you are determined, you can do it -- and you will do it."

 Potential ways through 

Some hope a breakthrough on one article, or a trade-off over two articles, could break the logjam.

Striking an skeleton agreement then fleshing out the details afterwards -- particularly on PABS -- could be another approach.

Donald Trump is hostile to the WHO and his return to the US presidency in January could also sharpen minds.

  What happens next? 

Countries will resume the 12th round of talks from December 2-6, at the end of which they will take stock and decide if they are ready to call a World Health Assembly special session, which takes 35 days to arrange.

The advantage is that the focus would be entirely on the agreement, while the May regular assembly's business would not be disturbed.

Concluding an international agreement in three to four years would be exceptionally fast, given the typical glacial pace of such processes.