World Leaders Urge Completion of Pandemic Pact as Ebola Crisis Exposes Preparedness Gaps

Six years after COVID-19 killed 20 million people and cost the global economy $10 trillion, the United Nations General Assembly convened its second high-level meeting on pandemic preparedness — and the message from the podium was near-unanimous: finish the deal. With over 7,800 Ebola cases and 3,700 deaths mounting in the Democratic Republic of Congo, dozens of delegations and the WHO director-general pressed for completion of the pathogen access and benefit-sharing annex that would unlock the WHO Pandemic Agreement for ratification. The United States, however, declared it could not support the session's political declaration, exposing fault lines that will follow the text to the General Assembly floor.

• WHO chief delivers a single demand to the world: finalize the pathogen-sharing deal that makes the Pandemic Agreement real
• United States refuses to back political declaration, citing "divisive ideologies" and unresolved negotiations
• DRC Ebola outbreak surpasses 7,800 cases as donors pledge hundreds of millions but fall short of the $1.5 billion gap
• OECD warns infectious disease aid will drop 40% in 2026, widening a $15 billion annual preparedness shortfall
• Norway, the UK, Canada, and Japan announce major funding for vaccine development and Ebola response
• Barbados proposes a novel "Pandemic Preparedness Development Compact" to link health and finance ministries

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"Get PABS Done": The One Request That Defined the Day

Why it matters: Without a completed Pathogen Access and Benefit-Sharing (PABS) Annex, the WHO Pandemic Agreement adopted in May 2025 cannot open for signature — leaving the world without a binding framework for sharing virus samples and ensuring developing countries actually receive the vaccines, diagnostics, and therapeutics that result.

Where things stand: WHO Director-General Tedros Adhanom Ghebreyesus made the demand the centerpiece of his address, boiling his entire message down to six words: "So today, I leave you with just one request, just one. Get PABS done," he told the Assembly.

The principle is straightforward but politically explosive: when a country shares pathogen samples or genomic sequences with international labs, it should receive equitable access to the medical products those samples help create. During COVID-19, wealthy nations hoarded vaccines while much of Africa, Asia, and the Caribbean waited months. Delegations from the African Group, CARICOM, Indonesia, Singapore, South Africa, Brazil, France, the United Kingdom, Japan, and many others called for rapid conclusion of the PABS negotiations, making it the single most referenced action item across the nearly eight-hour session.

Co-chair of the Independent Panel for Pandemic Prevention, Preparedness and Response Helen Clark sharpened the urgency by connecting the stalled negotiations to a real-world failure. Noting that the Bundibugyo strain of Ebola — now ravaging the DRC — had caused two previous outbreaks, she asked: "As Bundibugyo was a known and very deadly risk, we have to ask why it had not been a priority to develop countermeasures to combat it."

Clark also warned the Assembly that the world remains "still far short of the $15 billion needed every year" for preparedness, underscoring that the PABS system is only one piece of a much larger financing puzzle.

The other side: The United States was the most prominent dissenter. The delegate from the United States told the plenary that "the United States is not in a position to support this text in full. We regret that we were unable to resolve these issues." Washington objected to references to unfinished PABS negotiations and what it called "divisive ideologies that lack definitional consensus" embedded in the political declaration. The U.S. did highlight its own domestic reforms, noting that "the United States has strengthened oversight of high-risk life sciences research and prohibited federal funding for dangerous gain-of-function research."

Italy went further on the underlying agreement itself. The delegate from Italy stated that Italy "did not support the adoption of the Pandemic Agreement" and could not associate with provisions welcoming it — a notable break within the European Union.

The EU Commissioner for Preparedness, Crisis Management and Equality Angela Dinkla said the declaration text "contains setbacks" and listed explicit red lines on technology transfer language, financing provisions, and the omission of any reference to the WHO Hub for Pandemic and Epidemic Intelligence.

Decisions: The political declaration received broad support but was not formally adopted at this session. General Assembly President Khalilur Rahman noted in closing that "while there is broad support for the text, there continue to be some observations" and said it would be "considered further by the member states in the General Assembly."

What's next: The declaration moves to the General Assembly for further negotiation. The PABS Annex itself remains under negotiation through separate WHO-led processes. Until it is finalized, the Pandemic Agreement cannot open for signature or ratification.

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Ebola in the Congo: A Real-Time Test of Global Promises

The basics: The ongoing Bundibugyo Ebola outbreak in the DRC has killed more than 3,700 people across over 7,800 confirmed cases, according to figures cited by the delegate from the African Union / Africa CDC. The outbreak has spilled across borders, with Uganda detecting cases before the DRC formally announced the epidemic.

Why it matters: The DRC crisis is serving as a live stress test for the global health architecture that world leaders spent years redesigning after COVID-19. Whether the response succeeds or fails will shape political will for the Pandemic Agreement and PABS completion.

Where things stand: Several major donors announced contributions:

• Norway: 1 billion Norwegian crowns for CEPI's next strategic period. "Norway intends to provide 1 billion Norwegian crowns to CEPI for its next strategic period," said the delegate from Norway.
• United Kingdom: £100 million for CEPI's 3.0 strategy, plus £78 million for surveillance and frontline health services.
• Canada: $36 million for DRC Ebola response.
• Japan: $8.5 million for DRC Ebola response.

On the vaccine front, the delegate from Singapore announced that "Hillerman Laboratories, which is a JV between MSD and Wellcome Trust in Singapore, will be producing for clinical trials a vaccine for Ebola Bundibugyo virus by the end of the year."

The African Group called on the international community to close the remaining $1.5 billion financing gap for the Ebola response and urged lending countries to apply innovative debt relief mechanisms, including debt-for-health swaps.

Tedros noted that while Ebola is unlikely to become a pandemic, the outbreak nonetheless tests collective readiness — and the speed at which resources flow will signal whether post-COVID reforms are delivering results or merely rhetoric.

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Equity or Injustice: The Developing World's Central Demand

Why it matters: During COVID-19, wealthy nations secured vaccine doses months before low-income countries. Without enforceable mechanisms for technology transfer, local manufacturing, and intellectual property flexibility, delegations warned the same pattern will repeat.

Where things stand: The demand for structural change in how medical countermeasures reach developing countries was the plenary's dominant theme alongside PABS. Deputy Secretary-General Amina Mohammed, reading a message from UN Secretary-General António Guterres, stated that "equity is not optional; it is foundational."

The delegate from Brazil offered the session's most quoted line on the subject, declaring that "innovation without access is not innovation, is injustice." General Assembly President Rahman echoed the phrase in his closing remarks.

Countries detailed concrete steps to close the gap. Indonesia highlighted expanding its vaccine manufacturing base from one to four facilities, with annual capacity now at 3.6 billion doses. Indonesia also expanded molecular diagnostic capacity across 10,000 primary healthcare centers and built genomic surveillance across 41 regional labs. The delegate from South Africa called for unhindered technology transfer and full use of flexibilities under the WTO's TRIPS Agreement and the Doha Declaration.

The delegate from Barbados introduced a novel proposal: "I propose a Pandemic Preparedness Development Compact to support the actual implementation of the agreement." The compact would bring health and finance leaders together around practical investment plans and regional supply chains — an attempt to bridge the gap between health policy and fiscal reality that has historically stalled implementation.

India highlighted its Vaccine Maitri program, which supplied 300 million doses to approximately 100 countries during the COVID-19 pandemic, as a model for South-South cooperation.

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Health Aid Heading for a Cliff

Why it matters: Even as countries called for more preparedness spending, the money is moving in the opposite direction. The delegate from the OECD reported that health official development assistance for infectious disease is projected to decrease by 40% in 2026 from 2024 levels — a dramatic reversal at a moment when the world is asking developing countries to invest heavily in surveillance, labs, and One Health platforms.

The OECD announced development of a new Global Health and Resilience Tracker to monitor these trends. Multiple countries called for the Pandemic Fund, established during Indonesia's 2022 G20 presidency, to be adequately capitalized and for financing to be pre-arranged rather than reactive. Tanzania warned that preparedness financing must not deepen debt distress in countries already struggling with fiscal constraints.

Clark's assessment that the world remains $15 billion short annually in preparedness funding loomed over every financial pledge — substantial as some were, the announced commitments covered only a fraction of the gap.

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National Preparedness: What Countries Built After COVID

Countries used the plenary to showcase post-pandemic investments in health system resilience, offering a snapshot of where capacity has grown — and where it remains fragile.

Thailand highlighted its network of over 1 million village health volunteers embedded in primary care. Rwanda described linking community-based primary care with national surveillance and digital emergency response systems. Sierra Leone established a national public health agency in 2023. Nigeria reported its joint external evaluation score improved from 39% in 2017 to 54% in 2023.

Uganda provided one of the session's most vivid examples: the country detected the Ebola spillover from the DRC before the DRC announced it, deploying mobile laboratories and achieving genomic sequencing in less than 24 hours. Singapore outlined a three-pronged approach including regional manufacturing resilience and global biofoundry networks.

The One Health approach — connecting human, animal, and environmental health surveillance — was universally endorsed, with President Rahman listing it as one of four key takeaways from the day's discussions alongside equity, trust-building before crises, and a more inclusive global health architecture.

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Minor Items

• Andorra highlighted its centralized electronic health record system as a model for small-state preparedness.
• Cuba raised concerns about the impact of unilateral coercive measures on health system capacity.
• Venezuela, speaking for the Group of Friends in Defense of the Charter, regretted the absence of language on unilateral coercive measures in the political declaration.
• Malta delivered a national statement during the plenary segment.
• Germany delivered a national statement emphasizing international cooperation.
• China delivered a national statement during the plenary.
• The Russian Federation delivered a national statement during the plenary.
• India stated it regards the political declaration as non-binding and regretted omissions on member state review roles.
• Lesotho shared its interoperability platform connecting health services with identity and social protection systems.