True global health security requires collective resilience, not dependency. As we enter the final phase of negotiations in Geneva this November, European leaders must recognize that a successful agreement must prioritize equitable access to life-saving technologies and resources for all countries. We cannot afford to repeat the mistakes of the past.
During the COVID-19 pandemic, vaccine distribution was a glaring example of inequity. While countries like Germany, France, and the UK quickly secured vaccines for their populations, low- and middle-income countries (LMICs) in the Global South were left struggling. Over 85%[1] of African nations were unable to provide even a single dose to their populations by mid-2022, while many Western European countries double-vaccinated more than 70%[2] of their people. This imbalance led to unnecessary deaths, perpetuating a global divide where lives in the Global North were deemed more valuable than those in the Global South.
To break this cycle, the Pandemic Agreement must not just offer high-income countries the opportunity to donate surplus vaccines but actively support the creation of regional production hubs in the Global South. The future of pandemic preparedness should be built on shared resilience, with knowledge, technology, and resources flowing in both directions—not through charity but through partnership.
SOS advocates across Africa, which was disproportionately affected by staggering inequalities during the COVID-19 pandemic, are calling for an equitable Pandemic Agreement that works for all nations, not just the super-rich.
One of the most crucial aspects of the Pandemic Agreement is the commitment to ensure the transfer of knowledge and technology to LMICs. High-income countries, including many in the EU, have historically defended pharmaceutical companies' interests, which prioritize profit over public health. This defense of monopolies and intellectual property rights during crises has devastating consequences, as seen with COVID-19 vaccines.
For the Pandemic Agreement to be successful, it must include binding provisions for technology transfer, intellectual property sharing, and the establishment of local manufacturing in LMICs. Europe, as a leader in global health, must champion these commitments. If the current text remains focused on “voluntary” or “mutually agreed terms,” we will see the same inequities repeated, leaving the Global South dependent on handouts instead of being self-sufficient in the face of future pandemics.
The negotiations for the Pandemic Agreement have, thus far, been riddled with vague commitments and unenforceable promises. European leaders must push for clear, binding financial commitments from high-income nations. Voluntary contributions are insufficient to support the necessary infrastructure and health systems in LMICs. Article 20 of the agreement, which addresses sustainable financing, must include concrete obligations for European nations to contribute long-term, reliable funding for pandemic preparedness in the Global South.
Financing should not be viewed as charity but as an investment in global security. A pandemic that starts in one part of the world will inevitably spread. The COVID-19 pandemic showed that when one region fails to contain a virus, the entire world suffers. Sustainable, predictable funding will help all countries prepare for and respond to future health crises, ensuring that no nation is left behind.
Latin American SOS advocates and global health experts speak to the media at a press conference in Mexico on May 24, 2024, demanding a Pandemic Agreement that puts lives before the profits of big pharma.
Europe is at a critical juncture. By leading the way in advocating for these changes, the EU can help redefine global health policy for the 21st century. Moving away from the outdated, paternalistic model of aid and charity to a model based on shared responsibility and equity will not only benefit the Global South but will also strengthen Europe’s own health security.
The stakes are high. The Pandemic Agreement is our chance to prevent the kind of vaccine hoarding, technological monopolization, and funding gaps that have left much of the world vulnerable. A global health crisis does not respect borders and neither should our response. Now is the time for Europe to demonstrate its commitment to equity by ensuring that the Pandemic Agreement prioritizes the needs of the Global South—not as an act of charity, but as a necessary step toward building a resilient global public health system that protects us all.
As the final negotiations approach, Europe must commit to equity as the foundation of this agreement. By supporting regional production hubs, transferring technology, and guaranteeing sustainable financing, the EU can ensure that the Pandemic Agreement does not simply reinforce old patterns of dependency but instead builds a robust, global response network. European leaders must push for a transformative agreement that leaves no one behind—because true global health security is only possible when every nation, regardless of income status, can stand on its own.
Daniel Reijer, Ph. D., AHF Europe Bureau Chief
[1] Wariri O, Afolabi MO, Mukandavire C, et al. COVID-19 vaccination implementation in 52 African countries: trajectory and implications for future pandemic preparedness. BMJ Global Health 2023;8:e013073. https://gh.bmj.com/content/8/12/e013073
[2] Moss K, Wexler A, Dawson L, Kates J. Tracking global COVID-19 vaccine equity: an update. KFF. 2022. https://www.kff.org/coronavirus-covid-19/issue-brief/tracking-global-covid-19-vaccine-equity-an-update/
