Madrid, 14 May 2025. The COVID-19 pandemic exposed the profound vulnerability of individuals and societies to global health emergencies. It revealed critical weaknesses in underfunded and overburdened public health systems, the fragility of supply chains for essential medical goods, North-South disparities in research and production capacities, the proliferation of misinformation, and the severe social consequences of mobility restrictions and lockdowns.
Faced with these challenges, the international community recognised the urgent need to strengthen the legal and institutional frameworks for pandemic prevention, preparedness and response. Although the World Health Organization (WHO) played a central role during the crisis, its normative and operational limitations became evident.
In response, various initiatives emerged in 2021, driven by the trauma of COVID-19, including the Panel for a Global Public Health Convention (PGPHC) and the Independent Panel for Pandemic Preparedness and Response (IPPPR), both of which called for a legally binding international treaty. Building on these efforts, WHO Member States launched a process to negotiate an international convention, led by the Intergovernmental Negotiating Body (INB).
From the outset, Club de Madrid supported these initiatives, actively engaging with both public and private platforms, including the AIDS Healthcare Foundation (AHF) and the AHF Global Public Health Institute.
The complexity of the negotiations, compounded by the diversity of interests involved, led to significant delays. The sense of urgency, diminished by the success of vaccination campaigns, further slowed the process. By late 2024, after three years of inconclusive negotiations, there were growing concerns that only a voluntary instrument could be achieved.
Aware of the historic importance of this opportunity, many actors redoubled their efforts. Club de Madrid intensified its advocacy by sending communications (2024 & 2025) to WHO leadership, the INB, and key Member States, highlighting the need for an ambitious agreement. This mobilization culminated in a meeting held in Madrid in December 2024, where Club de Madrid Members and PGPHC representatives renewed their call for a legally binding treaty.
On 16 April 2025, following intense final rounds of negotiation, the WHO announced the successful conclusion of an agreement. The draft text will be submitted for consideration at the 78th World Health Assembly, scheduled for 19–27 May 2025.
It is noteworthy that the United States, having announced its withdrawal from the WHO in January 2025, did not participate in the final round of negotiations and therefore will not be bound by this agreement.
The negotiations addressed particularly complex issues, including the establishment of robust zoonotic disease surveillance systems in areas of wildlife-human contact, and demands from developing countries for greater technology transfer and sharing of research outputs. While significant progress was made, adequate financing for these measures remains a key unresolved challenge.
The agreement has been widely recognized as a major step forward for global health equity. Notwithstanding, different civil society organizations, such as AHF, noted the remaining need for stronger commitments to achieve some equitable and timely access to life-saving medical countermeasures, as expected.
Although challenges remain — particularly regarding financing and equitable access — the adoption of the agreement would represent a historic milestone: it would become only the second legally binding instrument promoted by the WHO, after the Framework Convention on Tobacco Control. It, therefore, marks a decisive step towards a more resilient and inclusive international health system, better prepared to face future threats.
Club de Madrid reaffirms its commitment to continue working alongside international actors to strengthen the implementation of this treaty and to advance towards a world where all countries are protected against future pandemics, acknowledging that no country is safe until every country is safe.
