The WHO Pandemic Agreement: No True Health Security Without Taiwan

The recent approval of the World Health Organization (WHO) Pandemic Agreement by the 78^th World Health Assembly (WHA) Committee marks a landmark global commitment to fortify pandemic prevention, preparedness and response (PPR) capacities. The agreement aims to achieve the common interest of a more equitable and better prepared world to prevent, respond to and recover from pandemics. Its implications extend beyond politics, emphasizing that true global health security requires Taiwan’s inclusion.

Inside the Pandemic Agreement

Emerging from the catastrophic lessons of COVID-19, the Pandemic Agreement establishes mechanisms to improve pathogen surveillance, promote equitable access to medical countermeasures, and enhance health system resilience.

A key provision is the Pathogen Access and Benefit-Sharing (PABS) system, whereby countries are obligated to share pathogen samples and related genetic information rapidly and equitably through the system. Pharmaceutical manufacturers accessing pathogen information commit to providing 20% of their vaccines, therapeutics, and diagnostics (10% as donations, 10% at affordable prices) to the WHO for distribution in emergencies.

The treaty also embraces a One Health approach, addressing animal-to-human transmission risks, and mandates combating misinformation while protecting health workers from stigma and violence.

COVID-19 revealed profound inequities and fragmentation in global health systems. A treaty fostering transparent data exchange, equitable resource allocation, and diversified regional manufacturing capacities can transform pandemic response from reactive crisis management to proactive resilience-building.

Tsung-Ling Lee, Professor at Taipei Medical University, told the Science Media Center Taiwan that the treaty is “a positive step toward preventing future pandemics - where the question is ‘when,’ not ‘if.’”

Yet, critiques persist over its lack of enforcement mechanisms or concrete funding obligations, leaving effective implementation dependent on voluntary compliance and goodwill.

Over the next year, further negotiations will focus on drafting an annex to the treaty aimed at resolving outstanding questions, e.g. the PABS system.

Taiwan’s Contributions and Exclusion

Despite being denied WHA observer status for nine consecutive years, Taiwan continues to demonstrate its value as a trusted global health partner. During COVID-19, Taiwan was among the first to notify WHO of the emerging outbreak in Wuhan, leveraging its epidemic intelligence system to detect unusual pneumonia cases and formally raising inquiries as early as December 31, 2019.

Taiwan implemented effective border controls, and maintained a zero-COVID policy until 2022 – without lockdowns, recording the world’s ninth-lowest excess death rate from 2020-2022 according to The Economist. Taiwan scaled up mask production to become the second-largest global supplier, provided vaccines such as Medigen to countries like Australia and Thailand, and contributed rapid tests and traditional medicines to global diagnostic and treatment advancements.

The Pandemic Treaty permits participation only by UN member states, effectively preventing Taiwan from becoming a signatory. In Science Media Center Taiwan’s post, Po-Han Lee, Associate Professor, and Hsien-Ho Lin, Professor at National Taiwan University, Taiwan, warned that “without formal inclusion, jurisdictions like Taiwan risk being excluded from key data flows and benefit-sharing frameworks, despite their contributions to global health security.“

Taiwan Centers for Disease Control (CDC) reaffirmed that Taiwan is an indispensable part of the global health system. “Taiwan will continue strengthening its domestic pandemic PPR while also deepening international cooperation with like-minded countries such as the US, Japan, and EU members, as well as with international professional organizations.” said Philip Lo, Deputy Director of Taiwan CDC.

Lin Shih-chia, CEO of Taiwan’s Foundation of Medical Professionals Alliance, emphasized Taiwan’s vital role as a manufacturing and R&D hub for pandemic prevention in the Asia-Pacific. She urged that, if formal inclusion is not possible, Taiwan should attend as an observer and domestically implement the treaty as part of its “Taiwan can help” commitment.

A Call to Action

After three years of negotiations, the Pandemic Agreement offers hope for a safer and more equitable world. As WHO Director-General Dr. Tedros remarked, “In our divided world, nations can still work together to find common ground and a shared response to shared threats.” Yet the path forward remains uncertain. The US decision to withdraw from WHO and the unresolved PABS system annex cast doubt on its implementation.

Crucially, without inclusive participation, the treaty’s goals remain incomplete. Taiwan's exclusion is unjustified; it poses a global health security risk. Pathogens don’t respect borders, and any gap in surveillance or response endangers everyone. The international community must ensure Taiwan’s meaningful involvement - whether through observer status, parallel or bilateral agreements, or other collaborative frameworks.