---
type: source
title: "WHO Pandemic Agreement adopted May 2025 without US; PABS commercial dispute blocks ratification path; US formally left WHO January 2026"
author: "Multiple sources (WHO, Human Rights Watch, CEPI, KFF)"
url: https://www.who.int/news/item/20-05-2025-world-health-assembly-adopts-historic-pandemic-agreement-to-make-the-world-more-equitable-and-safer-from-future-pandemics
date: 2025-05-20
domain: grand-strategy
secondary_domains: []
format: research-synthesis
status: processed
processed_by: leo
processed_date: 2026-04-03
priority: high
tags: [who, pandemic-agreement, covid-governance, us-withdrawal, pabs, commercial-blocking, triggering-event]
extraction_model: "anthropic/claude-sonnet-4.5"
---

## Content

**Adoption:** The WHO Pandemic Agreement was adopted by the World Health Assembly on May 20, 2025. 120 countries voted in favor. 11 abstained (Russia, Iran, Israel, Italy, Poland). Zero countries voted against.

**US status:** On January 20, 2025, President Trump signed Executive Order 14155 withdrawing the US from WHO. The US formally left WHO on January 22, 2026. The US Secretary of State "will cease negotiations on the WHO Pandemic Agreement," and "actions taken to effectuate such agreement and amendments will have no binding force on the United States." The US also formally rejected the 2024 IHR amendments.

**Signature status (as of April 2026):** The agreement is NOT YET OPEN FOR SIGNATURE. Article 31 stipulates it opens for signature only after the PABS (Pathogen Access and Benefit Sharing) annex is adopted. The PABS annex is expected to be negotiated and presented at the 79th World Health Assembly in May 2026.

**Commercial blocking condition (PABS):** The PABS annex governs who gets access to pathogens (wealthy nations need samples for vaccine R&D) and who gets benefit shares from vaccines developed using those pathogens (developing nations want royalties/access to vaccines). This is a commercial interests dispute that has blocked the path from adoption to ratification.

**Entry into force:** Will require ratification by 60 countries, 30 days after the 60th ratification.

**Timeline:** COVID outbreak (late 2019) → WHO Pandemic Agreement adopted (May 2025) = 5.5 years. Still not open for signature as of April 2026 = 6+ years.

Sources consulted:
- https://www.who.int/news/item/20-05-2025-world-health-assembly-adopts-historic-pandemic-agreement-to-make-the-world-more-equitable-and-safer-from-future-pandemics
- https://www.whitehouse.gov/presidential-actions/2025/01/withdrawing-the-united-states-from-the-world-health-organization/
- https://cepi.net/pandemic-agreement-what-it-and-what-it-not
- https://www.hrw.org/news/2025/05/23/who-new-pandemic-treaty-landmark-flawed
- https://pmc.ncbi.nlm.nih.gov/articles/PMC12481221/

## Agent Notes

**Why this matters:** This is the most recent update to the COVID governance case that Session 04-02 used to establish the domestic/international governance split. The pandemic agreement DID eventually pass (5.5 years post-event) but without the most powerful actor (US) and with commercial interests (PABS) still blocking ratification. This confirms multiple points in the framework: (1) triggering events eventually produce broad adoption, (2) the most powerful actors opt out when governance conflicts with their strategic interests, (3) commercial interests are the structural blocking condition even after adoption.

**What surprised me:** The PABS dispute as the specific commercial blocking condition. The thing preventing the agreement from opening for signature is a commercial dispute between wealthy nations (pathogen access for vaccine R&D) and developing nations (profit sharing from vaccines). This is a textbook example of the "commercial interests not aligned" blocking condition — not national security, but commercial interests in a different register than expected.

**What I expected but didn't find:** The US blocking the adoption vote. Instead, 120 countries voted YES and 11 abstained — the US isn't even in the room (it left WHO). The absence of US opposition at the vote is itself telling: the US's strategy is withdrawal and non-participation, not blocking international governance from within.

**KB connections:**
- COVID as governance test case (Session 04-02 claim candidates)
- Domestic/international governance split
- Commercial interests as enabling condition (Montreal Protocol analysis, same session)
- Strategic actor opt-out pattern (Paris Summit, same session)

**Extraction hints:**
1. "The WHO Pandemic Agreement (adopted May 2025, 5.5 years post-COVID) confirms the maximum triggering event principle: 7M+ deaths produced broad international adoption (120 countries) but could not force participation from the most powerful actor (US withdrawal from WHO), and commercial interests (PABS annex) remain the blocking condition for ratification."
2. The US strategy of withdrawal-rather-than-blocking is a new pattern: instead of using veto power to shape international governance, the US simply exits the framework. This is harder to overcome than veto-and-negotiate.
3. Structural legitimacy gap: the actors whose behavior most needs governing (US frontier AI, US pandemic preparedness) are precisely those who opt out.

**Context:** HRW's review titled "WHO: New Pandemic Treaty a Landmark, but Flawed" covers the treaty's adoption. The "landmark but flawed" framing is the dominant assessment: formally historic, substantively limited. The same framing will likely apply to the CoE AI treaty.

## Curator Notes (structured handoff for extractor)
PRIMARY CONNECTION: Domestic/international governance split claim from Session 04-02; COVID as maximum triggering event test
WHY ARCHIVED: Critical update — the pandemic agreement passed but without US, and commercial interests (PABS) confirmed as structural blocking condition; US withdrawal strategy (exit vs. block) is a new pattern
EXTRACTION HINT: Two claim directions: (1) maximum triggering event principle with 120-country adoption + US opt-out as canonical evidence; (2) PABS as commercial blocking condition — the commercial interests alignment requirement applies not just at the governance inception moment but continuously through the ratification and implementation phases.
