The adoption of the pandemic agreement at the World Health Assembly in May 2025 marks a welcome commitment to global solidarity in anticipation of the next pandemic.
Adoption has taken almost three years, but the agreement now provides an improved set of principles around human rights, equity, solidarity, and science-based evidence to underpin pandemic preparedness planning and a governance framework to implement across World Health Organization member states.
Bodies such as the International Pandemic Preparedness Secretariat have called for immediate national implementation. However, some key challenges remain, such as agreeing on the pathogen access and benefit sharing (PABS) annex, and subsequent ratification and country implementation will require determined leadership at a time when cuts to WHO and wider global health funding are dominating agendas.
The PABS annex aims to support equitable access to pandemic related health products (eg, vaccines, therapeutics, and diagnostics) during any future pandemic in return for faster access to pathogens and genetic sequences for the developers of these products.
However, this is contentious and subject to ongoing lobbying and dilution. The annex has to be adopted by the WHA before the 18 month clock starts ticking for at least 60 member states to formally ratify the pandemic agreement, allowing it to take effect.
Furthermore, the final wording of the agreement is disappointingly weak with commitments being “voluntary” and for “mutual agreement,” which will make it challenging to ensure national implementation results in effective action.
Improving UK preparedness
Pandemic preparedness requires many elements, including good executive governance, a resilient public health system, a vibrant research and innovation sector, and public confidence in both policy making and science. The UK’s national inquiry into the covid-19 pandemic is still ongoing, but many important lessons and practical steps are already evident.
The inquiry’s first module, which considered resilience and preparedness, was particularly critical of the lack of cohesion of communications and decision making across government departments. The UK’s pandemic scenario exercise planned for autumn 2025 will provide an initial test of whether these governance gaps have been addressed.
Public health and social interventions such as social distancing, face coverings, self-isolation, and school closures were central to the pandemic response. However, they have been criticised for lack of precision and proportionality; failing to take account of societal inequality, cultural norms, and socioeconomic impacts; and weak evidence of effectiveness. This resulted in a polarisation of views and a decline in public confidence.
Nevertheless, public health measures will remain fundamental to the response to future pandemics and considerable work, including research into public acceptance, is needed to make them optimally effective next time around.
The scientific lessons of the pandemic are already well summarised in reviews published by research funders and the UK chief medical officers.
Overall, the UK’s scientific response to the covid-19 pandemic was remarkable, directly improving health outcomes nationally and globally and helping to end the pandemic.
This response was based on key research capacities built over many decades, including the clinical, public health, and biomedical research sectors and highly skilled and experienced researchers funded by entities such as the National Institute for Health and Care Research (NIHR) and UK Research and Innovation (UKRI).
The chief medical officers’ report highlights the continued need to support ongoing research ready to deliver prioritised, focused national research programmes through pre-established and coordinated funding mechanisms.
However, UK investment into pandemic preparedness research has stalled, with government funding falling by £3bn since the peak of covid funding in 2020.
Notable gaps in research portfolios, such as across the UK’s diagnostics sector, have not yet been addressed, and some core capabilities built during the pandemic have not been retained because of other national needs taking precedence.
Plans for a new government funded vaccine manufacturing and innovation centre were shelved when it was sold to drug company Catalent in 2022, and AstraZeneca’s planned investments in a Liverpool vaccine plant were also axed because of state funding cuts. It remains to be seen whether Moderna’s new vaccine centre, part of a partnership with the UK government, will deliver the ambition of effective vaccine preparedness for public interest.
New funding calls through UKRI and NIHR for interdisciplinary research for epidemics and clinical trial platforms are welcome progress, and the latest spending review outcomes indicate increased resource for science.
The government’s new framework for research on pandemic preparedness, prevention, and response indicates an improved strategic approach, in alignment with the 2025 implementation report on the UK biological security strategy.
The achievement of adoption of the WHO Pandemic Agreement by 124 member states, should not be downplayed.
However, given the weakness of the language, the lack of agreement on the PABS annex, US withdrawal from WHO membership, and major reductions in global health investments, global solidarity now needs bolstering with strong multilateral leadership.
The UK has already spearheaded the “100 days mission,” aiming to have diagnostics, drugs, and vaccines available within the first 100 days of a pandemic.
With the UK’s ambition to be a science superpower and its world leading scientific track record, it should now fill the remaining gaps in national preparedness and contribute globally to implementing the principles of the pandemic agreement.
Reproduced from British Medical Journal, Norton A, Vanderslott S, Horby P, 390 :r1742 2025 with permission from BMJ Publishing Group Ltd.
This editorial was commissioned by the British Medical Journal and published on 19 August 2025. It is available for subscribers on the BMJ website.