The Politics of Pandemic Preparedness: Why South and Southeast Asia Need a Stronger Voice
When a pandemic strikes, sharing viral samples and genetic data is essential to develop vaccines, diagnostics, and treatments quickly. But how are the benefits of these scientific advancements distributed? This is the core question being debated at the World Health Organization (WHO).
Negotiators are currently meeting in Geneva to finalize the terms of the Pathogen Access and Benefit-Sharing (PABS) instrument, an annex to the WHO Pandemic Agreement (PA) adopted in May 2025. This round of negotiations runs from November 2 to 13 and marks the ninth meeting to discuss the terms of PABS.
PABS has been described as the heart of the equity bargain in pandemic response. It stems from the failure of global solidarity during the COVID-19 pandemic, when vaccine hoarding by high-income countries delayed roll-outs of vaccines and caused unprecedented socio-economic distress in developing countries. Without the PABS annex, the Pandemic Agreement cannot move forward to signature and ratification. Together, the PA and PABS aim to resolve the underlying ambiguity and inequities in global pandemic response through a legally binding instrument negotiated collectively at the WHO.
Even if PABS is successfully adopted, whether it will deliver on its intended objectives will only be tested in the next pandemic. Yet the way the rules are being written has profound implications for transforming dependency on concentrated supply chains, and for health sovereignty in South and Southeast Asia.
Global negotiations at the WHO and in the broader United Nations system are shaped by deep structural power asymmetries, such that decision-making advantages those with economic leverage and resources to influence global rule-making. Yet the collective bargaining power of developing countries has historically led to several breakthroughs. Climate negotiations revealed these possibilities through the recognition of the principle of “Common But Differentiated Responsibilities” and establishment of the Loss and Damage Fund at COP27. The PA raises a similar political question – can developing countries exert collective influence over the rules governing pandemic preparedness?
For South and Southeast Asia, this question is complicated by the tension between national priorities and ambitions to shape global rules.
Countries like Indonesia, Malaysia, the Philippines, Thailand, Bangladesh, and India had varying contributions through a cross-regional grouping, the “Group for Equity.” With a wide-based membership of countries across Latin America, Africa, and Asia, the group was held together by advocating the broad principle of “equity,” differentiating it from predominantly regional blocs such as the European Union, Caribbean Community, and the Africa Group.
Although the Equity Group shared this common principle, in reality, members’ priorities were split on different provisions, including PABS. This offered an opportunity for more vocal countries to take the lead on particular provisions. Indonesia, arguing on behalf of the Equity Group, recently stated within PABS negotiations, “PABS was never meant to be ‘only’ about equitable access to medical countermeasures. It should help developing countries build local production, strengthen technological capacity, and strengthen their overall capacity when the next crisis arrives.”
Despite a history of technical cooperation on infectious diseases and pandemics, South and Southeast Asia have struggled to translate this cooperation into a regional negotiating position. There are three contributing factors. For Southeast Asia, its “ASEAN Way” of consensus enables stronger functional problem-solving through technical coordination (for instance through the ASEAN Center for Public Health Emergencies and Emerging Diseases and ASEAN BioDiaspora Virtual Center), but limits political consensus-building among its member-states.
In South Asia, SAARC’s political deadlock has restricted broader engagement. However, health remains an important tool to facilitate continuity in cooperation. For instance, the SAARC Tuberculosis Center has had more success than other areas such as security and counterterrorism.
The third reason limiting a regional position is the composition of WHO regional offices, where many pre-negotiation consultations and initial consensus building take place. For instance, Pakistan and Afghanistan are grouped into the Eastern Mediterranean Region (EMRO); India, Bangladesh, Myanmar, Thailand in South-East Asia (SEARO); and Indonesia, Singapore, Philippines in Western Pacific (WPRO).
By design, forging a regional political consensus that will translate into shared negotiating positions is more complex for South and Southeast Asia, compared to other regions that present a stronger regional identity within global fora. However, global rules will directly impact regional pandemic preparedness, with major implications for health sovereignty. This reality necessitates strengthening political and diplomatic influence within negotiations.
For South and Southeast Asia, given the regions’ varying institutional contexts, adding a layer of diplomatic capacity building to regional technical exchange can serve as a starting point. Countries with strong health diplomatic capacity such as Thailand have already begun regional trainings, for instance with Bhutan and Sri Lanka. These can be expanded further to region-wide efforts helping negotiators with skills of strategic framing and agenda building.
More so, habits of cooperation already exist beyond government-to-government engagement and are strengthened by a coalition of actors such as nongovernmental organizations, donors, scientific institutes, and technical bodies. The Asia Pathogen Genomics Initiative connects governments, scientific institutions, and other actors across South and Southeast Asia on the sensitive issue of genomic surveillance. The political imperative is to build on this cooperation around contentious provisions such as access and benefit sharing and create links between technical networks and negotiators.
Given the urgent need to arrive at an agreement on PABS, there is a small window of opportunity for countries to press on the non-negotiables for an effective instrument. South and Southeast Asia have directly experienced both the consequences of inequitable access and the value of technical cooperation. The next step is to connect existing technical capacity to the diplomacy that shapes who can access the tools to respond. Without this connection, countries may contribute pathogen samples and data to global pandemic preparedness without having equitable access to vaccines, diagnostics, and treatments developed from them.
