Contesting Global Health Justice: Normative Limits and Legal Debates of the Pandemic Treaty
DOI:
https://doi.org/10.22437/up.v7i1.52330Keywords:
pandemic treaty;, global health governance;, global solidarity;, health equityAbstract
Background: The COVID-19 pandemic exposed structural weaknesses in global health governance, particularly in unequal access to vaccines, health technologies, and financing between developed and developing countries. It also revealed the limitations of IHR 2005 in addressing such disparities. In response, the Pandemic Treaty was developed to strengthen the legal framework for global health emergencies. Methodology: This study employs a normative juridical approach based on literature analysis of key international legal instruments, guided by Lawrence O. Gostin’s framework of global solidarity for health equity. Objective: It examines the Treaty’s normative design in addressing justice-related gaps and analyzes the legal debates that shape the Treaty. The Findings: The research shows that the Treaty attempts to fill normative gaps in the IHR by introducing provisions on local manufacturing, technology transfer, pathogen access and benefit-sharing, transparency in procurement contracts, needs-based allocation, and collective financing mechanisms. However, the formulation of these provisions reflects ongoing legal debates regarding the choice of legal basis within the WHO framework, the degree of binding obligations, and the tension between mandatory and voluntary commitments. Originality: This study argues that the Treaty represents a normative shift toward equity-based global health governance, yet its effectiveness remains constrained by its reliance on soft-law formulations and political consensus. It highlights that these limitations are not merely technical but stem from deeper structural tensions within international law concerning sovereignty, equity, and global solidarity.
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References
An International Agreement on Pandemic Prevention and Preparedness - Consilium.” Accessed January 2, 2026. https://www.consilium.europa.eu/en/policies/coronavirus-pandemic/pandemic-treaty/.
Annas, George J. American Bioethics after Nuremberg: Pragmatism, Politics, and Human Rights. 2005.
antaranews.com. “Indonesia nilai WHO Pandemic Agreement kemenangan multilateralisme.” Antara News, May 23, 2025. https://www.antaranews.com/berita/4852873/indonesia-nilai-who-pandemic-agreement-kemenangan-multilateralisme.
Bureau’s Text of the WHO Convention, Agreement or Other International Instrument on Pandemic Prevention, Preparedness and Response (WHO CA+). n.d.
Chala, Bayissa, Tigist Tilaye, and Gemechis Waktole. “Re-Emerging COVID-19: Controversy of Its Zoonotic Origin, Risks of Severity of Reinfection and Management.” International Journal of General Medicine 16 (September 2023): 4307–19. https://doi.org/10.2147/IJGM.S419789.
“Covid-19: Global Response Was Too Slow and Leadership Absent, Report Finds | The BMJ.” Accessed January 1, 2026. https://www.bmj.com/content/373/bmj.n1234.full.
“Covid-19: Vaccine Pricing Varies Wildly by Country and Company.” Accessed January 2, 2026. https://finance.yahoo.com/news/covid-19-vaccine-pricing-varies-044212280.html?guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAAG9XsN06msg9iR9qR1Zbb-i2H-C-sqpVP3D01bPCWX0AOy45b7lJRdTve1qEap1rpMXR2m6-dCiLkPJqmECeOjU-96ASRYCLDeXfgvQ7EU68M9WS1sd6UtmK9WNGK2wMyC3QkfsNKUWIRkvnu-Y0vrVuyfqWUcOfvCioOdQi8Gj0&guccounter=2.
Eilstrup-Sangiovanni, Mette, and Oliver Westerwinter. “The Global Governance Complexity Cube: Varieties of Institutional Complexity in Global Governance.” The Review of International Organizations 17, no. 2 (2022): 233–62. https://doi.org/10.1007/s11558-021-09449-7.
Evaborhene, Nelson Aghogho, Jessica Oreoluwa Oga, Onyeka Vivian Nneli, and Sheila Mburu. “The WHO Pandemic Treaty: Where Are We on Our Scepticism?” BMJ Global Health 8, no. 6 (2023): e012636. https://doi.org/10.1136/bmjgh-2023-012636.
Eyawo, Oghenowede, and A. M. Viens. “Rethinking the Central Role of Equity in the Global Governance of Pandemic Response.” Journal of Bioethical Inquiry 17, no. 4 (2020): 549–53. https://doi.org/10.1007/s11673-020-10001-2.
Frenk, Julio, and Suerie Moon. “Governance Challenges in Global Health.” New England Journal of Medicine 368, no. 10 (2013): 936–42. https://doi.org/10.1056/NEJMra1109339.
Getachew, Emnet, Tsegaye Adebeta, Seke G. Y. Muzazu, et al. “Digital Health in the Era of COVID-19: Reshaping the next Generation of Healthcare.” Frontiers in Public Health 11 (2023): 942703. https://doi.org/10.3389/fpubh.2023.942703.
“Getting in Formation: WHO Constitutional Heads of Power and the Pandemic Agreement.” Opinio Juris, March 13, 2024. https://opiniojuris.org/2024/03/13/getting-in-formation-who-constitutional-heads-of-power-and-the-pandemic-agreement/.
Getzzg. “Shared Health Governance, Mutual Collective Accountability, and Transparency in COVAX: A Qualitative Study Triangulating Data from Document Sampling and Key Informant Interviews.” JOGH, December 8, 2023. https://jogh.org/2023/jogh-13-04165/.
“Global Leaders Unite in Urgent Call for International Pandemic Treaty.” Accessed January 2, 2026. https://www.who.int/news/item/30-03-2021-global-leaders-unite-in-urgent-call-for-international-pandemic-treaty.
Gostin, Lawrence O., Kevin A. Klock, and Alexandra Finch. “Making the World Safer and Fairer in Pandemics.” Hastings Center Report 53, no. 6 (2023): 3–10. https://doi.org/10.1002/hast.1538.
Gostin, Lawrence O., and Allyn L. Taylor. “Global Health Law: A Definition and Grand Challenges.” Public Health Ethics 1, no. 1 (2008): 53–63. https://doi.org/10.1093/phe/phn005.
Gurgula, Olga, and Luke McDonagh. “Access Denied: The Role of Trade Secrets in Preventing Global Equitable Access to COVID-19 Tools.” SSRN Scholarly Paper No. 4484507. Social Science Research Network, June 19, 2023. https://doi.org/10.2139/ssrn.4484507.
Held, David. “Cosmopolitan Democracy and the Global Order: Reflections on the 200th Anniversary of Kant’s ‘Perpetual Peace.’” Alternatives: Global, Local, Political 20, no. 4 (1995): 415–29.
“Indonesia Dorong Kesetaraan Akses Lewat Pandemic Treaty.” June 1, 2024. https://kemkes.go.id/id/indonesia-dorong-kesetaraan-akses-lewat-pandemic-treaty.
Jeon, Jihee, and Eunyoung Kim. “Exploring Future Pandemic Preparedness Through the Development of Preventive Vaccine Platforms and the Key Roles of International Organizations in a Global Health Crisis.” Vaccines 13, no. 1 (2025): 56. https://doi.org/10.3390/vaccines13010056.
Jon, WooJung. “The WHO Pandemic Agreement: Why Countries Will Not Use Compulsory Licensing – and How to Fix It.” BMJ Global Health 10, no. 9 (2025). https://doi.org/10.1136/bmjgh-2025-020856.
Kheir-Mataria, Wafa Abu El, Hassan El-Fawal, Shahjahan Bhuiyan, and Sungsoo Chun. “Global Health Governance and Health Equity in the Context of COVID-19: A Scoping Review.” Healthcare 10, no. 3 (2022): 540. https://doi.org/10.3390/healthcare10030540.
Kickbusch, Ilona, and David Gleicher. Governance for Health in the 21st Century. Health Policy. WHO, n.d.
Klafki, Anika. “Post-Pandemic Reform Discussions in International Health Law: The Reform of the International Health Regulations and the New WHO Pandemic Agreement Proposal.” European Journal of Risk Regulation 16, no. 2 (2025): 744–52. https://doi.org/10.1017/err.2024.79.
Kohler, Jillian, Anna Wong, and Lauren Tailor. “Improving Access to COVID-19 Vaccines: An Analysis of TRIPS Waiver Discourse among WTO Members, Civil Society Organizations, and Pharmaceutical Industry Stakeholders.” Health and Human Rights 24, no. 2 (2020): 159–75.
Lal, Arush, and Nina Schwalbe. “Primary Health Care: A Cornerstone of Pandemic Prevention, Preparedness, Response, and Recovery.” The Lancet 401, no. 10391 (2023): 1847. https://doi.org/10.1016/S0140-6736(23)00963-7.
Lay, Kat, and Kat Lay Global health correspondent. “Are We Ready for Another Pandemic?” Global Development. The Guardian, January 2, 2025. https://www.theguardian.com/global-development/2025/jan/02/are-we-ready-for-another-pandemic.
Lazarus, Jeffrey V., Cristina Pujol-Martinez, Christopher J. Kopka, et al. “Implications from COVID-19 for Future Pandemic Global Health Governance.” Clinical Microbiology and Infection 30, no. 5 (2024): 576–81. https://doi.org/10.1016/j.cmi.2023.03.027.
Mahoney, Richard, Peter J. Hotez, and Maria Elena Bottazzi. “Global Regulatory Reforms to Promote Equitable Vaccine Access in the next Pandemic.” PLOS Global Public Health 3, no. 10 (2023): e0002482. https://doi.org/10.1371/journal.pgph.0002482.
Malik, Yashpal Singh, Kuldeep Dhama, and Raj Kumar Singh. “Emerging and Zoonotic Virus Challenges of Developing Nations.” The Open Virology Journal 12, no. 1 (2018). https://doi.org/10.2174/1874357901812010042.
Nadila, Sabrina. “KRISIS COVID-19: PERSPEKTIF HUKUM INTERNASIONAL TERHADAP PANDEMI: (Covid-19 Crisis: An International Law Perspective to Pandemics).” Majalah Hukum Nasional 50, no. 2 (2020): 261–80. https://doi.org/10.33331/mhn.v50i2.65.
“Ninth Meeting of the Intergovernmental Negotiating Body (INB) for a WHO Instrument on Pandemic Prevention, Preparedness and Response.” Accessed January 2, 2026. https://www.who.int/news-room/events/detail/2024/03/18/default-calendar/ninth-meeting-of-the-intergovernmental-negotiating-body-(inb)-for-a-who-instrument-on-pandemic-prevention-preparedness-and-response.
“Nipah Virus Infection - Bangladesh.” Accessed January 1, 2026. https://www.who.int/emergencies/disease-outbreak-news/item/2025-DON582.
“Pandemic Agreement Disahkan di WHA 78: Indonesia Tegaskan Komitmen Global untuk Ketahanan Kesehatan.” May 25, 2025. https://kemkes.go.id/id/pandemic-agreement-disahkan-di-wha-78-indonesia-tegaskan-komitmen-global-untuk-ketahanan-kesehatan.
“Pandemic Agreement Disahkan di WHA 78: Indonesia Tegaskan Komitmen Global untuk Ketahanan Kesehatan.” May 25, 2025. https://kemkes.go.id/id/pandemic-agreement-disahkan-di-wha-78-indonesia-tegaskan-komitmen-global-untuk-ketahanan-kesehatan.
Proposal for the WHO Pandemic Agreement. n.d.
Proposed Workplan, Meeting Schedule and Updates, as Appropriate, to the Method of Work. n.d.
Rosenau, James N., and Ernst-Otto Czempiel, eds. Governance without Government: Order and Change in World Politics. 1st ed. Cambridge University Press, 1992. https://doi.org/10.1017/CBO9780511521775.
Schwalbe, Nina, Susanna Lehtimaki, and Elliot Hannon. “The Pandemic Treaty: A Forensic Review of Process and Pitfalls.” Global Public Health 20, no. 1 (2025): 2522916. https://doi.org/10.1080/17441692.2025.2522916.
Sekalala, Sharifah, Shajoe Lake, Sarah Hodges, and Yureshya Perera. “Navigating Time Equity: Balancing Urgency and Inclusivity in Pandemic Treaty Negotiations.” PLOS Global Public Health 4, no. 4 (2024): e0003118. https://doi.org/10.1371/journal.pgph.0003118.
Sheerah, Haytham A., Shouq M. Alzaaqi, Ahmed Arafa, et al. “Navigating Hurdles: A Review of the Obstacles Facing the Development of the Pandemic Treaty.” Journal of Epidemiology and Global Health 14, no. 3 (2024): 580–85. https://doi.org/10.1007/s44197-024-00233-5.
Sheerah, Haytham A., Shouq M. Alzaaqi, Ahmed Arafa, et al. “Navigating Hurdles: A Review of the Obstacles Facing the Development of the Pandemic Treaty.” Journal of Epidemiology and Global Health 14, no. 3 (2024): 580–85. https://doi.org/10.1007/s44197-024-00233-5.
Sheerah, Haytham A., Shouq M. Alzaaqi, Ahmed Arafa, et al. “Navigating Hurdles: A Review of the Obstacles Facing the Development of the Pandemic Treaty.” Journal of Epidemiology and Global Health 14, no. 3 (2024): 580–85. https://doi.org/10.1007/s44197-024-00233-5.
Spicer, Neil, Irene Agyepong, Trygye Ottersen, Albrecht Jahn, and Gorik Ooms. “‘It’s Far Too Complicated’: Why Fragmentation Persists in Global Health.” Globalization and Health 16, no. 1 (2020): 60. https://doi.org/10.1186/s12992-020-00592-1.
Taylor, Luke. WHO Pandemic Treaty: Negotiations Falter as Pharma Companies Warn That Intellectual Property Rules Will Harm Profits. News. British Medical Journal Publishing Group, October 25, 2023. https://doi.org/10.1136/bmj.p2475.
Taylor, Luke. WHO Pandemic Treaty: Negotiations Falter as Pharma Companies Warn That Intellectual Property Rules Will Harm Profits. News. British Medical Journal Publishing Group, October 25, 2023. https://doi.org/10.1136/bmj.p2475.
“The Role of Civil Society in the International Negotiations on the Arms Trade Treaty - Whall - 2014 - Global Policy - Wiley Online Library.” Accessed January 2, 2026. https://onlinelibrary.wiley.com/doi/10.1111/1758-5899.12173.
Zero Draft of the WHO CA+ for the Consideration of the Intergovernmental Negotiating Body at Its Fourth Meeting. n.d.
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