Context:

• At the United Nations High Level Meeting (UN HLM) in New York, in September 2026, India made official remarks on the Political Declaration on Pandemic Prevention, Preparedness and Response (PPPR).
• This Declaration forms part of an emerging global legal regime on pandemics, led by the WHO Pandemic Agreement (PA).
• This article highlights India’s stakes in the emerging global pandemic governance framework, examining the WHO Pandemic Agreement, North-South divisions, PABS negotiations, national sovereignty and India’s role in promoting equitable access.

The Pandemic Agreement: Origins and Divide

• The PA was adopted by 124 member-states in 2025, including India.
• No country voted against it, while 11 abstained — reflecting broad alignment across high-, middle- and low-income countries (HICs/LICs/LMICs).
• Negotiations centred on balancing national sovereignty with international cooperation and solidarity, exposing clear fault lines between the Global North and Global South.
• Key Contested Issues
  • Whether a global treaty can set binding targets (e.g., for 'One Health' measures) without securing funding for countries with fragile health systems.
  • Whether national pandemic regulations can be harmonised through global frameworks.
  • Whether private manufacturers can be required to share vaccines in real time at affordable prices.

The Unfinished Piece: PABS

• The PA is not yet open for ratification, because negotiations continue on an annexe concerning the Pathogen Access and Benefit-Sharing (PABS) system.
• PABS aims to ensure that during a pandemic, LICs and LMICs receive a fair share of vaccines, medicines and other therapeutics.
• Even without ratification, the PA has already created a first-of-its-kind global legal regime for PPPR.
• Operationalisation will require countries like India to balance the interests of HICs, LICs, and LMICs — a balance that will determine whether the PA entrenches COVID-19-era inequities or makes global health governance genuinely inclusive.

India's Position at the UN HLM

• India succeeded in enshrining the multilateral components of the PA within the principle of national sovereignty, while reiterating its commitment to strengthening global pandemic preparedness.
• India's position rests on two pillars:
  • Equitable access to drugs, vaccines, and therapeutics, and the creation of global public goods such as digital infrastructure — priorities that also align with India's own national interests.
  • Respect for national sovereignty — the primacy of member-states in shaping global policy interventions according to their own circumstances.
• A contrasting stance: The United States rejected the Declaration, calling PABS and the WHO's role in declaring pandemics a challenge to its national interests — a sharp contrast to India's engaged, balancing approach.

Where the North-South Fault Lines Lie?

• India's remarks acknowledged concerns from both sides, with sovereignty invoked by each in different ways:
  • African countries did not consent to commitments for monitoring the human-animal-environment interface — a key source of pandemic outbreaks — without significant, guaranteed funding from the Global North.
  • Global North countries, conversely, resisted binding targets on technology transfer and similar provisions.
• India's framing at the UN HLM was direct: "Global Solidarity must be demonstrated through action."

India's Role Going Forward: Three Proposed Options

• Technical Partnerships
  • Develop partnerships in specific technical areas of the PA — One Health, surveillance, and health workforce strengthening — to build trust with Global South countries; and
  • Create a "store" of operational solutions to difficult sovereignty-related problems.
• Leveraging Existing Platforms
  • Using India's leadership role within established global groupings:
    • The H20 summit (a health and development partnership spanning G-7 and G-20) will convene under the UK's G-20 leadership at the end of 2027, with pandemic preparedness as a core health agenda.
    • India already holds significant influence here — during its own G-20 presidency in 2023, India launched the Global Initiative for Digital Health.
  • 'Partners for Multilateralism', launched in 2026 by the European Union (co-sponsors: Australia, Barbados, Brazil, Canada, India, Kenya), is another relevant platform.
• Strengthening Domestic Policy
  • Aligning India's own regulatory architecture — particularly around access to biological material and benefit distribution — with the highest standards of equity.
  • The underlying logic: global leadership rests on domestic strength; India must practise at home the equity it demands globally.

Why This Matters for India Specifically?

• An equitable global PPPR regime is framed as being in India's own interest, not merely a responsibility toward the Global South.
  • India is the "pharmacy of the world," manufacturing one of the largest shares of vaccines globally by volume.
  • Yet India needs an equitable global vaccine distribution regime itself — a seeming paradox explained by two structural dependencies:
    • Patents for many vaccines India manufactures are held by global pharmaceutical companies.
    • India remains import-dependent for Active Pharmaceutical Ingredients (APIs).
• What India Needs From the North: Access to the latest technology to strengthen domestic manufacturing of high-grade personal protective equipment and medical devices.
• What India Must Offer the South: Leadership in South-South Cooperation, sharing its technological strength with other Global South nations.

India's Health System as a Global Public Good

• India's health system operates at a continental scale, and its interventions in digital health infrastructure, laboratory networks, and One Health are valuable as global public goods.
• Hence, an effective PA needs an engaged India, and a strong PA will strengthen India's own pandemic management.