They won't cooperate on governance unless that changes
In Geneva, a gathering meant to strengthen the world's defenses against future pandemics has instead revealed the fault lines that run beneath global health governance. African nations, invoking the memory of vaccine inequity during COVID-19, have moved to slow American-led reforms to the International Health Regulations — not out of indifference to preparedness, but as a reminder that cooperation cannot be separated from justice. The procedural dispute is, at its heart, a reckoning with who bears the costs of global crises and who controls the rules written to manage them.
- A U.S. proposal to fast-track thirteen specific WHO regulatory reforms — including expert deployment powers and compliance monitoring — has been formally blocked by African delegations at the Geneva assembly.
- African nations, speaking through Botswana's Moses Keetile, insist that reforms must come as a unified package rather than piecemeal changes rushed through a two-week meeting.
- Beneath the procedural objections lies a harder demand: wealthy nations that hoarded vaccines and treatments during COVID-19 must offer concrete equity commitments before poorer countries will cooperate on governance reform.
- Russia has entered the fray with its own competing draft revisions, and a parallel pandemic treaty process is already straining negotiators — prompting warnings that too many overlapping platforms will produce decisions nowhere.
- With the full IHR reform process now expected to unfold over two years and the U.S. declining to comment, the assembly that promised consensus is closing as the opening act of a far longer and less certain negotiation.
The WHO's annual assembly in Geneva arrived with rare expectations: that member states might finally agree on concrete reforms to the International Health Regulations, the legal backbone governing how the world responds to disease outbreaks. The United States had put forward thirteen specific changes — technical in appearance but significant in ambition — including the power to deploy expert teams to outbreak sites and a new body to monitor compliance. Most consequentially, the U.S. sought to cut the timeline for future reforms from twenty-four months to twelve, betting that speed would be the decisive advantage in the next crisis.
African delegations, led by Botswana's Moses Keetile, rejected the approach. Their argument was procedural on its surface: reforms should not be rushed through in fragments but assembled into a comprehensive package and addressed together. The objection carried enough formal weight to potentially derail the proposal entirely — a striking outcome for a meeting that had little else to show as a concrete achievement.
But the deeper logic was strategic. Throughout the COVID-19 pandemic, wealthy nations secured vaccines and treatments while much of Africa waited. Diplomats in Geneva read the African bloc's resistance as leverage — a signal that cooperation on WHO governance would not come free, and that richer countries must first commit to more equitable sharing of medical resources in future emergencies. As one African delegate put it anonymously, some things simply cannot be rushed.
The assembly's difficulties were compounded by a parallel negotiation over a new pandemic treaty, which developing nations say is already stretching institutional capacity to its limits. Observers warned that the WHO risks building so many overlapping negotiating platforms that meaningful decisions become impossible anywhere. Russia's submission of its own competing draft revisions only deepened the complexity. What was designed as a focused two-week meeting now appears to be the prologue to a two-year process — one whose destination remains genuinely uncertain.
The World Health Organization's annual assembly in Geneva was supposed to deliver a rare moment of consensus on pandemic preparedness. Instead, on Tuesday, African nations threw a wrench into what many had hoped would be the meeting's signature achievement: a streamlined reform of the International Health Regulations, the legal framework that binds WHO members to respond to disease outbreaks.
The United States had proposed thirteen specific changes to these regulations. The reforms sound technical—authorizing the deployment of expert teams to contamination sites, establishing a new committee to monitor whether countries actually follow the rules. But the real prize was something simpler: accelerating the timeline for future reforms from twenty-four months to twelve. This procedural change, the thinking went, would unlock faster action when the next crisis hit.
African delegates, speaking through Moses Keetile of Botswana's health ministry, rejected the approach outright. They argued that reforms shouldn't be rushed through piecemeal. Instead, they said, all changes should be bundled together into what they called a "holistic package" and tackled later, as a complete unit. The objection was formal enough to potentially block the proposal from passing—a significant setback for a meeting that had few concrete deliverables to show for itself.
What's really happening beneath the procedural language is harder to see but more important. Diplomats in Geneva suggested that African nations are using their blocking power as leverage. During the pandemic, wealthy countries stockpiled vaccines and treatments while poorer nations went without. The African group, the thinking goes, is signaling that they won't cooperate on WHO governance reforms unless richer countries agree to more equitable sharing of medical supplies and technology in future crises. One African delegate, speaking anonymously, put it plainly: "We find that they are going too quickly and these sorts of reforms can't be rushed through."
The timing is awkward. Alongside the IHR negotiations, the assembly is also discussing a potential new pandemic treaty—a separate, parallel process that some developing countries say is already overwhelming. Nithin Ramakrishnan, a consultant for the Third World Network, noted the frustration: "The WHO has too many platforms for negotiation, and it is simply not manageable." The organization risks creating so many overlapping forums that nothing gets decided anywhere.
Russia has now submitted its own competing draft revisions, adding another layer of complexity. What was supposed to be a focused, two-week assembly is shaping up to be the opening act of a much longer drama. Officials expect the full IHR reform process to stretch across two years, with no guarantee of where it will land. The U.S. mission declined to comment on the African objections, leaving the American position unclear as negotiations continue.
Citações Notáveis
The African region shares the view that the process should not be fast tracked— Moses Keetile, deputy permanent secretary in Botswana's health ministry
The WHO has too many platforms for negotiation, and it is simply not manageable— Nithin Ramakrishnan, consultant for the Third World Network
A Conversa do Hearth Outra perspectiva sobre a história
Why would African nations block reforms that seem designed to make the WHO more effective at responding to disease?
Because effectiveness isn't neutral. The question is: effective for whom, and on whose terms? African countries watched wealthy nations hoard vaccines during COVID while they waited. They're saying they won't cooperate on governance unless that changes.
But wouldn't faster reform processes help Africa too, if another pandemic hits?
In theory, yes. But they don't trust that the rules will be applied fairly. They've seen it before. So they're using the only leverage they have—their vote—to extract concessions on the thing that actually matters to them: access to vaccines and drugs.
Is this likely to work?
Maybe. It's a multilateral process, so nothing gets forced through. But it also means nothing gets decided quickly. The whole reform could drag on for years.
What about Russia's competing proposal?
That's the real problem. Now you have the U.S. pushing one vision, Russia pushing another, and African nations saying they won't move until they get what they want. The assembly becomes a negotiation with no clear endpoint.
So the WHO leaves Geneva without a win?
Probably. And that matters because the next crisis is coming, and the organization will still be operating under rules designed before anyone understood what a global pandemic actually looks like.