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). The Declaration is part of the emerging global legal regime on pandemics led by the WHO-Pandemic agreement (PA).
Shaping the framework
The PA was adopted by 124 member-states in 2025, including India. No country voted against it, while 11 abstained, reflecting alignment across high-, middle- and low-income countries (HICs/LICs/LMICs). The negotiations hinged on how to balance national sovereignty with international cooperation and solidarity, exposing the fault lines between the Global North and the Global South. Key issues included whether a global treaty can set binding targets for measures such as ‘One Health’ without securing funding for countries with fragile health systems. Or whether national pandemic regulations can be harmonised through global frameworks. And whether private manufacturers can be required to share vaccines in real time at affordable prices.
The PA is not yet open for ratification because negotiations are still ongoing for an annex concerning the Pathogen Access and Benefit-Sharing (PABS) system. PABS could help ensure that, during a pandemic, LICs and LMICs receive a fair share of vaccines, medicines and other therapeutics.
Even without ratification, the PA has created a first-of-its-kind global legal regime for the PPPR. Operationalisation requires countries such as India to balance interests of the HICs, LICs and LMICs. This will determine whether the PA will further entrench the inequities of the COVID-19 pandemic or make global health governance truly inclusive.
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At the UN HLM, India succeeded in enshrining the multilateral components of the PA within the principle of national sovereignty. India reiterated its commitment to strengthen global pandemic preparedness but stressed that effective pandemic management requires that international coordination is demonstrated. The first is equitable access to drugs, vaccines and therapeutics and the creation of global public goods, such as digital infrastructure (which admittedly align with its own national priorities).
The second is a respect for national sovereignty and the primacy of member-states in shaping global policy interventions according to national circumstance. As a contrast, the United States rejected the Declaration, calling the PABS and WHO’s role in declaring pandemics as a challenge to its national interests.
India’s line
In its remarks, India has acknowledged the concerns of the Global North and the South. Both sides have upheld national sovereignty as paramount in several provisions. The African countries did not give consent to commitments to monitor the human-animal-environment interface, a key source of pandemic outbreaks, without significant funding, which was not guaranteed by the Global North. Similarly, countries in the Global North did not want binding targets with regard to technology transfer (and other similar provisions).
But as India said at the UN HLM, ‘Global Solidarity must be demonstrated through action’; India must be an active player in the finalisation of the global PPPR regime. India is already actively engaged in the PABS negotiations and must lead the Global South in the post-PABS context. India can consider three options. First, developing partnerships on technical areas of the PA (One Health, surveillance, health workforce strengthening) to build trust with other countries in the Global South, and a ‘store’ of operational solutions to tricky national sovereignty problems.
Second, leveraging its leadership role within existing global political groupings. For example, the H20 summit (a health and development G-7 and G-20 partnership) will take place under the United Kingdom’s G-20 leadership at the end of 2027; pandemic preparedness is one of the core health agendas. During India’s G-20 presidency in 2023, India launched the Global Initiative for Digital Health and holds considerable influence within the platform’s health initiatives. Another is ‘Partners for Multilateralism’, which was launched in 2026 by the European Union (co-sponsors are Australia, Barbados, Brazil, Canada, India and Kenya).
Third, strengthening and aligning domestic policy and regulatory architecture around its own priorities for the PA. Global leadership always rests on domestic strengths. India must ensure that its national policies on PPPR such as regulation of access to biological material and distribution of the benefits uphold the highest standards of equity which India can then demand at the global level.
A South-South health role
An equitable global regime on PPPR is in India’s interests as much as a responsibility towards the Global South. India is the pharmacy of the world, manufacturing one of the largest shares of vaccines in the world in terms of volume. Yet, it needs an equitable global vaccine distribution regime. The patents for the vaccines that India manufactures are held by global pharmaceuticals. India is also import-dependent for Active Pharmaceutical Ingredients (APIs).
India needs access to the latest technology from the Global North to strengthen the manufacturing of high-grade personal protective equipment and medical devices. At the same time, India needs to lead South-South Cooperation and share its technological strength with other countries in the Global South.
India’s health system has a continental scale, and as India’s Health Secretary stated at the UN HLM, its interventions in digital health infrastructure, laboratories networks and One Health are valuable as global public goods. An effective PA needs an engaged India, and a strong PA will strengthen India’s own pandemic management.
Priyadarshini Singh is a Research Fellow at the Centre for Social and Economic Progress (CSEP). This article is based on a forthcoming CSEP working paper on the Pandemic Agreement.
Published – October 08, 2026 12:08 am IST
