Can New Delhi reconcile the global north and south?

An examination of the on-going negotiations around the WHO Pandemic Agreement reveals a stark reality: while COVID-19 demonstrated that a virus respects no borders, post-pandemic diplomacy has quickly retreated behind national lines. The United Nations High-Level Meeting in New York highlighted a growing geopolitical schism between the Global North and Global South. At the heart of this divide is a persistent structural injustice—low- and middle-income countries regularly share crucial pathogen genetic sequence data during outbreaks, yet find themselves locked out when multinational pharmaceutical companies monetize that data into patented, high-priced vaccines and therapeutics. This phenomenon, rightfully labelled “vaccine apartheid,” exposed the fragility of reliance on goodwill and voluntary mechanisms like COVAX. The Pandemic Accord was intended to replace charity with binding global obligations, yet its draft exposes how deeply entrenched commercial interests and sovereign anxieties remain.

The primary point of friction lies within the Pathogen Access and Benefit-Sharing (PABS) System and Intellectual Property rights. Developing nations entered negotiations demanding mandatory technology transfers, patent waivers, and strict TRIPS flexibilities to build decentralized, regional manufacturing capacity. Instead, the current language dilutes tech transfer to voluntary “mutually agreed terms,” preserving the status quo of high-income monopolies. Meanwhile, the technical annex governing PABS remains stalled because advanced economies and their powerful pharmaceutical lobbies resist committing to fixed, real-time allocations of emergency countermeasures for the World Health Organization to distribute. Unfunded mandates under the “One Health” framework further exacerbate this imbalance, burdening resource-constrained nations with costly wildlife and environmental surveillance without guaranteed financial support.

In this diplomatic deadlock, India occupies a uniquely pivotal position. As the “Pharmacy of the World,” India possesses both the high-volume manufacturing capabilities that high-income nations rely on and the lived experience of navigating global supply chain chokepoints. Through its Vaccine Maitri initiative, India demonstrated actionable global solidarity by shipping over 300 million doses across the globe when bilateral hoarding was at its peak. Furthermore, India’s deployment of open-source Digital Public Infrastructure—such as CoWIN and the Ayushman Bharat Digital Mission—offers a scalable, democratic model for health governance that requires no restrictive licensing or prohibitive costs.

To convert this credibility into structural change, India must act as an aggressive bridge-builder. First, New Delhi should lead a middle-ground compromise on the PABS framework: one that grants commercial viability to private innovators while legally locking in non-negotiable, guaranteed quotas of life-saving medical countermeasures for low- and middle-income nations during emergencies. Second, India should champion the uncompromised retention of the Doha Declaration on TRIPS and Public Health, ensuring no global treaty ever infringes upon a nation’s sovereign right to issue compulsory licenses in times of crisis. Simultaneously, India must expand South-South technical partnerships—exporting its digital health platforms as free global public goods and offering genomic sequencing expertise to build real-world capacity across Africa, Latin America, and Southeast Asia.

Ultimately, global health security cannot be built on the charity of wealthy nations or the unfettered market logic of corporate monopolies. Without a binding commitment to equitable access, the WHO Pandemic Agreement risks becoming another well-intentioned international instrument stripped of its enforcing power. By leveraging its manufacturing weight, digital innovations, and strategic posture across multilateral platforms like the G20 and BRICS, India has both the authority and the responsibility to shape a global health architecture where human life is prioritized over profit and geopolitical leverage.