Building Rights-Based Implementation After the Pandemic Agreement

Neiloy R. Sircar, Safura Abdool Karim, Roojin Habibi, and Benjamin Mason Meier

On May 20, 2025, the World Health Assembly adopted the Pandemic Agreement. Together, with the 2024 amendments to the International Health Regulations (IHR), these twin global health law reforms offer additional legal means to prepare for, coordinate during, and counteract pandemic threats. While reflecting multilateral health commitments amid rising international divisions, these reforms step back from human rights as a central foundation of global health governance.

COVID-19 exposed human rights vulnerabilities in global health governance: inequitable access to health goods, coercive emergency measures, and a failure to coalesce global solidarity. Addressing these vulnerabilities under the World Health Organization (WHO), early drafts of the Pandemic Agreement and IHR amendments incorporated human rights language, but these commitments diminished throughout intergovernmental negotiations, with the final text offering recognition of rights without obligations under law. Future reforms will be necessary to ensure rights-based implementation and accountability.

Why human rights still matter

Public health emergencies have repeatedly seen states backslide on human rights, using public health measures as pretext for human rights abuses. A human rights-based approach is essential to ensuring pandemic preparedness and evidence-based responses that protect health and dignity. Neglecting human rights undermines public health, as marginalized communities may be excluded and disease risks may be stigmatized.

COVID-19 responses challenged human rights through: inequities in access to healthcare systems that limited the right to health, invasive public health measures that restricted civil and political rights without adequate justification, extended lockdowns and other prevention measures that interfered with the realization of social and economic rights, and nationalist attacks on global governance that undermined extraterritorial rights obligations. These were not only ethical failures—they were legal violations of human rights obligations.

Despite these documented violations, global health law reforms retreated from rights-based frameworks—elevating less defined values of “equity” and “solidarity.” While important concepts, they lack the established history, normative clarity, and legal obligations of human rights law. These reforms ultimately maintain the status quo rather than addressing the human rights failures of the pandemic response.

Building rights back into Pandemic Agreement implementation

Rights advocates long cautioned that a Pandemic Agreement lacking adequate human rights safeguards is as likely to repeat the failures of the COVID-19 pandemic. Yet, while the development of the Pandemic Agreement remains inadequate, its implementation presents new opportunities for rights-based advancements by states parties, civil society, and international institutions.

The Pandemic Agreement’s COP (Conference of the Parties) will define the implementation process. The COP can clarify that state implementation must align with international human rights law, establish a human rights implementation working group to develop guidance for implementation, and develop reporting requirements that include human rights indicators—reflecting rights-based indicators of equity, participation, transparency, and accountability.

COPs can shape a treaty’s identity over time. As seen in the Framework Convention on Tobacco Control (FCTC), COPs have helped strengthen human rights foundations and opened doors for civil society inclusion. The COP of the UN Framework Convention on Climate Change evolved significantly over time, with the past decade seeing human rights integration that draws from civil society advocacy. Leveraging the COP for the Pandemic Agreement will be essential to realizing accountability for rights-based implementation.

Ensuring implementation through accountability mechanisms

Ambitious goals without clear accountability will hobble Pandemic Agreement implementation; however, the Pandemic Agreement lacks meaningful compliance mechanisms or independent oversight to ensure rights-based governance. In developing such accountability mechanisms, future COPs could adopt a protocol or annex establishing an ombudsperson focused on human rights––creating a mechanism for complaints about implementation that implicate human rights. As part of reporting processes, the COP could adopt a peer review model based on the Universal Periodic Review, offering mechanisms to monitor and review state actions during health emergencies.

Framing human rights accountability across global governance institutions, the Pandemic Agreement could be linked to existing human rights instruments. The preamble of the Pandemic Agreement already references several treaties and treaty bodies. In shaping health governance, these treaty bodies have increasingly treated implementation of instruments like the FCTC as evidence of state compliance with their human rights obligations. Similarly, these bodies can use reports on pandemic responses (from states or third parties) to link public health actions to rights commitments. While holding states accountable for human rights realization presents challenges, these existing models under international law offer a foundation to begin building accountability for equity and solidarity.

Strengthening bottom-up accountability

Such top-down reforms must be supported (and monitored) by bottom-up accountability. Where states fail to meet their obligations under the Pandemic Agreement, civil society advocacy can provide a powerful tool to demand rights implementation alongside state implementation. During the COVID-19 pandemic, civil society played a key role in tracking state abuses, disseminating public health guidance, and fighting for equitable access to health goods.

Advancing this advocacy under the Pandemic Agreement, civil society can:

• Push for inclusive COP processes and decision-making transparency
• Develop implementation indicators grounded in human rights law
• Monitor national pandemic plans and provide shadow-reporting on failures to uphold rights
• Leverage international forums to press states to implement human rights commitments in pandemic preparedness and response

Pandemic governance is no longer solely a state affair. The Pandemic Agreement itself recognizes the role of private actors and the need for whole-of-society approaches. Looking beyond pharmaceutical companies or philanthropic funders, civil society at all levels must counterbalance these powerful influences and ensure that rights are not lost in future negotiations. Where the Pandemic Agreement seeks to maintain public trust, civil society participation can cultivate public trust through state accountability.

Conclusion: Rights, not rhetoric

The Pandemic Agreement represents real progress for pandemic governance, but its potential will be defined by its implementation in the years to come. Human rights must extend beyond preambular language—they must shape how states prepare, respond, and recover. That means building rights into governance structures, providing external oversight, and empowering bottom-up accountability. The impact of global health law will be judged by how it upholds the most vulnerable—under the legal frameworks that will shape future pandemics. Rights-based implementation can make real the promise of global health law.

Neiloy R. Sircar is Adjunct Professor of Global Health and Human Rights, University of Minnesota School of Law, United States. Email:  sirca006@umn.edu.

Safura Abdool Karim is Adjunct Assistant Professor of Population and Family Health, Columbia University Mailman School of Public Health, United States.

Roojin Habibi is Assistant Professor of Law, University of Ottawa Faculty of Law, Canada.   

Benjamin Mason Meier^, is Professor of Global Health Policy, University of North Carolina-Chapel Hill Gillings School of Public Health, United States.