On June 15, on the eve of the G7 summit, Brazilian President Luiz Inácio Lula da Silva of the Workers Party (PT) and WHO Director-General Tedros Adhanom Ghebreyesus issued a joint open letter addressed to the leaders of the G7, G20, BRICS and “all nations.”

The letter’s stated aim is to press for the conclusion of negotiations on the Pathogen Access and Benefit-Sharing (PABS) Annex—the “final piece” needed for the WHO Pandemic Agreement, adopted in May 2025 at the 78th World Health Assembly, to enter into force.

With the next round of talks set for July 6–17, the outstanding negotiations center on the intellectual property provisions contained in the PABS Annex. The letter itself underscores their significance:

To respond to future pandemics in time, countries must be able to quickly identify pathogens with pandemic potential and share their genetic information and material so scientists can develop tools: the tests, the treatments, the vaccines that decide who lives and who does not. The system that makes this possible, fairly and on equal footing, is the PABS annex.

As the WSWS has extensively documented, the Agreement—whose adoption was originally slated for May 2024—is a hollowed-out instrument. Provisions that would have recognized the connection between environmental, climatic, social and economic factors and pandemic risk, along with international cooperation in scientific research aimed at pandemic preparedness, were stripped from earlier drafts.

The intellectual property provisions, which in the original proposal called for technology transfer to developing countries, were systematically gutted by the pharmaceutical industry. The International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) branded these provisions “damaging” and warned they would have “a chilling effect on the innovation pipeline for medical countermeasures.” German Health Minister Karl Lauterbach was blunter still: “For countries like Germany and most European countries, it is clear that such an agreement will not fly if there is a major limitation on intellectual property rights.” This record of the negotiations gives the lie to any characterization of the PABS Annex as a mechanism for international cooperation grounded in the fair and equitable sharing of benefits.

The industry and ministerial statements quoted above were reported by the World Socialist Web Site (WSWS) as the negotiations unfolded, and the retreat they signaled is documented, clause by clause, in the negotiating texts themselves. As Bill Shaw detailed, the passage from the October 2023 proposal to the March 2024 revised draft struck the clause requiring parties to recognize the impact of “environmental, climatic, social, anthropogenic and economic factors” on pandemic risk, removed the provisions that had envisioned a leading role for the WHO in directing scientific research, and reduced the obligation to “facilitate” technology transfer to a commitment merely to “encourage” it, subject to existing licensing restrictions. By the time the 78th World Health Assembly adopted the text in May 2025, every “shall” had been hedged with “subject to the availability of resources,” “as appropriate” and “where and as feasible,” and the instrument carried neither an enforcement mechanism nor any penalty for failure.

That assessment is shared, at least as to the facts if not the conclusions, far beyond the WSWS. The Lancet, in an editorial published before the talks had even concluded, called the emerging agreement “shameful and unjust.” The global health advisor Mohga Kamal-Yanni warned that its equity provisions were “inadequate and unnecessarily vague” and that language calling only for the promotion and encouragement of access had to be rewritten as binding obligation. Knowledge Ecology International judged the intellectual property provisions “well-intentioned but problematic.” Helen Clark, co-chair of the Independent Panel for Pandemic Preparedness and Response, warned that maintaining pure adherence to intellectual property protection in a pandemic will cost lives. Writing in the Journal of Law, Medicine and Ethics, the legal scholar Aisling McMahon reached the same conclusion from the perspective of the law, finding that the final text “leaves considerable discretion to states” over intellectual property, so that everything will turn on implementation, while the parties who decide who may use a patented technology, and on what terms, remain for the most part private, for-profit firms.

These critics part from the analysis advanced here on the question of the remedy. McMahon looks to voluntary conditions attached to public research funding, others to firmer language in the next negotiating round, all of them to the repair of a multilateral order that none of them proposes to overturn. Still, they establish that the incapacity of the Agreement is not a matter of interpretation. It was built into the text, clause by clause, in the interests of the pharmaceutical corporations and the governments that act on their behalf.

The simultaneous emphasis on national sovereignty—repeated throughout both the Agreement and the letter—means that division effectively prevails over cooperation. Subordinating international coordination to national sovereignty prevents the WHO from functioning as a genuine global health authority. As the letter itself puts it:

Nothing in the Agreement gives WHO any authority to direct or alter a country’s laws or policies, or to require measures such as lockdowns, travel restrictions or vaccination mandates. Those decisions remain with sovereign states.

In practice, this means every government retains the legal prerogative to disregard its international obligations and commitments whenever they conflict with its immediate political or economic interests. Within the framework of the imperialist crisis, data on pathogens and health responses are treated as strategic intelligence. Access to vaccines is wielded as geopolitical currency.

What is missing from this framework, and from the whole edifice of capitalist multilateralism, is any recognition that public health is by its nature an international condition. A pathogen recognizes no border, and the health of the population in any one country cannot be secured apart from the health of all. Genuine preparedness would demand that nation-states subordinate their interests to the needs of the global population, the very subordination that the profit system and the rivalry between capitalist powers make impossible. It is in this sense that the WHO has always been an instrument of capitalism, a body obliged to plead with governments over which it wields no authority and to package their competing appetites as cooperation. In the deepening breakdown of the postwar order, the organization now confronts its own crisis and, ultimately, its demise.

The underlying logic driving “cooperation” between states is made clear in the letter’s own citation of the IMF’s estimate of the toll of the COVID-19 pandemic: it “cost the world economy over thirteen trillion dollars in lost output, a loss borne in every nation, in shuttered businesses, broken supply chains and a generation of disrupted schooling.” In this context, it is worth recalling that when hospitals and morgues in New York City, the epicenter of the outbreak in the United States, reached their breaking point in March 2020, it was workers themselves who forced the initial shutdown of the economy, launching a wave of wildcat strikes that began on the shop floors of the auto plants and compelled the closure of workplaces across the country.

The Pandemic Agreement must be understood in this light: its priority is not the protection of life, but the construction of a framework that allows production to continue uninterrupted through future pandemics.

The context in which the letter was issued is itself telling. Lula attended the G7 summit—where the escalation of war was the central topic of discussion—as guest of honor. It was in this setting that Lula remarked casually to IMF Managing Director Kristalina Georgieva and German Chancellor Friedrich Merz, “I was never a leftist.” This statement is the perfect complement to the open letter: it signals to the real targets of the appeal—the imperialist powers and finance capital—that nothing fundamental will change.

Even as Lula and Tedros peddle a false “cooperative” solution built on reforming multilateralism, they cover up the real state of the imperialist crisis and their own role in sustaining this order, along with its policies of austerity and public-health negligence—subordinating human life to the imperatives of capital.

Under Tedros, the WHO prematurely declared an end to the public health emergency on May 5, 2023—a decision with no scientific basis, taken while repeated waves of infections and deaths continued for two more years, that abandoned fundamental public health principles and gave institutional cover to governments that had already abandoned any measure of containment.

When the Pandemic Agreement was adopted in 2025, the NB.1.8.1 variant was emerging in multiple countries. Today’s calls to conclude negotiations on the PABS Annex come precisely as fresh outbreaks of hantavirus and Ebola threaten global public health.

The escalating threat is driven by two connected developments. The first is the global expansion of capital, which pushes ever deeper into previously isolated ecosystems through deforestation, unplanned urbanization and climate disruption, breaking down the barriers between human populations and animal reservoirs and multiplying the conditions for zoonotic spillover. Both the Ebola and hantavirus outbreaks stem from such spillovers, which have been occurring with growing frequency, and mpox and avian flu have stoked mounting concern in recent years.

The second development is that, even as this danger is well understood, the institutions capable of containing it are being dismantled rather than strengthened. It is in this context that the response of the Trump administration, which withdrew the United States from the WHO and carried out sweeping cuts to international health programs, along with that of the WHO itself and of governments across the globe, has been rhetorical and political rather than substantive. The repeated and rapidly escalating outbreaks of Ebola, together with the emergence of a rare hantavirus on the global stage, are the expression of these developments.

Even as it acknowledges these factors, the Lula-Tedros letter lends credibility to the Wuhan lab-leak fraud. Its warning that “advances in biotechnology, matched unevenly by biosafety, raise the risk of accidental or deliberate release” is not a scientific observation but a political gesture, and a familiar one from this Director-General. Against the conclusion of his own Scientific Advisory Group for the Origins of Novel Pathogens, Tedros has repeatedly insisted that “all hypotheses must remain on the table, including zoonotic spillover and lab leak,” most recently in June 2025, when that same panel found the weight of the evidence points to zoonotic spillover. The letter’s language is a nod to the lab-leak current, a conspiracy theory manufactured by imperialism to justify its war drive against China.

They declare that “the world must finish what it started,” but they are not speaking of ending the current pandemic: they treat COVID-19 as a closed chapter and today’s outbreaks as a dress rehearsal for capitalism’s next homicidal response to the coming global pandemic.

The Lula government: attacks on health care and the consolidation of “forever COVID”

The Lula government has deepened the health crisis by consolidating the “forever COVID” policy, marked by the abandonment of universal vaccination and a blackout of public data. In February 2023, it reopened the country for Carnival before the WHO had even declared an end to the emergency. That same month, amid a fresh wave of infections, it stopped publishing daily pandemic figures, switching to weekly reports instead.

Under the imperative of the “new fiscal framework,” the government froze roughly R$2.8 billion (US$540 million) of the health budget between 2025 and 2026. On May 29, immediately after the vote to end the 6x1 work schedule in the Chamber of Deputies—the PT’s flagship social pledge for its reelection campaign—it announced a fresh freeze of more than R$22 billion for the 2026 budget, pushing the year’s total impoundment above R$23 billion and imposing a R$1 billion cut on health.

In 2025, Brazil posted its largest increase in military spending since 2001, with outlays surpassing R$130 billion. While war preparations are funded in the name of national sovereignty, public health absorbs fresh cuts.

The recent strikes in the health sector reveal both the government’s policy toward the sector and the resistance of the working class. Between March 30 and April 8, workers at the university hospitals run by the Brazilian Hospital Services Company (Ebserh) staged a national stoppage to demand the restoration of wages eroded by nearly a decade of inflation and the correction of distortions in the sector’s promotion rules. At the federal hospitals of Rio de Janeiro, workers waged one of the longest recent strikes in the health sector between 2024 and 2025, against the running-down of facilities, wage losses and precarious working conditions.

In April, the PT government inaugurated Brazil’s COVID-19 Pandemic Memorial. Its purpose is to symbolically bury the greatest health crisis of our time, honoring victims whose deaths could have been prevented, even as official policy continues to subject the population to ever-worsening public health conditions.

The WSWS’s extensive coverage of the pandemic has exposed the lies promoted by governments, institutions and the corporate media. SARS-CoV-2, the virus that causes COVID-19, continues to circulate year-round. New cases of Long COVID emerge with every wave of infection, disabling a growing number of workers of all ages, even as access to vaccination—which confers only limited protection—grows ever more restricted. The real toll is concealed by the dismantling of surveillance and testing.

The task of preventing future pandemics falls to the working class itself, which must reorganize the world economy on its own terms, placing social needs above private profit. This demands the building of an international socialist movement that fights for the global eradication of infectious disease as part of the revolutionary overthrow of capitalism.