WHO and CDC: Preparing for the Next Pandemic

PANDEMICS ARE devastating public health emergencies that claim millions of lives, disrupt societies and devastate economies. These global outbreaks of diseases occur between every 10 and 50 years, making them hard to predict and hard to prepare for.

The last pandemic, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), or COVID-19, was declared by the World Health Organization (WHO) in March 2020 and was officially declared over in May 2023. While WHO’s 2009 Pandemic Influenza Preparedness and Response: A WHO Guidance Document¹ provided some guidance for the COVID-19 pandemic, it was obvious as the COVID-19 pandemic unfolded how unprepared the Member States were for this novel respiratory pandemic. After it ended, there were many lessons learned.

Therefore, while this latest pandemic was still fresh in the minds of the public, the healthcare industry and government agencies, WHO adopted a new Pandemic Agreement on May 20, 2025.² This new agreement is expected to address prevention, preparedness and response capacities to ensure communities, governments and sectors are better prepared and protected and to prevent and respond more equitably to future pandemics. According to WHO, this “Pandemic Agreement represents a global commitment to a more robust international health architecture, one that is grounded in equity, cooperation and shared responsibility.”³ It addresses many lessons learned from the COVID-19 pandemic, which includes identifying gaps, and it includes two new annexes: a Pathogen Access and Benefit Sharing (PABS) system and a Coordinating Financial Mechanism (CFM).

The Centers for Disease Control and Prevention (CDC) is also addressing new guidance for responding to the next pandemic, including data and analytics, laboratory capacity, domestic and global preparedness and response, and a Vaccines for Adults (VFA) program.

WHO’s New Pandemic Agreement

According to WHO, “At the heart of the [new Pandemic] [A]greement is the need to ensure equity in access to the tools needed to prevent and prepare for pandemics (including technologies like vaccines, personal protective equipment, information and expertise) and access to healthcare for all people.”⁴

The agreement addresses gaps, weaknesses and inequities in key areas that were witnessed during the COVID-19 pandemic, including:⁵

• prevention, preparedness and response arrangements;
• coordinated funding for pandemic prevention, preparedness and response; and
• mechanisms to increase equitable access to pandemic-related health products, including vaccines, therapeutics and diagnostics.

The agreement represents a global commitment by Member States to work together, as an international community of sovereign nations, to prevent, prepare for and equitably respond to pandemics so that individuals, communities and countries do not witness a repeat of what happened during the COVID-19 pandemic.

It also establishes principles, priorities and targets for pandemic prevention, preparedness and response, with the aim to:

• build resilience to pandemics;
• support prevention, detection and responses to outbreaks with pandemic potential;
• ensure equitable access to pandemic countermeasures; and
• support global coordination through a stronger and more accountable WHO.

“Equity is a key driver, principle and outcome within the new agreement,” say WHO. “The agreement promotes political commitment at the highest level, through ensuring an all-of-government and whole-of-society approach within countries, and sustained and sufficient political and financial investment within and among countries.”⁶

PABS and CFM

The Intergovernmental Working Group (IGWG), a subdivision of the World Health Assembly established by WHO’s Member States, was directed to develop two key components of the new Pandemic Agreement: the PABS system and the CFM.

PABS system. IGWG will draft an annex PABS system, which will be designed to ensure the transparent and equitable sharing of pathogen samples and genetic sequence data. The PABS system will be submitted to the 79th World Health Assembly in 2026 for its consideration. According to WHO, “The PABS system aims to enable safe, transparent and accountable access and benefit-sharing for pathogen materials and sequence information, as well as equitable, rapid and timely sharing of vaccines, therapeutics, diagnostics and other resulting benefits.”⁷

Under article 12 of the new Pandemic Agreement, the PABS system will provide that, “… each participating manufacturer shall make available to [WHO], pursuant to legally binding contracts signed with [WHO], rapid access targeting 20 percent of their real-time production of safe, quality and effective vaccines, therapeutics and diagnostics for the pathogen causing the pandemic emergency, provided that a minimum threshold of 10 percent of their real-time production is made available to [WHO] as a donation, and the remaining percentage, with flexibility based on the nature and capacity of each participating manufacturer, is reserved at affordable prices to [WHO].”

The PABS system also includes that “… the distribution of these vaccines, therapeutics and diagnostics shall be on the basis of public health risk and need, with particular attention to the needs of developing countries and the Global Supply Chain and Logistics Network ….”

The PABS system will also include additional benefit sharing provisions, including options for capacity-building and technical assistance; research and development cooperation; rapid access to available vaccines, therapeutics and diagnostics; nonexclusive licenses to manufacturers in developing countries; and the transfer of relevant knowledge, skills and technical expertise.⁸

CFM. IGWG will also develop a proposal for the terms of reference for the CFM. The CFM aims to improve the coherence, efficiency and transparency of global pandemic preparedness and response funding. According to WHO, “The [CFM] is to promote sustainable, predictable, inclusive and transparent financing for implementation of both the [new Pandemic] Agreement and the International Health Regulations (2005).”

The CFM will “… enhance, facilitate and work to remove barriers and ensure equitable, timely, rapid, safe and affordable access to pandemic-related health products for countries in need during public health emergencies of international concern, including pandemic emergencies, and for prevention of such emergencies.”⁹

Under Article 18, Sustainable Financing in the new Pandemic Agreement, sustainable and predictable financing will be strengthened, to the extent feasible, in an inclusive and transparent manner for the implementation of the WHO Pandemic Agreement.

The CFM will be “… established to promote sustainable financing for the implementation of the WHO Pandemic Agreement, to support strengthening and expanding capacities for pandemic prevention, preparedness and response, and contribute to the prompt availability of surge financing response necessary as of day zero, particularly in developing country parties.”

The CFM will “identify all sources of financing that are available to serve the purposes of supporting the implementation of the WHO Pandemic Agreement, and maintain a dashboard of such sources and related information and the funds allocated to countries from these sources,” as well as “leverage voluntary monetary contributions for organizations and other entities supporting pandemic prevention, preparedness and response, free from conflicts of interest, from relevant stakeholders, in particular those active in sectors that benefit from international work to strengthen pandemic prevention, preparedness and response.”¹⁰

According to WHO, “[The CFM] will be considered by the Conference of the Parties (COP) to the WHO Pandemic Agreement, which is expected following the ratification of the Agreement by national legislatures in at least 60 countries. The COP will define the CFM’s operational modalities within one year of the agreement entering into force.”

CDC’s Pandemic Guidance Changes

Based on lessons learned from the COVID-19 pandemic, the Centers for Disease Control and Prevention (CDC) is already preparing for the next pandemic. In its congressional testimony in November 2024, CDC outlined several items that will support public health’s core capabilities.

World-class data and analytics. CDC has made investments in modernizing public health and healthcare data and is moving toward a more secure, interoperable health data infrastructure. “We continue to identify novel data sources and strengthen mission-critical data sources such as electronic case reporting, syndromic surveillance, electronic laboratory reporting, vital statistics and hospitalization data,” says the agency. “These data are used to detect, understand and respond to the full spectrum of health conditions.”

In October 2024, CDC launched the One CDC Data Platform (1CDP) to leverage data across the entire agency as one team. “The goal of the 1CDP is to improve programmatic, scientific and response work using proven technology, common tools and shared data assets that enable programs and public health experts to act on data to improve health and help save lives,” says CDC.

The 1CDP platform sets a foundation for CDC data throughout the agency and builds on CDC’s Response Ready Enterprise Data Integration platform (RREDI). According to CDC, “RREDI pulls data from state, local, tribal and territorial partners and other sources into one common operating picture and enables HHS [U.S. Department of Health and Human Services], other response leaders and public health partners to analyze, visualize and share that data in real-time during a public health response.”

CDC also says it needs to continue to innovate and expand its analytical abilities: “We are doing this by generating forecasts and scenario models in our Center for Forecasting and Outbreak Analytics to extract as much information as possible from the available data. These forecasts and models deliver actionable analyses to guide decision-makers at all levels of government.”

State-of-the-art laboratory capacity. CDC’s scientists are working in laboratories across the United States and in countries around the world, building capacity for the prevention and control of diseases domestically and abroad, as laboratories are often the first to detect, identify and respond to health threats. “Modern, high-performing laboratories will prepare the CDC to detect emerging threats and react quickly in emergencies,” says the agency.

CDC will work closely with state and local public health entities, as well as clinical laboratory companies, which is critical to providing timely and actionable data to protect public health, particularly at the onset of emergency responses and testing surges. CDC has also implemented extensive quality control measures internally and expanded partnerships to support development and distribution of tests. This means companies will be developing new tests for public health response alongside CDC, an arrangement “… intended to help move testing to clinical laboratory companies, where most people get tested, with the ability to scale up quickly and early rather than during an emergency.”

Domestic and global preparedness and response. CDC is improving how it collects and shares key disease data by bringing together multiple data sources, such as emergency department visits, test positivity, wastewater surveillance, hospitalizations, deaths and vaccine uptake, into its Respiratory Illness Data Channel (RIDC). According to CDC, “… we will be collecting and analyzing vaccine effectiveness data which informs our vaccination guidance, decisions on vaccine production and vaccine purchases.”

Vaccines for Adults (VFA) program. Currently, there is no central system in the United States that supports streamlined and efficient access to vaccines for adults. With funding from Congress, CDC will create a VFA program that will a) support routine vaccination for uninsured adults in the United States and b) create a warm base for future vaccine administration in the event of another widespread threat: “Having a VFA program already in place will prevent CDC from having to build infrastructure from scratch when a new threat emerges. With a VFA program, public health entities will be able to more efficiently administer future vaccines, whether as routine, outbreak or pandemic-related immunizations.”

Data authority. CDC plans to improve public health data capabilities at all government levels: “As of October 2024, more than 45,800 healthcare facilities across all 50 states are delivering automated, real-time, electronic case reports — up from only 187 before the COVID-19 pandemic. And more than 80 percent of hospital emergency departments now provide syndromic surveillance data to the CDC.”

However, it says “86 percent of providers still use some form of manual reporting to share information with health departments, and only approximately 20 percent of providers use electronic case reporting. Updating CDC’s policy levers will support CDC and the nation in having better real-time situational awareness for the next potential threat.”

Wastewater surveillance. CDC is leveraging wastewater surveillance to support all public health entities to rapidly detect infectious diseases that are spreading in their communities. CDC also uses wastewater data as part of its Traveler-Based Genomic Surveillance program, a public-private partnership that anonymously monitors for infectious disease threats in international travelers at nine sentinel airports.¹¹

Better Prepared for the Next Pandemic

Neither WHO nor CDC know when the next pandemic will occur, or what the disease will be, but WHO expects its new Pandemic Agreement should provide the critical components that were missing from the 2009 Pandemic Guidance Document. And, both WHO and CDC anticipate the world will fare much better during the next pandemic than it did during the COVID-19 pandemic.