The Future of Access and Benefit-Sharing (ABS) in Global Health

Abstract The COVID-19 pandemic has served as the most recent reminder of the overwhelming disparities which exist between high-income countries (HICs) and low-and-middle-income countries (LMICs) with regards to their ability to access life-saving vaccines and other critical medical countermeasures. This is by no means a new phenomenon; LMICs have consistently faced significant health inequalities and injustices that have prevented them from being able to access the vaccines/medical countermeasures required to protect their populations during a health emergency – in either a timely manner or in sufficient quantities. The favoured solution to this problem within the global health landscape has been the use of both bilateral and multilateral transactional Access and Benefit-Sharing (ABS) agreements. The ABS transaction allows LMICs to ‘trade’ their sovereign genetic resources (pathogen samples) in exchange for access to the vaccines that are developed as a result, seemingly ensuring both timely access to pathogens on a global scale and equitable access to vaccines/medical countermeasures for LMICs. The ability of the ABS transaction to truly deliver on its objectives is somewhat questionable, however. After all, is there equity if access to vaccines/medical countermeasures needs to be purchased, bartered, or traded for? With a range of concerns existing throughout the literature, these questions are particularly pressing given the ongoing negotiations of the Pandemic Accord by WHO Member States and the likely development of a new multilateral pathogen ABS system. This case study therefore offers an insight into the development of the ABS transaction within global health, examining its origins and current use, in addition to its future in light of the ongoing negotiations. Information © The Author 2024