MSF regrets that negotiations have not resulted in the adoption of a PABS system that ensures access based on enforceable benefit‑sharing obligations. Governments must continue negotiations and finalise a multilateral PABS framework enabling the Pandemic Agreement to enter into force.

Meanwhile, governments have the opportunity and responsibility to begin the groundwork now for early implementation through concrete actions, including binding access conditions on publicly funded R&D, guaranteed access for clinical trial participants and at-risk communities, transparent procurement practices, and fair allocation based on public health needs.

A more equitable system can begin today if governments choose to act on the commitments they have already made in the Pandemic Agreement.