The Covid-19 pandemic provided the ultimate challenge for modern health systems around the world, exposing deep gaps in equity, co-ordination, and resource distribution. In response, the World Health Organisation (WHO), adopted the Pandemic Agreement in 2025, an international treaty designed to be legally binding upon states’ ratification.
While the framework was formally adopted, key operational systems, specifically the Pathogen Access and Benefit-Sharing (PABS) system, remain under active finalisation. The framework aims to strengthen global prevention, preparedness, and response to future pandemics and health emergencies through mechanisms such as pathogen sharing and equitable vaccine access, marking a historic moment in global public health.
Although the discourse of emergency preparedness and treaty negotiations are mainly dominated by large states with large populations and extensive resources, Qatar, despite its modest geographic size, emerged as a key actor in global health. By implementing a comprehensive domestic strategy to contain the coronavirus outbreak, while simultaneously providing significant support to other countries and international agencies, Doha demonstrated that smaller states can influence emergency preparedness and response.
In 2020, Qatar’s government pledged $10mn to the WHO to improve testing capacity, refining treatment protocols and techniques, developing and advancing vaccine research while also contributing $20mn to Gavi, the Vaccine Alliance, to ensure swift distribution of diagnostic tools and vaccines. At a time when global supply chain systems were severely disrupted, these donations enabled healthcare systems worldwide to have proper access to the needed interventions. These contributions stemmed from the fact that officials in Qatar considered the Covid-19 pandemic as “a measure of our shared humanity” and emphasized international co-operation.
Qatar’s efforts extended beyond addressing the immediate crises; engagement continued by institutionalising funding mechanisms. For instance, Qatar Fund For Development (QFFD), in 2021, signed a Core Contribution Agreement with the WHO providing multilateral and unearmarked funds for both routine operations and rapid deployment in emergencies for a period of two years. As a result, Qatar was one of the top 10 core contributors to the WHO within this timeframe.
Doha also played an essential role in strengthening surveillance systems, increasing frontline workforce capacity, expanding essential stockpiles, and developing digital monitoring infrastructures and platforms, all of which are central to the objectives of the pandemic accord. Such provision of consistent and strategic financial assistance from Qatar represents an example of moving from a reactive approach and project-based aid to systemic support that aligns with the priorities of the Pandemic Agreement.
As a result, Qatar’s efforts were highlighted by the WHO leadership, emphasising that regular financial contributions support the organisation's ability to mobilise resources promptly in response to new health-related threats.
Qatar is not alone in this effort. It stands alongside a broader group of small and medium-sized countries that advocated, contributed financially, and utilised their technical expertise to push for a more equitable treaty. For example, the Small Countries Initiative, a network of European states with populations below 2mn, emphasised the need for treaty provisions that address their unique needs, including enhancing the health workforce, access to medicine, and emergency preparedness in resource-limited settings.
Similarly, in the Pacific and Caribbean regions, island nations highlighted their vulnerabilities stemming from geographic locations, inadequate health care infrastructure and limited supply chains. This perspective added practical insights during the drafting of the treaty, so that ultimately, the document incorporates the different realities facing health situations around the world. The persistent efforts of such states have made it possible to reach a pandemic agreement that will build resilient health systems for everyone, not just the economically powerful countries.
Multilateral negotiations related to the development of the pandemic agreement took place via consultative processes that gave all members the chance to voice their demands and problems. The negotiations were spearheaded by the co-chairs from South Africa and France, aided by the vice chairs from Thailand, Egypt, Brazil, and Australia.
The geographical diversity of the leaders helped incorporate views from small countries into the treaty, such as equitable vaccine distribution and shared surveillance, among other issues. Small states thus ensured that, in addition to rapid responses, the framework would also address other upstream structural determinants of vulnerability to diseases.
With the Pandemic Agreement moving towards the finalisation of its annexes and eventual ratification, small and mid-sized nations are well-placed to play leading roles within implementation committees, oversight mechanisms, and technical working groups. With their collective financial, technical, moral, and grassroots inputs, particularly regarding data-led early warning systems, such states will be invaluable in turning pledges into tangible and improved global health outcomes.
(Dr Esmat Zaidan is Associate Professor and Associate Dean for Academic Affairs at Hamad Bin Khalifa University's College of Public Policy; Dr Diana Alsayed Hassan is Assistant Professor at Hamad Bin Khalifa University's College of Public Policy.)
* This piece has been submitted by HBKU’s Communications Directorate on behalf of its authors. The thoughts and views expressed are the authors’ own and do not necessarily reflect an official University stance.