Hantavirus shows wisdom of South Africa’s position on pathogen access and benefit sharing

In recent weeks South Africans learnt about the hantavirus, after an outbreak on a cruise ship that had docked on the country’s shores. News spread that some passengers were very ill and that a small number of deaths had occurred due to the outbreak. Even so, ill patients were taken from the cruise ship, admitted to South African hospitals and provided with care. South African scientists immediately started mapping the genomic profile of the hantavirus pathogen causing the outbreak.

South African officials reached out to the World Health Organization (WHO) with data about the outbreak. They cooperated in international efforts to do contact tracing and repatriate ill patients to their countries. As they did when informing the world about the Omicron variant, South African scientists once again acted as responsible scientific citizens. Information about the pathogen and the outbreak was shared rapidly and transparently. Sick and symptomatic patients, as well as individuals potentially exposed to the virus, were treated with dignity and in alignment with a human rights-based approach to health. They were not stigmatised or prevented from accessing care.

The hantavirus outbreak brought back difficult memories of the Covid-19 pandemic for many people. It has also underlined the importance of ensuring the International Health Regulations and the Pandemic Agreement contain practical, specific and legally binding measures to promote equity and solidarity in pandemic preparedness and response. South Africa has been championing this mandate throughout the negotiations on the Pathogen Access and Benefit Sharing (PABS) Annex to the Pandemic Agreement. These negotiations were meant to conclude in time for a text to be presented to the 79th World Health Assembly, starting on 18 May 2026. However, this will not happen because countries participating in the negotiations could not agree on a final text to present to the assembly. This is a good thing.

Throughout the negotiations, but especially as the May 2026 deadline loomed, South Africa and the Africa Group have been under huge pressure from the WHO Secretariat, the European Union and Norway to agree to an unbalanced text, that if it were accepted, would offer little certainty of accessing vaccines, therapeutics and diagnostics during outbreaks, public health emergencies of international concern and pandemics. South Africa’s delegation, the Africa Group more broadly, and a group of mostly Global South countries known as the Group for Equity have repeatedly emphasised that pathogen access and benefit sharing cannot be uncoupled from each other.

These countries represent most of the world’s population. They are not opposed to sharing pathogens with pandemic potential but want to ensure anyone accessing pathogens and their digital sequence information (DSI) commits to sharing the benefits they generate from that research by signing a legally binding contract at the time of accessing pathogens or DSI. The Africa Group has argued that this should apply both to commercial actors (like pharmaceutical corporations and digital sequence information databases) and non-commercial actors (like public laboratories, universities or philanthropic foundations). The signing of contracts at the time of access brings legal certainty about benefit sharing. What are the Global South’s demands and what difference would these demands make in responding to health emergencies and pandemics?

• Guaranteed access to donations of vaccines, therapeutics and diagnostics during the early stage of a disease outbreak even before it becomes a pandemic: this would help contain transmission and prevent pandemics from occurring in the first place;
• Monetary contributions by users of accessing pathogens or DSI under the PABS system: these monetary benefits could be used to strengthen national and regional surveillance systems, which would enable more labs globally to share better-quality information, and to do so more rapidly, when outbreaks happen;
• The PABS system should have proper tracking and tracing measures for both biological materials and sequencing information and explicit rules governing onward sharing of pathogens as well as sequence information: this maintains biosecurity and anti-biopiracy safeguards, without unnecessarily restricting access to pathogens and sequence data;
• Access to all DSI of pathogens of pandemic potential is made only through databases that have contractual relationships with the WHO or through a database maintained by the WHO and have mandatory features such as user registration, account verification and data access agreements: this will allow the WHO to know which actors are accessing pathogens and therefore should commit to sharing benefits between and during health emergencies and pandemics; and
• Avoiding vague language around “capacity building” and insisting on meaningful benefits such as allowing the WHO to issue non-exclusive licenses to developing country manufacturers or to WHO-supported initiatives for regionally diversified manufacturing as well as other such benefits that will enable technology transfer and address the inequities between developed and developing country researchers in the current research and development ecosystems: this would allow manufacturers in the region or country to contribute health products needed to contain outbreaks, and to respond to health emergencies and pandemics without having to depend solely on the global supply chain.

South Africa has been important in defending these positions during the negotiations. A PABS Annex with the above guarantees will promote greater legal certainty on both access and benefit sharing in line with the international norms and standards set by the Convention on Biodiversity and the Nagoya Protocol. Further this would bring equity and the WHO would be able speedily secure and allocate pandemic products based on public health principles (rather than ability to pay). This is a system in which everyone stands to win – not only South Africa or the Global South.

A fair PABS system is a system worth fighting for. This is why it is important that a proposal will be tabled at this year’s World Health Assembly to continue the PABS Annex negotiations. Extending the negotiations allows WHO member states more time to create a more solidaristic and transparent legal framework for governing pandemic preparedness and response.

The hantavirus outbreak has once again shown that an outbreak never just affects one country. In a globalised world, it really is true that no one is safe unless everyone is safe. As a Guardian editorial recently argued, “the west’s fantasy negotiations have put the world at risk” and the hantavirus outbreak forces us to confront this. South Africa needs to uphold its position and not succumb to pressure from the WHO Secretariat and developed countries to accept an unbalanced PABS system which undermines sovereignty over genetic resources and equity. DM