Ramesh Thakur is one of Australia’s most distinguished and outspoken academics. A former United Nations Assistant Secretary-General and emeritus professor at the Australian National University, he has spent decades inside the machinery of multilateral institutions. That makes his sustained critique of the World Health Organisation’s pandemic architecture harder to dismiss as outsider polemic. Together with former WHO physician David Bell, he co-chairs the International Health Reform Project.
Their 2026 reports, The Right to Health Sovereignty, and Thakur’s own essays argue a simple, uncomfortable case: after Covid-19, the response has been to institutionalise the failures rather than correct them.
The unfinished Pandemic Agreement is the clearest example. Adopted in May 2025, it still cannot be opened for signature because the Pathogen Access and Benefit-Sharing annex remains incomplete.
On 13 November 2026, after another two weeks in Geneva, the WHO announced that member states had made “significant progress” and reaffirmed their aim to finish the annex by May 2027. Further formal sessions are already scheduled for January, February and March. The pattern is familiar.
Thakur has described the process with characteristic directness. “When an agreement becomes a proxy for institutional success that masks substantive disagreement over purpose and pathways,” he wrote in May, “the goal has shifted from ‘getting it right’ to simply ‘getting it done.’”
African and Equity Group delegations have said much the same: the obstacle is not time but the reluctance of richer countries to turn equity language into enforceable commitments on products, manufacturing and intellectual property. Developing countries are expected to share pathogen data – a genuine global public good – while the resulting vaccines and treatments remain contingent and largely controlled by manufacturers based in the Global North.
The North–South tension is not new. Thakur has compared it to the 1968 Nuclear Non-Proliferation Treaty, in which non-nuclear states accepted binding constraints while the nuclear powers’ disarmament obligation stayed vague and, fifty-eight years later, unfulfilled. “As the Americans say,” he noted, “fool me once, shame on you. Fool me twice, shame on me.”
The deeper problem is the mismatch between the architecture being built and the evidence of what actually happened.
Europe and the Americas suffered three to four times more reported Covid deaths than their share of world population; Asia and Africa were substantially under-represented. At the same time, the collateral damage of lockdowns – school closures that set back a generation, collapsed immunisation programmes, and sharp rises in extreme poverty – fell hardest on poorer countries.
UNICEF recorded the largest sustained decline in childhood vaccination coverage in thirty years. Prior to 2020 the WHO itself had rejected population-wide lockdowns as a pandemic strategy. That position was reversed without a clear, public evidence base.
Thakur’s argument is that a system built around the assumption of frequent, high-impact pandemics and uniform emergency measures will systematically misallocate scarce resources.
Proposed annual spending on pandemic preparedness has been put at around US$31 billion.
Independent analyses question the models that justify this scale, which often scale pre-modern mortality figures to today’s populations without adequate allowance for sanitation, nutrition, antibiotics or surveillance. Observed deaths from outbreaks between 2000 and 2019 were far lower. Meanwhile, malaria, tuberculosis and HIV continue to kill far more people in the places expected to contribute the most data and money.
WHO’s funding structure sharpens the concern.
After major traditional donors reduced support, the organisation became more dependent on a handful of large voluntary contributors, including the Gates Foundation and Gavi. Most of its budget is earmarked.
In a July 2026 briefing to Australian parliamentarians, Thakur put the institutional logic plainly: the WHO’s mission has shifted “from serving maximum global health outcomes in terms of the burden of disease around the world, to growing their own power, growing their own resources, growing their own authority… and that’s the way bureaucracies work.”
The alternative set out in the Right to Health Sovereignty reports is not isolation. It is subsidiarity: decisions taken as close as possible to the people affected.
As Thakur has written, “People bear primary responsibility for ensuring their individual health and states for protecting their populations’ health. International organisations exist to support states – not to replace or override them.”
Emergency powers must be proportionate to demonstrated risk and sensitive to highly different national disease burdens. Success is measured by contraction and redundancy, not by the permanent expansion of mandates and staff. Core medical ethics – beneficence, non-maleficence, confidentiality and informed consent – are restored as constraints rather than obstacles.
The Australian government has welcomed the Agreement, is participating in the annex negotiations, and has stated that it will retain full sovereignty over domestic public health decisions.
That claim will be tested by the final terms of pathogen sharing and benefit-sharing, and by any financing expectations that follow. The choice remains whether health governance is rebuilt around sovereign responsibility, or whether the emergency habits of 2020–23 are quietly normalised.
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