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The WHO, the pandemic agenda and Australian sovereignty
AMPS and the Australian Institute for Progress brought together Dr David Bell, Professor Ramesh Thakur and Katie Ashby-Koppens to examine the evidence behind the international pandemic agenda — and what Australia has already agreed to. Watch the full recordings and read the key points below.
What the event covered
Three presentations and an open panel, hosted jointly by AMPS and the Australian Institute for Progress.
The evidence base
Dr David Bell on the WHO, World Bank and G20 reports that governments rely on for pandemic policy, and what the underlying data in them actually shows.
Governance and sovereignty
Professor Ramesh Thakur on how global health governance expanded, why reform is so difficult, and what binding treaty obligations mean for national decision-making.
What Australia has agreed to
Katie Ashby-Koppens on Australia's WHO contributions, the 2024 IHR amendments, collaborating centres and the new Australian CDC.
Dr David Bell: the evidence behind the pandemic agenda
Public health physician. Co-chair of the International Health Reform Project, and co-lead of the University of Leeds project examining the evidence base behind the international pandemic agenda.
What he covered
Bell presented findings from two pieces of work. The first is a University of Leeds study, run with the University of Ghent, examining the primary and secondary sources behind WHO, World Bank and G20 messaging on pandemic risk. The second is the International Health Reform Project, an eleven-person panel he co-chairs with Professor Thakur, drawing on international law, public health, philosophy and experience inside international agencies.
His central claim was not that international cooperation on health is unnecessary, but that the specific evidence being put to governments to justify a large shift of health funding does not hold up.
Key points he made
- Infectious disease mortality has been falling globally for well over a century. On his reading of the data, COVID set that trend back to roughly 2008 levels and no further.
- Two WHO reports justify their focus on epidemics with a single graphic. Bell argued it omits the far larger plague, yellow fever, cholera and influenza outbreaks of 50 to 200 years ago, and that this meets the WHO's own definition of misinformation.
- The apparent exponential rise in outbreaks since 1960 coincides with the invention and rollout of PCR, antigen testing, serology and gene sequencing. His argument: what is being measured is detection capability, not disease.
- The G20 High Level Independent Panel's own evidence annex lists roughly 189,000 deaths from major outbreaks across two decades, against tens of millions from malaria, tuberculosis and HIV over the same period.
- The widely quoted figure of 2.5 million average annual pandemic deaths is arrived at by applying mediaeval bubonic plague mortality to today's population.
- Around 75 per cent of WHO funding is now specified by the donor rather than assessed from member states, which in Bell's view makes much of the organisation's work effectively work for hire.
Professor Ramesh Thakur: governance, sovereignty and the cost of the response
Global governance scholar, formerly inside the UN system under Secretary-General Kofi Annan. Co-chair of the International Health Reform Project.
What he covered
Thakur came at the question from global governance rather than medicine. Just as the UN sits at the centre of the normative architecture of world affairs, the WHO sits at the centre of global health governance — and his interest is in how that architecture is designed, funded and held to account.
He drew on long experience of UN reform processes to argue that the harder question is not whether international cooperation is worthwhile, but whether the returns on each new layer of bureaucracy, compliance and transaction cost actually justify it.
Key points he made
- 2.1 billion people still lack safe drinking water and 3.4 billion lack adequate sanitation. Thakur argued this, not pandemic preparedness, is where the great majority of WHO attention and resources belongs.
- COVID mortality was concentrated by region and by age. Asia, Africa and Oceania were substantially under-represented relative to their population shares, so a single global response distorted both the threat and the reaction to it.
- A systematic review of 132 peer-reviewed studies found between 75 and 90 per cent of unique lockdown outcomes were detrimental.
- 92 per cent of Australia's and 99 per cent of New Zealand's cumulative COVID-related deaths occurred after 70 per cent full vaccination coverage had been reached. His question to the room: “if this is COVID-19 vaccine success, what would failure look like?”
- He set out the human cost of lockdowns in low-income countries — lost daily wages, child trafficking, early marriage, domestic violence and suspended childhood immunisation campaigns.
- Treaty obligations are fixed while science evolves. He pointed to the International Court of Justice's climate advisory opinion as a template for how such obligations get carried into domestic law and become difficult to unwind.
- His own preference is a replacement health architecture rather than incremental reform: reform requires the consent of everyone already party to the arrangement, while a replacement needs only a coalition of willing states.
Katie Ashby-Koppens: what Australia has already agreed to
Lawyer, specialised in administrative law. She delivered a version of this presentation at Parliament House earlier in the same week.
What she covered
Where the first two presentations dealt with the evidence and the architecture, this one dealt with the paperwork: what Australia has actually signed, what it costs, and which domestic bodies are now tied to the WHO.
She worked through four things in turn — Australia's financial contributions, the 2024 amendments to the International Health Regulations, the WHO Collaborating Centres operating inside Australia, and the new pandemic agreement.
Key points she made
- Australia has contributed roughly $235 million to the WHO over three years: $100 million in voluntary contributions in September 2023, about $40 million in assessed contributions, and $15 million in aid funding. Compliance costs sit on top of that and are difficult to account for.
- The 2024 IHR amendments require each country to designate a National IHR Authority. She expects Australia's new Centre for Disease Control, established in 2026 at a cost of $251 million, to fill that role.
- Also carried in the amendments: digital health record sharing, real-time disease surveillance, enhanced public health surveillance, and obligations around risk communication and misinformation response.
- Australia hosts around 53 WHO Collaborating Centres, the most per capita of any country. FOI requests to the TGA and to AHPRA for their WHO arrangements have been refused, in AHPRA's case on commercial-in-confidence grounds.
- The pandemic agreement has been adopted but its final annex, the pathogen access and benefit sharing scheme, is still being negotiated in Geneva.
- The agreement makes the WHO the directing and coordinating authority in a future pandemic rather than an advisor, and creates a Conference of Parties.
Panel discussion
All three speakers, with questions from the room. Facilitated by the Australian Institute for Progress.
What the panel covered
The discussion ranged wider than the presentations. Much of it turned on a single practical question: if the current arrangements are not working, is the answer to reform the WHO or to build something alongside it?
Thakur set out a three-part answer. International cooperation does serve a purpose, but the architecture needs redesigning so it respects clinical decision-making at the individual level and sovereign decision-making at the national level. The United States can act unilaterally in ways no other country can, which makes it a potential catalyst but also brings political baggage. And logically, reform makes more sense than replacement — but the politics run the other way, because reform requires unanimity from parties with eighty years of accumulated interests.
Questions raised from the floor
- The Australian CDC's independence: attendees noted it has been described as independent of Parliament, raising questions about oversight, its FOI posture, and whether it can enter international arrangements separately from government.
- Non-government stakeholders in the CDC, and what industry involvement means for its priorities.
- Implications for Commonwealth and State responsibilities, given health is a State subject under the Constitution.
- WHO Collaborating Centres: Bell's view is that many do useful technical work, and the problem arises only when a centre becomes closer to the WHO than to its own national government.
- Whether a smaller grouping of like-minded countries would be a more practical route than reforming the WHO from within.
- Bird flu, culling policy and outbreak reporting, including the Canadian ostrich case.
- What people in the room can practically do next — the answer given was to take the analysis into policy debates at every opportunity.
These recordings and summaries present the views of the individual speakers. AMPS publishes them so members can consider the arguments and the source material for themselves. Figures and studies referred to are the speakers' own citations.
Key terms from the day
The International Health Regulations are a long-standing set of rules governing how countries report and respond to health events. They were amended in 2024 following COVID. Among the changes discussed on the day: each country must designate a National IHR Authority, and the amendments carry provisions on digital health record sharing, real-time disease surveillance, and risk communication including misinformation response.
A separate instrument negotiated after COVID. It has been adopted, but one annex — the pathogen access and benefit sharing scheme — is still being negotiated in Geneva and must be completed before the agreement opens for signature. Katie Ashby-Koppens noted that the agreement would make the WHO the directing and coordinating authority in a future pandemic rather than an advisor, and would create a Conference of Parties.
Pathogen Access and Benefit Sharing. It governs the terms on which countries share pathogen samples and genetic sequences, and what they receive in return — access to vaccines and treatments developed from them. On the day it was explained that the African Group and a broader Friends of Equity group, which includes Indonesia and several South-East Asian countries, have held out for better terms, which is why the annex remains unfinished.
An institution designated by the WHO to support its programmes and priorities, involving formal agreements and six-monthly reporting. Australia hosts around 53 of them, the most per capita of any country. The TGA is a collaborating centre for vaccines and biological medicines; AHPRA is one for health workforce regulation. Both have declined FOI requests for the underlying agreements.
A new national body established in 2026 at a cost of $251 million, modelled on the American CDC. It is expected to serve as Australia's National IHR Authority under the amended regulations. Questions raised from the floor concerned its stated independence from Parliament, its approach to freedom of information, its non-government stakeholders, and its relationship to State health responsibilities.
An eleven-person panel co-chaired by Dr David Bell and Professor Ramesh Thakur, drawn from several continents and from backgrounds in international law, international agencies, public health and philosophy. It has produced two main reports and a policy brief setting out principles for international health cooperation and assessing the WHO against them.
Neither of the two polarised options, in Thakur's framing. The panel did not accept that countries should sign on to everything the WHO recommends, nor that the answer is to withdraw entirely and defund the UN. Their position is that international cooperation serves a real purpose, but the architecture needs redesigning so that it respects clinical decision-making at the individual level and sovereign decision-making at the national level. Where reform is attempted, they argue it must be deep rather than incremental.
Read it for yourself
Full transcripts of each session, and the reports the speakers referred to. We publish the transcripts so the arguments can be checked against what was actually said.
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