WHO’s Pandemic Influenza Preparedness Framework : A Milestone in Global Governance for Health

In May 2008, the World Health Organization (WHO) adopted the Pandemic Influenza Preparedness Framework for the Sharing of Influenza Viruses and Access to Vaccines and Other Benefits (PIP Framework). The PIP Framework’s adoption ended years of difficult negotiations, which began after Indonesia refused to share samples of avian influenza A (H5N1) with the WHO in late 2006. Indonesia justified its actions on the need to create more equitable access for developing countries to benefits, such as vaccines and antivirals, derived from research and development on shared influenza virus samples. The global health community feared that failure to share influenza virus samples would jeopardize surveillance and response efforts against the threat of pandemic influenza. The PIP Framework seeks to improve pandemic influenza preparedness by addressing virus and benefit sharing on an equal footing and establishing mechanisms to achieve more equitable access to benefits. To facilitate virus sharing, the PIP Framework encourages WHO member states to share influenza virus specimens. It also creates a virus tracking mechanism that features two standard material transfer agreements to increase transparency concerning the use of shared viruses. This mechanism represents the Framework’s most significant contribution to strengthening pandemic influenza surveillance and response. The Framework’s benefit-sharing system contains many components, but its most notable accomplishment for increasing equitable access to benefits is the pharmaceutical industry’s agreement to provide monetary and in-kind contributions. The PIP Framework is a landmark for global governance for health because it is the first international agreement facilitating influenza virus and benefit sharing. However, the Framework is not legally binding, avoids intellectual property issues that complicated the negotiations, does not include commitments from developed countries to donate portions of influenza vaccines they purchase, and faces implementation challenges in an increasingly difficult global health environment