Vaccine Diplomacy and Global Health Governance Reform After the Pandemic

Background: The unequal global distribution of COVID-19 vaccines highlighted structural inequities in global health governance, prompting ongoing negotiations toward a Pandemic Treaty within the World Health Organization framework that remained unresolved through 2023 and 2024 amid disagreements over technology transfer obligations. Aims/objectives: This research examines how vaccine diplomacy during the pandemic shaped subsequent multilateral negotiations on pandemic preparedness governance reform and equitable access mechanisms. Method: A qualitative analysis of WHO negotiation documents, bilateral vaccine donation records, and interviews with global health policy experts was conducted to assess negotiation dynamics through the most recent treaty drafting sessions. Results: Findings reveal that vaccine nationalism during the pandemic's acute phase undermined trust between high-income and low-income states, complicating subsequent negotiations over intellectual property waivers and technology transfer commitments central to the proposed treaty framework. Regional vaccine manufacturing initiatives in Africa and Southeast Asia emerged as partial responses to perceived dependency vulnerabilities. Conclusion: The study concludes that meaningful global health governance reform requires addressing underlying structural trust deficits exposed during the pandemic rather than procedural negotiation adjustments alone. Sustained investment in distributed regional manufacturing capacity is recommended to reduce future dependency on concentrated production hubs during health emergencies and to rebuild diplomatic trust eroded during the pandemic's unequal vaccine rollout period.

Keywords: vaccine diplomacy, global health governance, Pandemic Treaty, World Health Organization, health equity