The Drugs for Neglected Diseases initiative (DNDi) is pleased to announce the publication of its new policy report, Implementing Article 9.5 of the WHO Pandemic Agreement: Building on current policy and practice for publicly funded R&D, developed in collaboration with the Global Health Innovation Alliance Accelerator (GHIAA).

Public research and development (R&D) funding plays a central role in incentivizing and enabling the development of new health tools, as seen during the 2020-2023 COVID-19 pandemic. While public funding supported the development of urgently needed vaccines and other health technologies, countries also experienced vast inequities in access to these products, highlighting systemic flaws in how new health tools are developed and shared. These inequities cost lives and prolonged the pandemic.

The Pandemic Agreement, adopted by Member States during the World Health Assembly in May 2025, seeks to address these issues. Most notably, Article 9.5 of the Pandemic Agreement requires countries to develop and implement national or regional policies related to the inclusion of access provisions in public R&D funding arrangements for pandemic-related health products.

As one of the few binding ‘shall’ commitments in the Pandemic Agreement, Article 9.5 requires countries to develop and implement relevant policies rather than simply encouraging them to do so. It is the first time a binding approach like this has made it into an international agreement of this kind.

Informed by DNDi’s more than 20 years of experience negotiating access conditions into R&D partnerships, the report gathers examples of both well-established and newly emerging access practices that governments and public funding agencies can learn from, adapt, and build on as they set out to create their own policies. Bringing in examples from across the world, it examines:

• Existing policies and practices, organized around the five types of access provisions set out in Article 9.5, from Canada’s IDRC licensing guidelines and South Africa’s IPR Act to India’s ICMR pricing requirements, Malaysia’s and Mexico’s open science laws, and affordability obligations under Horizon Europe programmes Global Health EDCTP3 and the Innovative Health Initiative;

• How access planning can work in practice, including the US NIH Access Planning Policy, EDCTP3’s published access plans, and the first call for proposals from the Global Coalition for Local and Regional Production, Innovation and Equitable Access;

• Practical considerations for moving from policy to contract provisions, including passing access obligations through to downstream partners, monitoring and reporting requirements, and enforcement tools such as ‘step-in’ and ‘march-in’ rights;

• Recommendations and next steps for Member States, including reviewing and aligning existing national policies, consulting stakeholders, publishing model provisions, establishing phase-in periods, and building the infrastructure needed for implementation.

‘Despite governments being among the largest investors in medical research, there is currently no guarantee their citizens will get access to the medical innovations they help create,’ said Rachael Crockett, DNDi Senior Policy Advocacy Manager. ‘This is unacceptable at the best of times, but catastrophic in a pandemic. Article 9.5 gives countries a concrete opportunity to change this.’

‘The challenge now is implementation: turning this commitment into practical policies, funding conditions, and agreements that make equitable access part of how pandemic-related R&D is funded from the start. By attaching access conditions to public R&D funding, governments can help ensure that publicly funded innovation delivers not only new medical tools, but equitable access to them.’

Governments looking to create their own policies do not need to start from scratch. While there is no set formula they must follow, the building blocks do exist, and there are many examples to learn from. By starting this work today, we can ensure that publicly funded innovations reach the people who need them, in the next health emergency and beyond.

DNDi invites policymakers, funding agencies, researchers, and advocates to draw on these examples as they develop context-specific policies and implementation approaches for Article 9.5.