Regional Organisations and the 2026 UN Political Declaration on Pandemic Prevention, Preparedness and Response

As world leaders prepare to adopt a new UN Political Declaration on Pandemic Prevention, Preparedness and Response (PPPR) on September 25th, this article examines whether the draft text adequately defines the role of regional public health organisations within the evolving global health architecture. While the declaration recognises the importance of regional capacities, particularly for research, manufacturing, and preparedness, it stops short of assigning clear governance responsibilities, financing mechanisms, and decision-making authority to regional institutions.

On 25 September, world leaders will gather in New York for the second UN high-level meeting (HLM) on PPPR. The UN describes the 2026 meeting as an opportunity to renew political commitment and action at the national, regional, and international levels.

Since the first HLM in 2023, WHO Member States have adopted amendments to the International Health Regulations in 2024 and the WHO Pandemic Agreement in 2025. The July 2026 draft declaration acknowledges these developments and includes more explicit language on regional preparedness planning and PPPR financing. Yet the division of responsibilities among national authorities, regional public health organisations, and global institutions remains insufficiently defined.

That gap matters because, at the same time, regional institutions are being given a more explicit place in a separate process to reform the global health architecture. On 31 August, Africa CDC announced that it had been selected to represent regional health organisations worldwide on the Joint Task Force on Global Health Architecture Reform. The organisation says its role includes bringing the perspectives of regional health organisations into the Task Force's deliberations, while representing the priorities of its 55 African Union Member States.

This invitation represents a progression from the draft political declaration on PPPR, providing Africa CDC with a seat at the table and a clear mandate and process by which to voice the organisation’s concerns within the discussions of how a reformed global health architecture is governed, coordinated, and financed.

What does the declaration actually say about regions?

Our review of the full draft political declaration placed under silence procedure on 28 July 2026, the latest complete version we could locate[1], shows that terms such as “region,” “regional,” “regionally,” and “subregional” appear repeatedly. Most references to the regional level appear within a three-part formula: “national, regional and international.” The preamble invokes “national, regional and international collaboration, cooperation, global solidarity and multilateral commitment,” while other provisions call for collaboration across countries and regions. These formulations recognise the regional level, but they do not clearly define distribution of responsibilities across levels.

The language becomes more specific in relation to research, development, and manufacturing. The declaration supports “geographically diversified regional research and development and manufacturing capacities” and calls for “regional targets including for local production.” Here, regional cooperation is connected to concrete capabilities and measurable objectives.

The contrast is sharper in preparedness planning and financing. The draft asks countries to develop national preparedness plans, while referring to regional plans only “where appropriate,” making regional planning less clearly expected. It also refers to the Pandemic Fund supporting national, regional, and global capacities, but does not assign regional organisations a specific coordinating mandate or establish a dedicated, predictable financing mechanism for regional functions.

The message, in effect, is that regions are welcome to manufacture and produce the health technologies they need, but not necessarily to plan, govern, or be funded as coordinating actors. In essence, the draft supports regional PPPR capabilities without specifying institutional responsibilities or dedicated funding.

A familiar gap between political commitment and governance

This is not the first PPPR declaration to leave implementation mechanisms underdeveloped. Writing about the 2023 HLM, Meier, Finch and Schwalbe described the meeting as a missed opportunity to translate high-level political commitment into stronger PPPR governance. Two years later, the 2026 draft retains some of the same characteristics, broad commitments, limited specification of institutional responsibilities, and a review process that may still leave substantial time between political commitments and assessment of implementation.

The issue is particularly important for regional organisations because they operate between national and global levels. They can support cross-border coordination, pool resources, facilitate technical cooperation, and represent shared regional priorities. But these functions require more than general references to “regional” action, they require clearly assigned responsibilities, authority to act, and sustained resources.

Why the Africa CDC example matters

Recent analysis has made a strong case for greater regional leadership in pandemic PPPR governance. A Lancet Global Health comment by Evaborhene and colleagues, for example, argues for stronger accountability through regional leadership and domestic political ownership, drawing on the expanded role of Africa CDC and its experience in responding to public health emergencies.

Our argument is somewhat different. Rather than asking whether a particular regional organisation has earned a larger role, we examine how the declaration itself structures regional responsibility. The draft is specific about some regional capacities, especially research, development, and manufacturing, but much less specific about the coordinating responsibilities and financing of regional public health organisations.

The Africa CDC's participation in the Joint Task Force offers a useful comparison because it demonstrates what institutional recognition can look like in practice, a named representative, an explicit purpose, and a process through which regional perspectives can be brought into global reform discussions. Africa CDC itself describes the role as representing regional health organisations while consulting them throughout the process.

From recognition to implementation

The draft political declaration is not without value. It reflects significant developments since 2023 and gives greater attention to regional capacities, including research, manufacturing, preparedness planning, and financing. The challenge is to ensure that these commitments can be implemented through a clear division of responsibilities across national, regional, and global levels.

Three areas deserve particular attention during implementation. First, regional organisations need clearly defined coordinating responsibilities within PPPR, especially where outbreaks and preparedness needs cross national borders. Second, regional functions require predictable and sustainable financing rather than being left entirely within broad references to existing funds. Third, regional organisations need meaningful political participation in setting priorities, implementing commitments, and assessing progress.

The 2026 HLM and the WHO Joint Task Force process are unfolding at the same time, creating an opportunity to strengthen coherence across these efforts. The UN has emphasised that the HLM is intended to mobilise political will and action at national, regional, and international levels. The Africa CDC Task Force example shows that regional institutions can be given a formal place within global health reform processes.

The next step is to translate recognition into institutional arrangements: clearly assigned responsibilities, sustained support, and meaningful participation in decision-making. Regional organisations should not simply appear in the language of PPPR commitments, they need both the means to fulfil their responsibilities and a seat at the table that carries decision-making authority and voting rights.

[1] A Health Policy Watch report published on 19 August indicated that further edits had been made, including a shorter implementation review timeline, although a complete revised text had not yet surfaced at the time of writing.