In 2025, it often felt as if the world was tearing itself apart. Then, on 16 April at around 2 a.m. local time in Geneva, Switzerland, came a glimpse of unity. The 190-odd nations belonging to the World Health Organization (WHO) had reached a consensus on the draft text of the first global pandemic treaty. The fruit of more than three years of gruelling negotiations, the document lays out guiding principles for how the world should pull together to prevent, prepare for and respond to the next pandemic. “I’m overwhelmed, overjoyed,” said Precious Matsoso, who co-chaired the WHO group that steered the negotiation, that morning.
A large source of friction during talks was how to make a plan that would be more equitable than the response to the COVID-19 pandemic had been. The open sharing of samples and data on the spread and evolution of the SARS-CoV-2 virus enabled the development of life-saving treatments and vaccines. But those benefits were not shared equally between nations. Low-income countries were forced to wait for life-saving drugs, and high-income nations were accused of hoarding them.
Matsoso, an experienced figure in global health, was well placed to navigate the sometimes fractious negotiations. At several points in her career, she had helped to expand access to HIV medications, including as director-general of South Africa’s health department from 2010 to 2019. Based in Pretoria, she is currently at the Wits Health Consortium of the University of the Witwatersrand and has held various leadership roles at the WHO over the past two decades.
Steering the pandemic-treaty negotiation was punishing, says Roland Driece, a director at the Dutch health ministry in The Hague, who co-chaired the first 2.5 years of talks with Matsoso. “Everybody is unhappy with you because you never do what they want you to do,” he says. “You always try to find a middle ground.”
Matsoso used a variety of tactics to encourage compromise. At times, she had to be firm in the face of acrimonious debate. “I don’t want to hear anybody’s red line here,” she recalls saying. “I think you need to tell me: how are we going to solve this problem?”
But she also brought a warmth and originality to the process that Driece admires. On at least one occasion she sang to delegates: ‘All you need is love’ by the Beatles carried the message of cooperation. “I had to use every trick in the book to get them to get the work done,” she says.
Lawrence Gostin, a legal scholar at Georgetown University in Washington DC who advised the WHO on the treaty, says that her efforts were instrumental. “If it were not for her, we might not have a pandemic agreement.”
The text was formally adopted by national governments in May, but several challenges remain before it can come into force. Details in the contentious section about pathogen access and benefit sharing are still being hashed out by a dedicated working group and are due to be finished in May 2026. Then, for it to be fully binding, 60 countries must ratify the treaty, which could take months or even years.