The world has spent five years drafting its insurance policy against the next pandemic; it cannot, it turns out, agree to frame the certificate while it waits for the ink to dry. At the United Nations’ second High-Level Meeting on pandemic prevention, preparedness and response, objections from America and the European Union blocked endorsement of a political declaration that would officially recognise the World Health Organization’s Pandemic Agreement.
That agreement, in the works since 2021, sets out the principles and tools for co-ordinating a global response; the World Health Assembly adopted it in May 2025 by 124 votes to none, with 11 abstentions, according to Health Policy Watch. America was absent from the adoption, having announced its intended withdrawal from the WHO — an absence, Reuters reported at the time, that cast doubt on the treaty’s effectiveness. The UN declaration also called for finishing the agreement’s annex, the Pathogen Access and Benefit-Sharing System, designed to ensure the timely sharing of dangerous pathogens so that diagnostics, treatments and vaccines can be developed quickly. Amina Mohammed, the UN’s deputy secretary-general, called the system “critical to unlocking the full potential of the WHO Pandemic Agreement. There is no time to waste.”
Washington disagrees. “Whether it is the inclusion of divisive ideologies that lack definitional consensus or references to an unfinished negotiation on pathogen access and benefit sharing in an agreement that failed to achieve international consensus, the United States is not in a position to support this text,” Erica Schwartz, director of the Centers for Disease Control and Prevention, told the meeting, according to Health Policy Watch. The EU was more regretful but no more accommodating: the declaration, its representative said, offers useful elements yet “also contains setbacks toward our crucial, shared goal: a safer, healthier world for all.” Among its red lines is technology transfer, which Brussels insists must be voluntary and on mutually agreed terms.
The declaration is expected to return at a future General Assembly meeting. The split is telling: America objects to the ideology, Europe to the industrial policy, and each for reasons its voters would recognise. For a treaty whose worth will be proved only in a crisis, disunity at the ribbon-cutting is an ill omen.
America’s health agencies, at least, still have older foes to fight. The CDC and the Food and Drug Administration are investigating a multistate outbreak of E. coli infections linked to Graziers raw (unpasteurised) milk cheeses sold by Sierra Nevada Cheese Company of Willows, California. Thirteen cases in nine states have been identified, with eight patients hospitalised, including three with haemolytic uraemic syndrome, a severe complication that can cause acute kidney failure; no deaths have been reported, and over half of those sickened are under five. Three cases each were recorded in California and Nevada, with single cases in Oregon, Utah, Colorado, Michigan, Kentucky, Georgia and Tennessee, and onset dates from July 7th to August 26th. “The true number of sick people in this outbreak is likely much higher than the number reported,” the CDC cautions.
The cheese was sold at retailers nationwide, and it keeps. “This product has a long shelf life. Check your refrigerators and freezers for the recalled raw milk cheeses and throw them away,” the FDA urges — and if you kept the cheese but lost the packaging, throw it away anyway. Both agencies advise choosing pasteurised dairy over raw, especially for children under five.
For patients who do end up in hospital, timing can be everything. A study in JAMA Network Open of nearly 30,000 adults with community-onset bacterial sepsis at 67 Michigan hospitals found that 74% received antibiotics within the recommended three hours — and that how a patient presents helps determine whether they are among them. A fever recorded before hospital arrival raised the odds of timely antibiotics (adjusted odds ratio 1.34 with hypotension, 1.26 without); gastrointestinal symptoms lowered them (aOR 0.84 and 0.80); urinary symptoms nudged them up (aOR 1.13) and respiratory ones slightly down (aOR 0.91) in patients without hypotension.
The stakes are plain: among all 29,647 patients, timely treatment was associated with lower 30-day mortality — 18.9% against 21.0%, an adjusted difference of 2.1 percentage points. The authors’ remedy is “proactive screening for sepsis among patients with less obvious clinical presentations”. A disease that rewards suspicion and punishes delay is a fitting emblem for the week’s bigger quarrel: pathogens do not wait for consensus.