The US representative, Erica Schwartz, director of the US Centers for Disease Control and Prevention (CDC), declared that the Trump administration’s opposition was due to “the inclusion of divisive ideologies that lack definitional consensus” and “references to an unfinished negotiation on pathogen access and benefit sharing in an agreement that failed to achieve international consensus.”

The “divisive ideologies” were the declaration’s references to global solidarity and universal access to sexual and reproductive health care services, which the Trump administration had sought to strip from the text. The “unfinished negotiation” is the fight over who will profit from the vaccines and drugs developed in the next pandemic.