“Essentially, 2–3 people may have unfortunately died from a virus that has probably existed at least as long as humans,” wrote David Bell two days ago, a former WHO physician and public health scientist. “The news story is that it was made into an international news story. Yesterday, about 4,000 people died of TB, and 2,000 children died of malaria. The same news services missed it.”
Bell is right. The real story is not the outbreak aboard the cruise ship MV Hondius. The real story is that within days, it became international news. But perhaps even more interesting is the precise timing of this story.
The first cases aboard the vessel, which some media outlets quickly labeled the “virus ship” or even the “plague ship” – appeared in early April, shortly after the ship departed from Ushuaia, Argentina, on a voyage that was expected to include Antarctica and the Atlantic Ocean.
According to an official World Health Organization report, one passenger began developing symptoms on April 6 and died on April 11. In the days and weeks that followed, additional illnesses, deaths, and medical evacuations were reported.
On the surface, an international cruise ship experiencing serious illnesses and deaths during a voyage would seem destined to become an immediate global news story. But that did not happen.
Only weeks later, on May 1, the story suddenly received intense international coverage. Within a short time, headlines around the world warned of a “plague ship” at sea, passengers from 23 countries under monitoring, quarantine measures, and fears of human-to-human transmission.
After the Covid years, and the way the crisis unfolded in early 2020, the sense of déjà vu was almost unavoidable. An isolated cruise ship, passengers effectively trapped at sea, international monitoring, uncertainty about transmission, and the possibility that a localized event could evolve into a cross-border crisis.
That imagery remains deeply embedded in public memory because of the story of the Diamond Princess at the beginning of the Covid pandemic. The world followed the ship almost in real time as it became a kind of microcosm of global anxiety.
The Diamond Princess was one of the defining moments in which Covid shifted from a distant and ambiguous event into a global drama unfolding live before the world.
This time, the timing is particularly striking. On May 1, three days before the MV Hondius story received widespread international media attention, the World Health Organization announced yet another one-year delay in negotiations over the PABS annex of the Pandemic Agreement.
On the surface, this may appear to be just another technical delay within a cumbersome diplomatic process. In reality, however, it reflects one of the most significant crises the WHO has faced in the post-Covid era.
The dispute over PABS is far more than a bureaucratic disagreement. It is a symptom of a much broader and deepening crisis of trust surrounding the very idea of centralized global pandemic governance.
The WHO’s Deeper Crisis
To understand why the timing of the MV Hondius story is so striking, one first has to understand the position in which the World Health Organization now finds itself.
The WHO’s May 1 announcement of yet another one-year delay in negotiations over the PABS annex was far more than a routine diplomatic setback. It amounted to an acknowledgment that one of the organization’s central post-Covid projects – a project with enormous international implications, has become stalled in a deep political and institutional deadlock.
At first glance, PABS – short for Pathogen Access and Benefit-Sharing – sounds like a technical mechanism. In reality, it lies at the heart of the broader conflict surrounding the Pandemic Agreement itself: who controls access to pathogens, genetic sequence data, and the technologies developed from them. This is a domain in which science, geopolitics, finance, and public health governance become deeply intertwined.
Covid exposed a profound divide between wealthy countries and developing nations regarding vaccines, manufacturing technologies, and access to medical resources. Many countries in the Global South argued that they rapidly shared genetic data and biological samples, yet when vaccines and new technologies were developed, control over production, patents, and profits largely remained in the hands of Western governments and pharmaceutical companies.
The PABS annex was intended to address this imbalance: countries would share pathogens and genetic data in real time, and in return would receive more equitable access to vaccines, medicines, and medical technologies. But the reality is far more complicated. In an era of mRNA platforms and advanced molecular biology, genetic sequence data itself has become a strategic asset. Once a country shares the genetic sequence of a novel pathogen, it is effectively providing the essential substrate for future vaccines, therapeutics, diagnostics, and potentially broader technological platforms.
This is why negotiations over PABS quickly evolved into a geopolitical and economic struggle extending far beyond the technical question of pandemic preparedness itself.
Developing countries are demanding technology transfer, local manufacturing capacity, and faster access to medical countermeasures. Western governments and the biotechnology industry fear damage to intellectual property protections and to the economic model underpinning biomedical innovation.
Without agreement on PABS, the Pandemic Agreement risks becoming largely declarative and practically toothless. And this is precisely why the repeated delays matter so much for the WHO. The agreement is not merely a public health initiative. It is also, perhaps above all, an effort to restore the organization’s standing after Covid and to strengthen its institutional authority within global health governance.
For decades, the WHO was generally perceived, and formally defined, as a professional coordinating body: an organization that issued recommendations, centralized information, and assisted countries during outbreaks.
During Covid, however, the organization assumed a far more influential role than ever before in shaping domestic pandemic responses, including lockdowns, movement restrictions, vaccination policies, emergency regulations, and surveillance frameworks.
Officially, the WHO continued to describe itself as an advisory body. In practice, however, its recommendations often became the framework within which governments defined their emergency policies – policies that later contributed to profound economic and social disruptions, as well as a significant erosion of public trust in health institutions, governments, and even scientific authorities themselves.
The Pandemic Agreement, together with other mechanisms the WHO has been developing in recent years, reflects a broader process of institutional expansion: from an advisory organization toward one seeking stronger transnational coordinating and regulatory influence in future global health emergencies.
It is against this backdrop that the current crisis began to emerge – not only between the WHO and segments of the public, but increasingly between the organization and member states themselves.
The debate has gradually shifted from narrower questions, such as whether the WHO responded quickly or effectively enough to a particular outbreak, to far deeper issues: how politically independent the organization truly is; how dependent it has become on private philanthropic funding and powerful institutional actors; how much influence an unelected international body should exert over the domestic policies of sovereign states; and to what extent the expansion of its authority through the Pandemic Agreement and related mechanisms could affect national sovereignty and policy autonomy.
This crisis is no longer theoretical. In January 2026, the United States became the first country in history to formally withdraw from the World Health Organization since its founding in 1948. The Trump administration justified the move by citing the organization’s conduct during Covid, concerns over transparency, and what it described as an excessive concentration of authority in international institutions.
Shortly afterward, Argentina’s withdrawal also took effect, framed by its government as part of a broader struggle for “health sovereignty.”
Even countries that have not withdrawn are signaling growing discomfort. When the Pandemic Agreement was adopted at the World Health Assembly in May 2025, eleven countries abstained, including Israel, Poland, Italy, the Netherlands, Russia, and Iran.
What matters here is that these countries do not represent a single ideological bloc. They differ profoundly in their political systems, strategic interests, and worldviews. What they share is a growing unease over the expansion of centralized global health governance.
This is why the delay surrounding PABS carries significance far beyond a technical negotiating dispute. It reveals a much deeper fracture: an erosion of trust surrounding the very idea of centralized global pandemic governance itself.
And it is against this backdrop, as the WHO faces one of the most serious legitimacy crises in its history, that another “plague ship” suddenly emerges at sea: passengers from dozens of countries, global monitoring, uncertainty surrounding transmission, and a narrative structure strikingly reminiscent of the opening stages of Covid.
It is difficult to imagine a more effective narrative illustration of a message the WHO has increasingly emphasized since Covid: that infectious diseases do not respect borders, and that without stronger international coordination mechanisms, the world risks once again being unprepared for the next pandemic.
“Disease X:” When the Future Becomes a Permanent Emergency
The term “Disease X” first appeared in WHO documents in 2018 as part of the organization’s R&D Blueprint for diseases with pandemic potential.
Officially, the concept was entirely technical: a placeholder term for an unknown future disease – a pathogen not yet identified but potentially capable of causing a global pandemic. The idea was rooted in the argument that outbreaks such as SARS, Ebola, Zika, and later Covid-19 demonstrated how vulnerable the world remains to unexpected epidemics and how unprepared health systems often are when such crises emerge.
That framing, however, is itself contested. Many countries, including Israel, already possessed pandemic preparedness plans and emergency-response frameworks prior to Covid, many of which were only partially implemented during the crisis. Nevertheless, the broader logic of preparedness appears, at least on the surface, difficult to dispute.
But “Disease X” was never merely a technical term. More fundamentally, it embodied a broader worldview: the idea that public-health systems should organize themselves not around a specific existing disease, but around the permanent possibility of an unknown future threat.
This approach transformed the meaning of preparedness itself. No longer simply emergency stockpiles or contingency plans, preparedness increasingly came to mean the construction of a permanent infrastructure of surveillance, genetic data sharing, emergency regulation, rapid-response vaccine platforms, and global coordination mechanisms designed to operate before anyone even knows what the next threat might be.
After Covid, this logic quickly translated into concrete initiatives and institutional mechanisms: from expanding genomic databases and international surveillance systems to projects such as CEPI’s “100 Days Mission,” which aims to develop a vaccine within roughly 100 days of identifying a novel pathogen.
What makes the “Disease X” framework so powerful is its flexibility. It does not refer to one specific disease, but to an open-ended framework broad enough to encompass almost any unusual biological event: a novel virus, animal spillover, a mysterious cluster of infections, or virtually any outbreak involving uncertainty and international dimensions.
In a deeply interconnected world, almost any outbreak can potentially be interpreted through this framework.
This framework influences not only how institutions prepare for future crises, but also how such events are publicly constructed and communicated. And the outbreak aboard the MV Hondius provides a striking example.
Although hantavirus is not among the central pathogens featured in the WHO’s Disease X framework, the outbreak nevertheless fits remarkably well into the narrative template that has emerged in recent years around the idea of “the next pandemic.”
Epidemiologically, however, hantavirus differs profoundly from SARS-CoV-2. It is not readily transmissible through airborne human-to-human spread. Rather, it belongs to a well-known family of zoonotic viruses typically transmitted from rodents to humans through exposure to saliva, urine, or feces.
The Andes strain, which according to reports was identified in at least some passengers aboard the cruise ship, is primarily associated with South America. In rare cases, limited human-to-human transmission has been documented, usually involving prolonged close contact.
In other words, this outbreak differed substantially from Covid in epidemiological terms Yet in narrative terms, it fit almost perfectly into a now-familiar pandemic script: a rare zoonotic virus, scientific uncertainty, and the possibility, however limited, of human-to-human transmission.
Add passengers from multiple countries and an isolated ship at sea, and the result is a scenario almost perfectly designed to evoke the imagery of an emerging global pandemic.
In our book Risk Communication and Infectious Diseases in an Age of Digital Media, Anat Gesser-Edelsburg and I examined how public-health campaigns surrounding epidemics are shaped not only by epidemiological data, but also by narratives, imagery, and the activation of collective memory.
The narrative of an “isolated ship at sea” almost immediately activates the same cognitive and emotional template formed in early 2020. Such narratives reinforce the incentives of nearly every institution involved in circulating them – international organizations, public-health systems, biotechnology industries, and the media ecosystem itself.
A continuing narrative of “the next threat” helps sustain large-scale funding commitments, expand emergency infrastructures, broaden surveillance systems, and accelerate regulatory and technological pathways. This dynamic has become especially visible in the post-Covid era, in which preparedness itself has evolved into a vast institutional and economic sector.
The more global and unpredictable a threat appears, the more authority flows toward institutions claiming the ability to manage it. Within such a system, even relatively limited epidemiological events – as David Bell correctly observed – can rapidly acquire symbolic and political significance far beyond the scale of the outbreak itself.
Emergency as an Operating Model
For decades, medical regulation was based, at least officially, on the assumption that the development of drugs and vaccines required a relatively slow and cautious process. The time needed for clinical trials, data collection, and long-term safety monitoring was considered essential for evaluating both efficacy and risk.
Covid altered that framework dramatically. Within months, health systems, regulators, and the pharmaceutical industry reorganized themselves around the principle of speed. Once a novel pathogen was identified, the central pressure was no longer simply to understand it, but to compress as much as possible the time between detection, product development, authorization, and distribution.
Emergency gradually ceased to be viewed as a temporary condition and became an operational framework.
Emergency regulatory pathways quickly evolved from rare exceptions into central mechanisms of global pandemic response. Manufacturing during clinical trials, accelerated authorization procedures, and the distribution of medical products under conditions of still-limited clinical evidence increasingly became normalized.
One of the key mechanisms the WHO has developed within this rapid-response model is the Emergency Use Listing (EUL) system. Officially, the mechanism is intended to accelerate access to medical products during public-health emergencies, particularly in countries lacking strong independent regulatory systems.
In practice, however, the EUL framework has given the WHO growing influence over international authorization, procurement, and distribution processes for medical products. The result is a system in which the same institution that declares global health emergencies and emphasizes the threat of future pandemics also plays an increasingly influential role in determining which medical products receive accelerated international deployment during those emergencies. The result is that a single institution increasingly shapes both the definition of global health emergencies and the mechanisms used to respond to them.
Around the idea of “the next threat,” a broader ecosystem gradually emerged in which emergency mechanisms and rapid-response technological platforms reinforce one another. The more rapid response became a central organizing principle of global health policy, the greater the demand for accelerated regulatory pathways and technologies capable of developing and distributing medical countermeasures at unprecedented speed. Technologies capable of delivering that kind of speed quickly became strategically and economically valuable.
mRNA platforms fit almost perfectly into a system organized around principles of emergency response and rapid adaptation. Unlike the older vaccine-development model, in which each product was developed individually over many years, mRNA platforms are built around an entirely different logic: a generic technological platform that can be relatively quickly adapted to different pathogens simply by changing the genetic sequence.
Moderna may represent the clearest example of this shift. The company was not originally built around one specific vaccine or disease. In fact, for years it had no approved commercial product at all. What it offered investors was the promise that the same technological platform could eventually be rapidly reprogrammed for multiple pathogens.
This is where hantavirus re-enters the story. As early as September 2023, Moderna announced a collaboration with South Korea’s Vaccine Innovation Center-Korea (VIC-K) to develop mRNA platforms targeting hantaviruses. During 2024, the collaboration expanded into what was described as a “full-scale collaboration,” and by early 2025 preliminary preclinical animal-study results were already being reported.
At present, however, these developments remain at a very early stage. Hantavirus is not generally regarded as a pandemic-scale threat comparable to SARS-CoV-2, and no approved vaccine currently exists.
But in the post-Covid landscape, the mere existence of a potential future threat has itself become part of the strategic value of platform technologies. In that sense, the MV Hondius outbreak was quickly folded into an existing ecosystem of pandemic preparedness and rapid-response technologies.
At the same time, media articles quickly began describing the outbreak as another “wake-up call” underscoring the need to accelerate the development of hantavirus treatments and vaccines, despite the fact that such technologies remain in relatively early stages of development.
The platforms themselves already existed. What events like the MV Hondius outbreak provide is a renewed sense of urgency – public, regulatory, and financial, that can substantially reshape how such technologies are perceived and prioritized.
Even financial markets appeared to reflect this dynamic. Shortly after the outbreak aboard the ship became an international headline, Moderna’s stock price rose sharply. Financial markets, of course, respond to multiple variables simultaneously, and it would be simplistic to attribute such movements to any single event alone. Still, the timing is difficult to ignore.
“The Plague Ship:” Season 2, Episode 1
The outbreak aboard the MV Hondius was not Covid 2.0. Hantavirus is not SARS-CoV-2, and epidemiologically the event was far more limited in scope.
Yet that did not prevent international health authorities, public-health systems, and the media from rapidly reactivating a familiar narrative structure, one that strongly resembled the opening episode of another “next pandemic” scenario.
The practical significance of the “plague ship” narrative is not merely communicative. In public health governance, those who shape the narrative framework often gain substantial influence over the response itself.
Once a localized outbreak is framed as a potential global threat, and uncertainty becomes associated with emergency conditions, the discussion rapidly shifts into the logic of crisis management: accelerated coordination, expanded emergency authority, and growing pressure for governments to align with what is presented as the responsible professional response.
This is precisely the arena in which the WHO has spent recent years attempting to restore and expand its institutional authority after Covid.
The timing of the MV Hondius story illustrates how rapidly the pandemic script can be reactivated – a script that reinforces the argument for stronger international coordination mechanisms, pandemic agreements, and emergency-response infrastructures.
Such narratives operate through one of the oldest and most powerful dynamics in risk communication: fear and uncertainty. These mechanisms shape not only public perception, but also the political environment within which policymakers make decisions, particularly when governments are already divided over questions of sovereignty, global governance, and the future role of institutions such as the WHO.
The central question is whether, after Covid, the public and policymakers will once again rush to embrace this familiar script, or whether they have become more capable of recognizing how it is once again being used to expand the power and authority of institutions in which public trust has already eroded.
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