So, rather than arguing over the fine print in these pandemic agreements, we first must make an obvious and fundamental decision. Is the intent of all this to live longer, more equitably, and healthily? Or is it to grow the pharmaceutical sector of wealthy countries? We cannot do both, and we are currently set up to support Pharma. It will take a lot of unraveling, and rethink on conflict-of-interest rules, to make this a public health program. It probably comes down to who makes decisions, and whether they want an egalitarian society or a more traditional feudalistic and colonialist approach. This is the real question to be addressed in Geneva.