Beyond dependency: Ethical health sovereignty and global justice after the pandemic treaty.
The inequities observed during the COVID-19 pandemic were not an accident. They reflect deeper patterns of injustice already embedded in rules, financing models and power arrangements in global health governance. This paper argues that the paradigm of ethical health sovereignty offers a moral countermodel to the dependency shaping global health relations. It examines how sovereignty, solidarity and justice are being reinterpreted after the pandemic by drawing on the WHO Pandemic Agreement (A78/10, 2025) and Africa's regional responses through the African Union and Africa Centres for Disease Control and Prevention. The Agreement represents a partial moral advance by acknowledging equity and shared responsibility while still leaving hierarchy intact through voluntarism and sovereignty-based limits. In contrast, Africa's pooled procurement, regulatory harmonisation and coordinated diplomacy show solidarity as shared governance rather than charity. The paper concludes that global health equity requires redesigning governance so that fairness is built into institutions and sovereignty is understood as shared and cooperative decision-making.