Pandemic Preparedness: The Urgent Lesson from the MV Hondius

The MV Hondius crisis reveals why pandemic preparedness remains fragile: insufficient international mechanisms, health inequalities, and funding cuts that threaten the global response.

[Elizabet Diago is the coordinator of the Preparedness and Response Hub at the Barcelona Institute for Global Health (ISGlobal).]

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On May 10, the cruise ship MV Hondius anchored at the port of Granadilla de Abona, in Tenerife. Spain. On board were 151 people from 23 nationalities and an outbreak of the Andes virus, the strain of hantavirus capable of human-to-human transmission. The outbreak has already caused three deaths and 10 confirmed cases, while dozens of people remain under monitoring.

It is a scene nobody expected in the Canary Islands: personnel in protective suits, buses from the Military Emergency Unit (UME), staggered evacuations, and protests outside the port.

The MV Hondius crisis is not only a health emergency. It is also an urgent lesson in why pandemic preparedness matters, why international response mechanisms are indispensable and, above all, why the failure to properly fund these systems is a mistake we could pay dearly for in the near future.

Why Spain had to respond

There has been debate over whether Spain was obliged to receive the cruise ship. The answer is clear: Spain acted in compliance with the legal obligations derived from the International Health Regulations (IHR), created in 2005 in response to another international health emergency, the 2002–2004 SARS coronavirus outbreak. The World Health Organization (WHO) simply invoked them when formally requesting support to receive the vessel. The IHR are not an external imposition: they are a treaty ratified by Spain (and 195 other WHO member states) that reflects a basic principle of global health: a health emergency anywhere is a shared responsibility.

This crisis should not make us question whether welcoming the ship was the right thing to do —it was— but rather why the global system, which should have contained this outbreak much earlier, still has so many gaps

Article 13.1 of the IHR requires states to develop core capacities to respond to public health emergencies, including diagnostic laboratories, adequate isolation units, properly trained personnel and international evacuation logistics. WHO considered that the Canary Islands had these capacities. Cape Verde, the first port the ship attempted to approach, did not. This asymmetry in capacities between countries is exactly the problem the IHR were designed to correct, and we still have not solved it.

Spain’s response followed a fundamental principle, expressed by Prime Minister Sánchez in recent days: “ask for help when needed and offer it when capable.” In this sense, the operation has been exemplary. This crisis should not make us question whether welcoming the ship was the right thing to do —it was— but rather why the global system, which should have contained this outbreak much earlier, still has so many gaps. One of the most evident relates to the Pandemic Agreement.

A historic agreement stranded by political differences

In May 2025, WHO member states adopted by consensus the first global Pandemic Agreement, the result of more than three years of negotiations. Its purpose was to address the gaps and inequalities revealed during the international response to COVID-19. It was real progress. But the agreement still lacks a critical piece: Article 12, dealing with the pathogen access and benefit-sharing system (PABS), without which the text cannot be opened for signature or enter into force. Negotiations have stalled over disagreements between high-income and low- and middle-income countries regarding equitable access to vaccines and contributions from the pharmaceutical industry, extending negotiations until May 2027. Once these differences are resolved, the agreement will still require ratification by 60 countries to enter into force.

The road ahead is long and the context is not helping: Argentina announced its withdrawal from WHO in March, following the steps of the United States. Health multilateralism is not only unfinished: it is under direct attack from some of the most relevant actors, precisely when it is most needed

The road ahead is long and the context is not helping: Argentina announced its withdrawal from WHO in March, following the steps of the United States. Health multilateralism is not only unfinished: it is under direct attack from some of the most relevant actors, precisely when it is most needed.

Aid cuts threaten to turn the IHR into dead letter

The IHR and the Pandemic Agreement are only as strong as the health systems implementing them. And those systems are losing funding at an alarming speed.

The United States accounted for approximately 40% of all global development aid. The dismantling of USAID is leaving a gap that nobody has filled. On top of that, its withdrawal from WHO has resulted in the loss of nearly 15% of the organisation’s total budget, forcing it to cut almost 3,000 jobs (22% of its workforce) by mid-2025. These cuts directly affect the strengthening of health systems in developing countries: nearly 24 million people are at risk of losing access to essential health services, and more than 2,600 facilities have already suspended services in crisis areas. And it is not only the United States: the United Kingdom, France, Germany and the Netherlands have also reduced their global health cooperation budgets.

The IHR and the Pandemic Agreement are only as strong as the health systems implementing them. And those systems are losing funding at an alarming speed

What is being cut is not abstract aid. These are surveillance systems and laboratories that detect outbreaks before they reach a cruise ship. It is community health personnel identifying index cases and having the resources needed to manage them safely and effectively. These are the data systems that make coordinated responses like that of the MV Hondius possible. Without this infrastructure, the IHR become dead letter.

The lesson from Tenerife

The management of the MV Hondius crisis is still ongoing and it is too early to draw definitive lessons. But the mere fact that Spain was able to respond with laboratories, protocols, specialised personnel and international coordination demonstrates the difference that prepared systems make. That difference is precisely what the IHR and the Pandemic Agreement seek to guarantee for all countries, not only those that already have the necessary resources.

Recent studies estimate nearly a 50% probability that within the next decade we will face another health crisis comparable in scale to COVID-19. In this case, hantavirus arrived from the South Atlantic aboard a cruise ship. The next threat will come from somewhere else, under another name. We cannot control when it will appear, but we can control the investment in systems, agreements and coordination that allow us to prevent, prepare and respond together. What happened ten days ago demonstrates that a better prepared world is possible. But it cannot be built by stripping it of financial and legal resources.