Some of abstaining nations include the United States, Poland, Israel, Italy, Russia, Slovakia and Iran. 46 countries were absent.

The Agreement explicitly rules out the WHO holding "any authority to direct, order, alter or otherwise prescribe" any policy, or to "impose any requirements that parties take specific actions." However, this 'agreement' opens the door for the WHO to collect data and implement changes later.

Senator Malcolm Roberts from Queensland, Australia, advised the Treaty had been watered down from its original, draconian draft. What the new Treaty contains has not yet been ascertained.