Investing in a transformed WHO

Unpredictable and inflexible funding, lack of resources for strategically-important programmes (so-called pockets of poverty), inefficiencies in donor reporting and heavy reliance on a small number of donors have been WHO’s key funding challenges for some time. They were thrown into sharp relief during the pandemic and Member States mandated robust changes with the historic decisions in 2022.

Historically, the World Health Organization was set up with almost 90% of its budget supported through Member State assessed contributions. However, with inflation and rising funding needs due to the expanded role of WHO, especially since the turn of the millennium, this has dwindled to around 16%. It is evident that WHO requires more sustainable financing to face today’s complex and intersecting global health challenges

“Health is an investment,” says Catharina Boehme, Assistant Director-General for External Relations and Governance. “It’s an investment in populations that allows people to thrive and to grow and to give back to their society.”

To boost resource mobilization in WHO, a new Coordinated Resource Mobilization (CRM) department was created, and a global network of resource mobilization focal points was established to coordinate efforts at the three levels of the Organization. The CRM department put together a resource mobilization strategy and a WHO investment case. At the 148^th session of the Executive Board, held in January 2021, a Working Group on Sustainable Financing was formed. The Group’s recommendations, along with the work of the Secretariat, set the stage for some historic decisions in 2022. Member States decided to make a significant increase to assessed contributions and introduce an investment round to drive and sustain political commitment.

The first of its kind in the entire UN system, the Investment Round will include several key milestones culminating in a pledging event and summit at the end of 2024. It aims to raise US$ 7.1 billion over four years, a figure which represents the GPW 14 budget shortfall of US$ 11.1 billion after assessed contributions.

“We are very pleased to have Member States from every region on board now, who will launch the Investment Round in May at the upcoming World Health Assembly,” says Ms Boehme. “The investment case spells out what WHO will deliver over the next four years, whether it is making 10 000 health facilities climate- and pandemic-resilient or training 3.2 million health-care workers. So, in every area we work on, we are concretely saying how the world will look different in the next four years.”

The estimated return on investment for WHO is US$ 35 for every dollar spent, and the core message of the investment case is that working with Member States and partners, the Organization will save 40 million lives over the next four years. But what will it take to really achieve such immense impact? Ms Boehme explains that it will rely primarily on strong country offices. This strength will underpin three value contributions that are unique to WHO. First, stewardship and leadership, where a strong country presence provides the legitimacy to convene partners on health matters and set the global health agenda. Second, setting norms and standards backed by a robust core of science and data. Having country offices with strong relationships with ministries will ensure Member States can rapidly translate guidelines and ensure they make it into country legislation. Finally, WHO stands in a unique position to provide technical assistance and help countries with measurement and monitoring tailored to their distinct needs.

With a continuing downward trend in political commitment and fiscal space for global health, the Investment Round is coming at a crucial moment.