Member States voice historic support for a better and more sustainably funded WHO at 74th World Health Assembly

WHO Director-General, Dr Tedros Adhanom Ghebreyesus addressing the 74th World Health Assembly. Photo by ©WHO/Chris Black

The world needs a stronger WHO, now more than ever. That was the clear consensus that emerged from the World Health Organization’s most important annual decision-making meeting.

On 31 May 2021, the 74th World Health Assembly wrapped up with a call from the WHO Director-General, Dr Tedros Adhanom Ghebreyesus to Member States for drastic action. He urged countries to provide more reliable funding to WHO and to make a global treaty on pandemic preparedness a reality.

“WHO cannot grow stronger without sustainable financing. This is not a new issue. More sustainable financing has been one of my priorities as part of the WHO Transformation,” said Dr Tedros during the Assembly’s closing remarks.

A key turning point now is that “the message that a strong WHO needs to be properly financed has been amplified by all the expert reviews that reported to this Assembly,” the Director-General highlighted.

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As a short term step in the right direction, the Assembly fully endorsed WHO’s proposed Programme Budget 2022-2023. The new budget, which increased 5% over the last biennium, presents an ambitious 16% rise in the base budget for strategic priorities and enabling functions.

Positive momentum

The session was “one of the most positive, lively and supportive programme budget discussions of the recent past. Many Member States acknowledged that WHO’s financing has not been commensurate in terms of level and sustainability,” said Raul Thomas, WHO Assistant Director-General of Business Operations. “There was strong support for addressing the predictability and sustainability of WHO’s financing,” he added.

Several Member States noted that an increase in resources must be accompanied by robust monitoring of progress and data-driven measurable results. Numerous delegates also expressed concern about WHO’s dependency on voluntary contributions to finance essential work. Heavy reliance on earmarked contributions results in a misalignment between priorities and financing their delivery. This has been a long term issue, speakers highlighted. During the discussions, many delegations pledged to commit further non-earmarked flexible funding.

Evidence for change

Supporting the key takeaways from the assembly, several recent reports all concluded that the world needs a stronger WHO at the centre of the global health architecture. These included reviews by the Independent Panel for Pandemic Preparedness and Response, the International Health Regulations Review Committee, and the Independent Oversight and Advisory Committee for the WHO Health Emergencies Programme.

"As the reports all say, and many Member States have emphasized, a paradigm shift in the quantity and quality of funding for the Secretariat is a key issue,” said the Director-General.

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While Member States widely acknowledged that WHO requires budgetary reform to fight future disease outbreaks, more urgently WHO faces a challenge to maintain its response to COVID-19 even at the current level, said Dr Tedros. The budgetary challenges come at a time when countries are facing serious economic challenges following a year and a half of fighting the COVID-19 pandemic. Dr Tedros called on Member States to respond to the shortfall in the WHO Strategic Preparedness and Response Plan with flexible funding to help deliver on the ACT Accelerator’s goals and save lives. The ACT Accelerator is the world’s most comprehensive end-to-end solution to ending the acute phase of the devastating COVID-19 pandemic.

Evidence of the benefits and support to the call for more robust and predictable funding for WHO were highlighted by the report of the Working Group on Sustainable Finance, created last year. The Working Group has been drawing up proposals for a sustainable financial model. The group presented their interim findings at the Assembly. The initiative–led by Germany (with Björn Kümmel of the WHO Executive Board as its Vice Chair) included delegates from Ghana, Mexico, Tunisia, Indonesia and Australia. Two recent meetings were attended by 100 Member States and important regional bodies.   

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Concrete steps forward

In addition to gathering strong momentum toward sustainable funding and pandemic preparedness, Member States adopted more than 30 resolutions and decisions. These focused on diabetes, disabilities, ending violence against children, eye care, HIV, hepatitis and sexually transmitted infections, local production of medicines, malaria, neglected tropical diseases, noncommunicable diseases, nursing and midwifery, oral health, social determinants of health and strategic directions for the health and care workforce.

The Assembly also approved a historic resolution on strengthening WHO preparedness and response for emergencies, which could provide an important opportunity to reform how WHO is funded. 

“This is not the time for incremental improvements or tinkering at the edges. This is the moment for bold ideas, bold commitment and bold leadership; for doing things that have never been done before,” pleaded WHO’s Director-General during his closing address.

WHO’s budget is dedicated to accomplishing the Triple Billion Targets – providing one billion more people with Universal Health Coverage, one billion more people with better protection from Health Emergencies, and one billion more people with Better Health and Well-being – aligned with the Sustainable Development Goals through its Thirteenth Programme of Work.

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