“This is a historic turning point,” said Tedros Adhanom Ghebreyesus, director general of the World Health Organization (WHO). Tuesday, May 24, during the World Health Assembly, the member states of the UN agency based in Geneva adopted a long-awaited reform of the financing of the organization. The part of the budget financed by the Member States will increase from 16% to 50% by 2028, which should enable the WHO to regain part of its independence. This reform was one of the five priorities outlined by Dr Tedros “for the world and for WHO” on 24 January: strengthening the role of WHO “at the heart of the global health architecture”, so that she becomes more effective and efficient.
It was indeed urgent that the Member States regain control of their budget. Since the mandate, between 1998 and 2003, of Gro Harlem Brundtland at the head of the WHO, private funds have taken an increasingly important place in the financing of the agency. The former headmistress is known for her call to “reaching out to the private sector”, from its first World Assembly. A gesture presented at the time as a necessity, the Member States not giving enough money, but interpreted by many observers as a liberal turn in WHO policy.
Voluntary contributions
As a result, only 16% of the 2022-2023 biennium is supplemented by mandatory contributions from Member States, fixed from year to year according to the resources of each. Despite everything, they remain an essential source of funding for the organization, in particular because of their predictability, since their amount is established every two years by the World Health Assembly. The reform will make it possible to raise the level of these contributions from 956.9 million to 2.2 billion dollars by 2028. A significant gain if we consider that the current total budget is only 6.1 billion dollars (about 5.7 billion euros). In comparison, that of the Assistance Publique-Hôpitaux de Paris (AP-HP) is 7.8 billion euros.
Most of the budget (84%) comes from so-called contributions “volunteers”. These can come from states deciding to provide more money than their mandatory contributions require. The United Kingdom, in particular, provided 135 million voluntary contributions in the financial year 2020-2021, in addition to its mandatory contribution of 49 million, thus exceeding the Chinese participation. This additional contribution makes it possible to strengthen the play of influences within the organization.
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