Argentina Withdraws from WHO, Executive Board Pauses Approval of New Resolutions Pending Cost Reviews Universal Health Coverage 05/02/2025 • Elaine Ruth Fletcher Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to print (Opens in new window) WHO Executive Board in session on Wednesday just as Argentina’s decision to withdraw was announced. Argentina’s maverick President, Javier Milei, declared Wednesday that he would follow the United States in withdrawing from the World Health Organization,citing “profound differences in health management, especially due to the pandemic, which led us to the longest confinement in the history of humanity.” The announcement came as another blow to the morale of the Geneva-based specialised UN agency, which has enjoyed broad support from member states of all political shades since its founding in 1948. It has, however, less financial consequences insofar as Argentina’s assessed contribution to WHO is comparatively small, amounting to only $8 million as for the 2024-25 biennium, as compared to some nearly $1 billion paid by the US, including over $260 million in assessed contributions. The announcement came as WHO’s Executive Board was meeting in Geneva to debate the agenda for the May World Health Assembly. Total USA contributions to WHO for the 2024-25 two year period. Argentina’s total contribution to WHO for the two-year 2024-25 budget period. Cost impacts slow approval of new WHO initiatives The financial fallout of the US withdrawal was evident in the proceedings where decisions to move forward with several new member state initiatives – addressing issues ranging from rare diseases to strengthening health finance – were paused until their costs could be more fully assessed. WHO’s leadership, meanwhile, laid out three options that it said the EB could consider in advancing new member state resolutions and decisions to the WHA: “According to the option chosen,” stated an administration memo, “the Board could mandate the Programme, Budget and Administration Committee to recommend that Health Assembly: (1) adopt the resolutions as proposed and ask the Secretariat to de-prioritize other activities to allow for implementation of resolutions within the defined budget envelope; (2) postpone adoption of all resolutions by one year to 2026; or (3) approve the resolutions but with a provision that their implementation, other than advocacy for the topic at minimal costs, should be postponed until the review of the programme budget proposed for 2026”. The memo included a massive table of cost implications for every new decision being considered by the EB – more than two dozen in all. That includes projected costs as low as $9 million for stepped up advocacy and action on rare diseases to costs of $79.6 million for implementing a draft decision on strengthening global health financing by working with countries to help them devise better public health financial and insurance schemes. Other big ticket items, not yet debated, include a new draft global strategy on climate change and health ($161 million); an action plan for the global health care workforce ($125 million); and traditional medicines strategy ($119 million). More modest investments would be required for items like new WHO guidelines to governments on combating loneliness in mental health care ($38.77); accelerating guinea worm eradication ($35 million); and a road map for air pollution response ($34 million); as well as much more modest initiatives on prevention and care of sensory impairments ($18 million); and child nutrition planning ($3.38 million). Germany urges caution German delegate urges caution in green-lighting any new resolutions until priorities can be aligned with a shrinking budget. Against the gloomy financial outlook, member states such as Germany urged “caution” in the EB’s decisions to advance new WHA resolutions for which the budget might not exist to cover the promised work. “We would caution against deciding on resolutions before the budgetary implications and the process of prioritisation has been clarified and decided,” said Germany, during a discussion on Universal Health Coverage (UHC) that dominated the morning EB session. She added that Germany regards four priorities as central to achieving UHC. “First, essential health services must be accessible to all, especially the most vulnerable; a well- functioning primary health care system is the foundation of UHC. Second, we must make universal access to sexual and reproductive health and rights a reality,” she said. “We must expand health financing and social protection systems based on solidarity and equity. This is key to reducing out of pocket payments and ensuring access to health services. Fourth, we must establish efficient and sustainable financing mechanisms for UHC and social protection, primarily through domestic resources.” Rare diseases resolution gets widespread endorsement Luxembourg, one of the co-sponsors of the rare diseases resolution considered at Wednesdays Executive Board meeting Despite the cost concerns, a new resolution aimed at promoting greater inclusion of rare diseases in health care services received widespread endorsement, with some 21 countries co-sponsoring the initiative, ranging from France, Spain and Luxembourg to China, Brazil, Somalia and island states like Vanuatu. “Somalia faces challenges in addressing rare diseases, which includes limited awareness and diagnostic capacity with no specialised centres for rare diseases,” said the nation’s EB delegate “Out of pocket expenditures place a disproportionate burden on affected families. Workforce shortages hinder the integration of her disease services into primary health care. “But there is opportunity to overcome these challenges, notably the growing political commitment to universal health coverage and health system strengthening and the potential for partnering with international organisations and research institutions to get the capacity and share knowledge. “Somalia is committed to integrate rare disease screening and management into essential package of health services, leveraging existing maternal and child health programs, training health workers to recognise rare diseases and refer cases to higher level facilities.” Resolution calls for WHO Global Action Plan Along with urging efforts by countries, the draft resolution would commit WHO to map existing policies and develop a draft plan of action on diseases that range from rare forms of cancer to genetic disabilities, and affect millions of people collectively – but too few individually to receive the kind of private sector investments and public sector attention that other leading infectious diseases and NCDs receive. In fact, some 300 million people worldwide are living with a rare disease, noted Rare Diseases International, the leading civil society advocacy group, along with the International Alliance of Patients Organizations and other NGOs. “Yet despite the growing recognition of their importance, millions of families continue to face barriers to timely diagnosis, treatment and care, hindering their ability to lead dignified and fulfilling lives. The WHO estimates that there are more than 7000 rare diseases defined and this number is steadily increasing. More than 80% of rare diseases are of genetic origin. 70% start in childhood, and about 95% lack treatments. The average time for an accurate diagnosis is four to eight years,” she added, “and about 30% of the affected children died before five years of age.” A WHO global action plan would provide member states with a strategic framework to integrate rare diseases into their national health priorities, she added, as well as fostering collaborations; supporting more innovation in diagnostics and therapies; and strengthening data collection. While the associated costs are only about $9 million, one civil society group, Knowledge Ecology International, said that one affordable solution “in a time of severe fiscal challenges” could include low-cost surveys of member states, regarding the publication of “prices, sales revenue, costs of trials and subsidies related to R&D” for medical products related to rare diseases. Taiwan also surfaces as issue US delegate makes a rare statement on Taiwan at the WHO Executive, on Wednesday. Throughout the day, the issue of Taiwan’s exclusion from the WHA and EB debates surfaced intermittently with China, Pakistan and Belarus, amongst others, punctuating their comments on universal health coverage with political references to the “One China” policy that should, they argued, exclude Taiwan. “With reference to the participation of Taiwan, that is to say, the Republic of China, in WHO and its bodies as an observer, we strongly abide by the one China principle. This issue is one that we think should guide all that we do. We should act in accordance with relevant WHO and resolutions that make it clear that the People’s Republic of China has the right to determine the membership.” Meanwhile, in a rare statement Wednesday afternoon, a member of the US delegation, which had been silently observing proceedings until then, spoke on behalf of re-admitting Taiwan to the assembly as an observer, the status it held until 2016. “We need the engagement of all members of the global community to help reach this shared aim,” said the US delegate to the EB, during a discussion of mental health strategies. “To that end, we urge WHO member states to support Taiwan’s meaningful participation in WHO and its work, and to call for the resumption of Taiwan’s participation as an observer to the WHO.” Image Credits: WHO Budget portal, WHO Budget Portal , Thiru Balasubramaniam . 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