Israel has called for a “brave conceptual overhaul” of the World Health Organization (WHO) following the recent withdrawal of the United States, warning that it too is under pressure to leave the global body.

Claiming that the WHO has become “too politicised”, Israel told the body’s Executive Board (EB) meeting on Monday that, “in Israel, there are also, unfortunately, strong public voices calling for us to leave the organisation as we enter the transitional period”.

“Just days ago, we witnessed the United States withdrawal from the WHO. The departure of the United States should compel us all to engage in an honest, urgent dialogue about the future and the purpose of our organisation,” said Israel.

“We must confront the fact that other nations may follow even without formal departure, lose interest, reduce contributions, and pursue alternative mechanisms for global health cooperation,” Israel concluded.

Later in the opening session, Israel – a close ally of the Trump administration – announced that it would be putting forward a resolution related to Argentina’s planned exit from the WHO.

Russia also expressed unhappiness at some EB agenda items and urged the WHO to revert to “impartiality”.

One of ‘most difficult years’

Opening the EB, Director-General Dr Tedros Adhanom Ghebreyesus said that the past year has been “one of the most difficult” in the WHO’s history.

The US contributed over $1 billion to the WHO in 2022/ 23, around 20% of the body’s budget, and the body has been forced to reduce its budget for 2026/27 from $5.3 billion to $4.2 billion. 

It is still short of 15% of its reduced budget, particularly for emergency preparedness, antimicrobial resistance, health financing, climate resilience and determinants of health.

However, Tedros said that WHO has “reached a position of stability”, and it will be able to wean itself from an “over-reliance on a handful of donors” if member states retain their commitment to incrementally increasing their membership fees.

This would enable WHO “non-dependence” on a handful of donors, inflexible, unpredictable funding and its biggest donors. 

When I say independence…. I mean an impartial, science-based organisation that’s free to say what the evidence says without fear or favour,” added Tedros.

 Disease prevention successes

Tedros also reported numerous successes over the past year.

Highlights in terms of disease prevention include access to more than 900 million influenza vaccine doses; the re-establishment of preventive cholera vaccination after a three-year gap, with 50 million doses going to Bangladesh, the Democratic Republic of Congo (DRC) and Mozambique; and preventative vaccination for Ebola for approximately 100,000 frontline health workers in the DRC and the Central African Republic. 

“Despite funding cuts, we protected the global measles and rubella lab network, enabling our network of more than 740 labs to process more than 700,000 tests to detect and respond to measles globally,” said Tedros.

Seven new countries were supported to introduce malaria vaccines, and 15 more countries to introduce HPV vaccination to prevent cervical cancer,” meaning that 65% of girls globally now live in a country with routine HPV vaccination”, he added.

Health emergencies 

The WHO Academy in Lyon, set up with the French government, had 100,000 enrollments. 

The academy’s basic emergency care programme provides standard training on how to manage acutely ill patients. 

“A study of over 35,000 patients in 17 hospitals in Nepal, Uganda and Zambia, showed a reduction in mortality of between 34% and 50% following the implementation of the WHO Academy basic emergency care training,” Tedros noted.

“Despite funding cuts, we protected the global measles and rubella lab network, enabling our network of more than 740 labs to process more than 700,000 tests to detect and respond to measles globally,” he added.

Last week was the sixth anniversary of COVID-19 being declared a public health emergency of international concern, and last year the WHO pandemic agreement was agreed and the amended International Health Regulations came into force.

Through the Pandemic Fund, the WHO and the World Bank, 70 countries to strengthen surveillance, laboratory networks, workforce capacity and multi-sectoral coordination.

WHO has also updated its international pathogen surveillance network, using AI to “support more than 110 countries and 30 organisations who use the platform every day to quickly identify new threats”.

Organisational reform

The report from the Programme, Budget and Administration Committee (PBAC), which recommended governance reform, Global Health architecture changes, and amendments to the external auditor selection process, was adopted by the EB.

PBAC requested that the WHO Secretariat ensure that country-level functions, such as emergency preparedness capacities, particularly in vulnerable settings, be protected during the cost-containment measures.

The Committee also underscored the importance of sustainable, predictable and flexible financing.

In its response, the WHO Secretariat reported that existing flexible funding was already being allocated to sustain underfunded priority areas, and reaffirmed its commitment to transparency, cost containment, strengthened prioritisation and ongoing engagement with member states on sustainable financing.

PBAC also requested the WHO Secretariat to host a member-state-led process that brings together current discussions on reforming the global health architecture and the United Nations reform initiative, UN80.

The aim would be to “facilitate convergence and consensus-building”, and include relevant global health actors, including development banks, philanthropies, civil society and academic institutions.