Merging WHO and UNAIDs, and combining the “operational” component of WHO’s Emergencies response with that of other agencies are just two among the several dozen ideas pitched by the UN80 Initiative Task Force – in the full text of options for interagency budget cuts and efficiencies, obtained by Health Policy Watch. 

The list of over 50 bullet points, dubbed a “compilation of non-attributable suggestions by the Task Force,” that was commissioned by UN Secretary António Guterres in March, cites options for wide-ranging operational reforms and mergers amongst the patchwork of UN agencies active in four key areas: peace and security; humanitarian affairs; sustainable development; and human rights.  

The listing, marked “strictly confidential” also proposes to “reduce number of high-level posts (D1 and above),” systems wide – echoing plans for cutbacks in senior staff, now reportedly planned by the World Health Organization, the Geneva-based specialized UN agency, as it faces a $2.5 billion budget deficit from mid-2025 to end 2027.   

A companion memo, issued by UN Deputy Secretary General Guy Bernard Ryder on 25 April, also obtained by Health Policy Watch, requests all UN Secretariat operations in New York City and Geneva – the highest-cost UN duty stations – to undertake internal reviews “to identify as many functions as possible that could be relocated to existing lower-cost locations, brought closer to mandate implementation or clients/stakeholders in the field, or otherwise reduced or abolished if they are duplicative or no longer viable.”

The initiative to review UN-wide relocation options was initially reported Wednesday by Devex while excerpts from the UN Task Force 80 memo were reported on Thursday by Reuters.  

Asked to comment on the feasibility of a UNAID/WHO merger and other Task Force 80 ideas, a WHO spokesperson deferred, saying it was a UN initiative, and referred Health Policy Watch to the UN Secretary General’s Office.

Farhan Aziz Haq, Deputy Spokesperson for the UN Secretary General’s Office, said in an emailed response: “These documents are part of an internal process which represents the operationalization of the UN80 initiative that the Secretary-General launched on 12 March. [It] is the preliminary result of an exercise to generate ideas and thoughts from senior officials on how to achieve the Secretary-General’s vision.”

The UN80 Task force is due to report its final recommendations to the 2026 UN General Assembly. 

UNAIDS-WHO merger and other global health moves? 

With regards to the UN’s activities on health, emergencies and related humanitarian and sustainable development initiatives, the task force’s list of consolidated ideas includes the following: 

Under Sustainable Development:  

• “Strategic integration of UNAIDS into WHO, creating a more unified and efficient global health authority.” Alternatively, the Task Force also notes that “UNAIDS, under severe financial pressure and with a sunset clause of 2030, could transition into another, larger entity such as WHO or UNDP.”

Under Humanitarian Response:  

• “Merge operational responsibilities and capabilities of major operational agencies (WFP, UNHCR, UNICEF, WHO) in humanitarian and conflict affected contexts.”

Although WHO made no comment, the agency’s Emergencies Department is one of the Organization’s largest, and some outside observers have long advocated for consolidating its on-the-ground operations with those of other humanitarian relief agencies.  The WHO Emergency response to the COVID pandemic, followed by mpox and a series of humanitarian crises was also the main reason for WHO’s massive surge in consultants – whose ranks doubled between 2017 and 2024, WHO’s Director General Tedros Adhanom Ghebreyesus told media on Thursday.  See related story.

UNAIDS also did not respond to Health Policy Watch requests for comment, as of publication.  However, the organization has been in deep trouble ever since the US government terminated its support earlier this year, with rumors of a possible closure or merger. The $93 million US contribution to the agency comprised some 41% of UNAIDS $222 million budget in 2023. Switzerland, the agency’s fourth largest donor also has announced it will end its support.

Merging UN institutions on climate and environment; women and sexual/reproductive health   

Other major innovations proposed by the UN 80 Task Force in the sustainable development arena include  the formal integration of the UN Environment Programme (UNEP) with the UN Framework Convention on Climate Change (UNFCCC), which manages the annual rounds of climate negotiations and tracks countries’ climate commitments. 

The task force also pitches a merger of UN WOMEN and the UN Nations Population Fund  (UNFPA) “to create a powerful new entity focused on advancing gender equality and reproductive health and rights.” 

As part of that latter move, the Task Force also calls for better alignment of “select UNICEF programmes with this new entity, especially those focused on adolescent girls’ well-being and gender-based violence prevention and response.”

The UN80 Task Force also proposes that the UN Secretariat establish a UN Sustainable Development Department “that consolidates relevant entities to ensure cohesive and integrated support for the 2030 Agenda and the SDGs, including: (Secretariat entities) DCO, DESA, UNDRR, UN-OHRLLS and (other entities) UNDP, UNCDF, UNV, UNRISD, FAO, IFAD, UN-Habitat, WHO, UN-Women, UNESCO, UNICEF, UNEP, WB, IMF, WTO, UNOPS, UNICEF, UNIDO, UNESCO.”

And the Task Force says that UNEP and UN Habitat should enhance their coordination to promote “sustainable urban development” – in a world seeing runaway, unplanned urban expansion – although it stops short of calling for a merger of the two agencies.   

Refugees and Human Rights 

The Task Force also suggests establishing a “UN Human Rights Department led by a High Commissioner for Human Rights, coordinating human rights promotion and protection across the UN system, including servicing the UN human rights mechanisms and integrating human rights into sustainable development, peace & security and humanitarian engagement.”

Currently, human rights work is centralized in a separate Geneva-based entity, the Office for the High Commissioner of Human Rights OHCHR, which also oversees the UN Human Rights Council, whose members have often been criticized for selectively focusing on human rights violations in the Israel-Palestine dispute, while while ignoring violations in China, Iran and elsewhere with regards to the systematic repression of minorities and dissident voices.   

With regards to humanitarian affairs, the Task Force suggested creating a “streamlined “UN Humanitarian Response and Protection Organization”, by integrating the OCHA (the UNOffice for Coordinating Humanitarian Affairs (OCHA), the UNHCR (the UN Refugee Agency) and the IOM (International Organization of Migration), leveraging WFP’s expertise for material assistance procurement, distribution and logistics.”

Alternatively, it proposes creating “a new UN Refugee and Migration Agency (merging UNHCR and IOM).”

Strikingly, the Task Force does not suggest merging UNRWA, the UN Relief Agency for Palestinian Refugees – with the UN’s other main refugee entity UNHCR. It does, however, suggest creating a “UN Humanitarian Operations Department – including OCHA, WFP, UNRWA and a UN Refugee & Migration Agency (merging UNHCR and IOM)” to manage UN-wide humanitarian preparedness and response.  

UNRWA’s $1.16 billion budget to a major blow when the United States halted its support while some European nations paused contributions in the wake of the bloody 7 October 2023 Hamas attacks on Israeli communities, in which Israel alleged some UNRWA employees participated. UNRWA has also been complicit in Hamas’ use of schools and clinics for military purposes, as well as filching humanitarian aid, Israel says. In the face of UNRWA’s rebuttals as well as Gaza’s dire humanitarian crisis, some donors resumed funding, while others, like Sweden, made the stoppage permanent.  Even so, UNRWA continues to enjoy strong financial and political support from key European nations, like Ireland and Norway, as well as many other G70 nations. 

Structural reorganization and response 

The Task Force 80 document also proposes a wide range of cross-cutting UN reforms, including:  “structural reform proposals around our four basic pillars, each with a geographic focus (Nairobi/ Africa should be the center of development agencies, including UNDP/ UNICEF/ UNFPA).”

It says that a patchwork of UN agencies working on “peace and security” should also be merged and consolidated, with resources and personnel “moved closer to the field.” 

Along with addressing fragmentation and duplication, it states that “outdated working methods are leading to inefficiencies,” citing intergovernmental meetings as one example of fora that “are not making use of modern tools and technologies.”

“The progressive proliferation of agencies, funds, and programmes has led to a fragmented development system, with overlapping mandates, inefficient use of resources, and inconsistent delivery of services,” the Task Force states.

Along with the consolidation of overlapping agencies and functions, it calls for “a strategic reduction of the UN’s presence in high-cost locations to ensure long-term financial sustainability” positioning forms as “proactive measures to enhance UN agility and responsiveness that extends beyond measures for cost-cutting or austerity.”

Image Credits: Wikimedia Foundation, United Nations , UN SG/Task Force 80, Dennis Sylvester Hurd, WHO/EMRO, UN.