Finances to Dominate WHO Executive Board Meeting After US Withdrawal Notice
A 2022 meeting of the WHO Working Group on Sustainable Finance hammer out the final agreement on increasing member state contributions in 2022.

Finances will dominate the World Health Organization’s (WHO) 156th executive board meeting, which begins on Monday (3 February) under the shadow of the withdrawal of the United States, the body’s biggest member state.

As the US has to give a year’s notice of its withdrawal from WHO, it is still technically a member until January 2026 and has a seat on the 34-person board.

Tressa Rae Finerty has been appointed the new Chargé d’Affaires for the US mission in Geneva. And on the eve of the EB session, it appeared she would be leading a 10-member US delegation to the eight-day WHO Executive Board session that begins Monday – despite the US announcement that it is leaving the organization. Finerty’s name, as well as that of the State Department’s new “Team Lead” for Global Health Security and Diplomacy,  appeared on a published WHO roster of EB participants, Sunday evening, ending speculation that the USA might not show up at all. 

List of USA participants in the WHO EB156 session.

The opening day of the EB focuses on finances and efficiency, kicking off with the Director General’s report, which as of Friday evening remained unpublished in the EB’s otherwise detailed agenda.

The report of the Programme, Budget and Administration Committee (PBAC), which has been meeting this week, will also take centre stage as the committee will have had to grapple with the imminent loss of some 18% of the WHO’s budget. Although, legally, the US exit is only supposed to take effect in a year’s time, Washington has meanwhile frozen its contributions. 

Also on the agenda is the presentation of the first draft of the proposed budget for 2026/ 27. The total proposed budget for 2026-2027 is $7,473.2 million, a 9% increase from the previous biennium, divided into four segments: base programmes mostly aimed at strengthening member states’ technical capacities;  emergency operations and appeals, polio eradication and special programmes.

However, without the US contribution, it is unclear how this budget will be raised. Ostensibly, the US must pay its remaining assessed dues before finalizing its withdrawal, but not voluntary funds, which form the bulk of its annual contribution.

Universal health coverage

There will be a focus on member states’ progress in extending access to universal health coverage (UHC), including primary healthcare and “integrated people-centred health services”. Particular areas of focus include noncommunicable diseases, looking forward to the September UN High Level Meeting on NCDs and reviewing strategies for mental health and social connection, cervical cancer elimination, and oral health.  A new draft resolution on rare diseases, obtained by Health Policy Watch, commits WHO and member states to redouble efforts to find treatments and cures for conditions that often fall below the radar of R&D initiatives because of the comparatively few numbers of people affected.  The resolution, co-sponsored by Brazil and 11 other nations, calls for countries to create national task forces and registries of rare diseases, improve access to rare diseases diagnosis and treatment, as well as R&D.  It has received strong support from a wide variety of patient and medicines access groups.

Health Emergencies raging from Ukraine to Gaza, DRC and Sudan, are also expected to get significant attention at the meeting.

The Director-General will also submit a report on the third review of WHO’s Global Code of Practice on the International Recruitment of Health Personnel , which facilitates the ethical migration of health workers.

Ambitious new climate and air pollution action 

Air pollution darkens skis in Delhi during the November 2024 seasonal emergency.

The board will also need to take positions on three major new documents on environmental health – including a new draft Global Action Plan on Climate Change and Health; an updated ‘Road Map’ for addressing the health impacts of air pollution; and a controversial proposal for WHO to play a leading role in a new intergovernmental science-policy panel on pollution and health, which is part of the UNEP-led International Framework on Chemicals and Waste management.  

The Air Pollution road map includes an ambitious new voluntary target, which would aspire to see countries achieve a 50% reduction in deaths related to human-made air pollution sources by 2040, relative to 2015 baseline values. 

The previous WHA air pollution roadmap, approved in 2016, only a year after the very first WHA resolution calling for action on air pollution and health was approved, contained no such ambition. 

However nearly a decade later, little progress has yet been made in pollution hotspots like South Asia – with air pollution as the number 1 risk factor, accounting for some 2.7 million deaths annually, 2 million of which are in India.  

The EB’s consideration of the new Air Pollution road map comes in the lead up to the Second WHO Global Conference Air Pollution and Health, 24-28 March in Cartagena. At the conference, the first since 2018, countries are expected to make fresh commitments to tackling air pollution and health – in domains ranging from more stringent air quality standards – to better monitoring, enforcement and reporting.  

At a preparatory meeting this week in Cartagena, WHO launched a “call to action” to the broader health community – for which it is hoping to gain tens of millions of signatures. 

It remains to be seen if the administration of new US President Donald Trump will oppose the new WHO targets for reducing air pollution levels globally in the same way that it can be expected to oppose WHO initiatives on climate and health – (which it denies is an issue at all).  

In the past, Trump has said he wants “really clean air and water”. But his recent executive orders included numerous measures to loosen restrictions on vehicle efficiency and tailpipe pollution emissions, lower standards for energy efficient appliances, and promote fossil fuels exploration– all of which contribute to more health-harmful air pollution as well as to climate change. 

-Updated Sunday 2.2.2024, with list of US EB participants.

Image Credits: Germany's UN Mission in Geneva , Chetan Bhattacharji.

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