Global health knowledge is expanding faster than ever, but so are confusion and inequity over who can access trustworthy information and use it to improve their lives.

In a live recorded discussion at the World Health Summit in Berlin, featured in the latest Global Health Matters podcast, Joy Phumaphi, executive secretary of the Africa Leaders Malaria Alliance, and Monica Bharel, clinical lead for public sector at Google, reflected on how health information has changed and what it will take to make it truly inclusive.

Phumaphi recalled a time when there was effectively one global reference point.

“Everything was recorded … by hand,” she said, and “you only had one source of information. That was the World Health Organization.”

Today, she noted, “there are so many sources of information, and it’s very, very confusing… We have the rogue scientists and the rogue medical practitioners who spread disinformation.”

The danger, she added, is that “the sad thing about both misinformation and disinformation is that is always mixed with a little bit of truth… What it does is that it kills people. You know, people who are not vaccinated during COVID died, and we see children who have not had their measles vaccines dying.”

Bharel brought the discussion down to the level of people living on the margins, drawing on her experience caring for patients experiencing homelessness in Boston. She argued that “information is also a determinant of health,” but many people lack “the infrastructure they have to get information… the phones, the internet access, the computer access.”

Both speakers stressed the need to strengthen trusted channels.

Phumaphi pointed to traditional, religious and social leaders as key messengers, saying health actors “should impart the right information to these… leaders, and even perhaps to the influencers.”

Digitalization and AI, they concluded, can be part of the solution.

Phumaphi called them “a huge opportunity,” saying, “we can reduce poverty, we can reduce ill health… We can bring the disenfranchised into the fold so, but we have to harness this in the right way and make it available to everybody.”

Bharel echoed the urgency: “We can close the gap in health equity and bring in those disenfranchised individuals… we can get people the right information at the right time, at the right level, that they can digest it, and we can do this now.”

Listen to more Global Health Matters podcasts on Health Policy Watch >>

Image Credits: Global Health Matters Podcast.

The opening of the Global Fund’s Eighth Replenishment Summit, co-hosted by South Africa and the United Kingdom, a high-level, hybrid side event convened on the margins of the G20 Leaders’ Summit. Johannesburg, South Africa, on Friday 21 November, 2025.

JOHANNESBURG – The United States pledged $4.6 billion to the Global Fund during its eighth Replenishment Summit in Johannesburg on Friday – a reduction from its previous pledge of $6 billion, but also an indication that it has not abandoned all multilateral global health efforts.

The Global Fund has now raised $11,4 billion of its $18 billion target for the next three years – but several key countries and groups, including France, Japan and the European Commission, have yet to pledge. 

South African President Cyril Ramaphosa, who co-hosted the Replenishment, said that it was a milestone at a time when multilateralism is being “sorely tested”.

“Building resilient health systems, scaling up local manufacturing of medicines, diagnostics and therapeutics and securing sustainable financing are vital for the social and economic development of the people of the world who are vulnerable,” said Ramaphosa. 

“Without a healthy population, nations cannot prosper. It is therefore essential that we close gaps in access to medicines, diagnostics and therapeutics and financing so that every country can protect its people and achieve health equity.”

South African President and Replenishment co-host Cyril Ramaphosa

United Kingdom Prime Minister Keir Starmer, the other co-host, said this was the first Replenishment to be hosted by countries in the Global North and South.

“Since the UK hosted the first Replenishment back in 2002, our shared investments have saved over 70 million lives across more than 100 countries, cutting the combined death rate of these diseases by almost two-thirds,” said Starmer.

“Heartbreaking, malaria still kills a child under five years of age every minute, 4,000 adolescent girls and young women still contract HIV every week. TB remains the world’s single deadliest infectious disease, even though we’ve had a cure for almost a century, and the rise of antimicrobial resistance threatens some of the progress that we thought we’d managed,” he added.

Starmer praised the growing investment of the private sector in the Global Fund, and the reforms in the development sector enabling countries to drive their own programmes more successfully.

UK Prime Minister and Replenishment co-host Keir Starmer

Announcing the US pledge via video, Jeremy Lewin, US Under Secretary for Foreign Assistance, Humanitarian Affairs, and Religious Freedom, described the Global Fund as a “critical partner” in advancing his country’s new ‘American First’ strategy.

The US had undergone a “rigorous review” of its multilateral commitments, and “left numerous multilateral organisations, including the WHO and Unesco, as they do not work for the American people,” Lewin noted.

However, while the Trump administration views “foreign assistance as a tool of US diplomacy” and every taxpayer’s dollar is being assessed in terms of “America First”, the US is “proud of its legacy as the most generous nation in the world”, he added.

“The best days of American healthcare leadership are yet ahead. The State Department recently unveiled our new ‘American First’ global health policy, which affirms our commitment to global health but enacts much-needed reforms. 

“The Global Fund is a critical partner in advancing our America First strategy. It has long advanced the key tenets of our approach, investing much of its resources in scaled procurement of health commodities,” said Lewin.

“Under the leadership of [executive director] Peter Sands, we have every confidence that its legacy of excellence will continue,” he concluded.

The US pledge is tied to a 1:2 commitment, meaning that every $1 from the US has to be matched by at least $2 from other donors.

Last month, Germany announced a €1 billion pledge at the World Health Summit in Berlin (down from €1.4 billion previously). Other substantial donors include Canada, which committed CAD$1.02 billion, the Netherlands, committing €195.2 million; Norway, which committed $200 million; Italy giving €150 million; Ireland increasing its commitment to €72 million, and the Gates Foundation, which pledged $912 million. 

Image Credits: Global Fund.

UNICEF offices in Geneva – most staff to be relocated to Rome.

The United Nations Children’s Fund (UNICEF) is transferring the majority of its Geneva jobs to Rome, in the latest wave of upheaval to hit the city and longtime global health hub, as UN agencies scramble to respond to international aid cuts and save money.

A UNICEF spokeperson confirmed on Friday that some 290 jobs would be transferred to the Italian capital, for cost-savings purposes, while about 70-100 posts would remain in Geneva. Meanwhile, approximately 70% of UNICEF staff in its headquarters in New York City will also be relocated to lower-cost duty stations, including Nairobi, UNICEF said in a statement earlier this week.  New York City, will, however, remain UNICEF’s global headquarters, with staff levels hovering between 350-500, the spokesman confirmed on Friday.

“UNICEF will continue to have a solid presence in Geneva, including through its emergency humanitarian operations, the Giga initiative (connecting every school to the internet), and some specific programme and private sector partnerships functions,” the spokeperson said.

The UNICEF Giga initiative to connect every child to the internet will remain in Geneva.

The agency, which protects children’s rights and provides aid in over 190 countries and territories, projects a 20% reduction in its income over the next four years compared with 2024 levels as a result of dwindling funding that began before 2025 but was catalysed by United States president Donald Trump’s drastic aid cuts after taking office in January.

United States has remained a UNICEF partner, despite funding cuts

Despite funding cuts to the organization, approved by Congress in July, the US has remained a partner with UNICEF both as a member state and as a key donor.  UNICEF USA, a non-profit NGO is also active in fundraising for the UN agency’s global mission.

The UNICEF announcement follows on reports earlier this week that the World Health Organization will shed about a quarter of its global workforce, around 2371 jobs, by next summer. Despite the dramatic cuts, the global health agency still faces a $1.05 billion budget gap for its 2026-27 biennium year.  The WHO reductions follow on the January withdrawal from the organization of the US, historically the agency’s largest donor.

“As you know, this year has been one of the most difficult in WHO’s history, as we have navigated a painful but necessary process of prioritization and realignment that has resulted in a significant reduction in our global workforce,” said WHO’s Director General Dr Tedros Adhanom Ghebreyesus in a message to WHO staff, announcing the cutbacks on Monday evening.

See related story:

EXCLUSIVE: WHO Cutting Up to 25% of Staff by June 2026 – But ‘Shadow Workforce of Consultants’ Is Unreported  

Other health organisations feel the pressure

Some of the city’s other leading global health agencies, including Gavi, the Vaccine Alliance, and The Global Fund to Fight Aids, Tuberculosis, and Malaria have also announced major overhauls as donors pull back on their commitments. Both groups have warned of the serious repercussions cuts will have on their work saving lives and on hard-won gains fighting infectious diseases.

Gavi staff at its Geneva headquarters are understood to be anticipating a second round of redundancies after launching a transformation plan at the end of October, which announces a 33 per cent and 40 per cent reduction in full-time and non full-time roles at its secretariat over the next four years. This year, the health group has already eliminated 155 full-time jobs in Geneva after a decision to reduce its global workforce by 24 per cent.

UNAIDS, meanwhile, has cut about relocated all but 19 of its 127 staff at its Geneva headquarters to Nairobia well as reducing the number of country offices from 85 to 54 and cutting about one-half of its staff worldwide to about 300. The agency’s leadership is, however,  pushing back against a proposal by UN Secretary General  António Guterres to shut down the agency by end 2026 as part of a UN80 reform plan.

Note: Includes updates and excerpts from a 20 November article in Geneva Solutions by Kasmira Jefford.

Image Credits: Shutterstock, UNICEF.

Fire in official Blue Zone area of COP 30 disrupts discussions Thursday.

A fire Thursday afternoon at the UN Climate Conference (COP30) venue in Belém, Brazil, led to delays in the crucial final stage of climate negotiations as discussions in the plenary paused for much of the penultimate day. 

The talks were at a contentious stage when the fire happened and remained so Friday’morning, when talks resumed again. 

Over 80 countries have called upon delegates at the climate talks to make reference to a roadmap for transitioning away from fossil fuels in the COP 30 outcome document. But host Brazil, under heavy pressure from petro-states, is not in favor.  And the latest text released by the COP Presidency failed to include even a reference to “fossil fuel transition”, as per the COP28 outcome of Dubai.  Brazil itself is also expanding its exploration and production of oil.

The talks, officially due to end Friday evening, are widely expected to continue into Saturday as delegates debate the contentious issue of a fossil fuel transition. COPs typically run into overtime, although this year host country Brazil had hoped to reach an agreement as early as Wednesday, November 19, which did not happen. 

Fire began in official Blue Zone pavilion

COP participants flee the Blue Zone fire.

The fire started  Thursday in the pavilion area of the Blue Zone, where access is restricted to official delegations from member states and UN observer groups. This is also where the core negotiations happen. The Green Zone, which is open to the public and displays new climate tech innovations by the private sector as well as civil society exhibits, remained unaffected. 

The entire Blue Zone was evacuated quickly and safely according to officials. Thirteen individuals were treated for smoke inhalation, and the fire was controlled in “approximately six minutes”. The cause of the fire has not been officially stated yet, but an electrical malfunction is suspected.

Red dot in purple area of the Blue Zone denotes where the fire broke out.

“The flames were really high,” Ornella Punzo, who was sitting nearby, told Health Policy Watch. Describing what happened, Punzo, a senior researcher at the Italian Public Health Institute, said a group of colleauges had just begun a side event at the WHO Health Pavilion when they heard a lot of noise and people shouting. Wearing headphones, they mistook the noise for protests. 

“But then the technical staff at the pavilion waved at our facilitator and pointed at the flames direction behind us, so she grabbed the microphone from the speaker and told everybody that there was an emergency and we needed to evacuate. So we grabbed our stuff, clothes, backpacks, PCs and so on and walked away very fast.”

Outside, the thousands of people evacuated – at one of the largest attended COPs ever -then encountered rain. Organisers later began offering help to those who had left valuables like laptops and passports while being evacuated. 

Fire as a metaphor for the urgency of climate action

A metaphor for the climate? Smoke billows up from the main COP30 venue in Belém, Brazil. 

The fire at the COP led to all sorts of metaphors – one of them being how collective action helped save lives Thursday afternoon and this same sort of collective effort is needed against global warming.  But whether the fire will ultimately increase pressure on negotiators to at least reaffirm previous COP agreements on fossil fuel “transition” remains to be seen.  The outcome document of COP 28 in Dubai included a reference to fossil fuel “transition” after language referring to a “phase out” was panned by negotiators.  

COP26 in Glasgow included a commitment to “phase down unabated coal power.” That was a historic first for a UN climate agreement – although that language was also watered down from the original “phase out” proposal as a result of pressure from India, among other countries.

The Paris 2015 goal to try and limit global warming to 1.5° above pre-industrial times is now virtually impossible in current scenarios, given the pace of how emissions have grown annually since 2020. The aim of the UN’s COP process now, is focused on halting and reversing greenhouse gas emissions, including shorter-lived super pollutants such as methane, thus reducing global warming.

Image Credits: Marcelo Rocha , Marcelo Rocha, Carbon Brief .

South Africa may be excluded from future PEPFAR grants as its relations with the US deteriorate.

The United States (US) government has not sought a meeting with South Africa to discuss the resumption of its HIV grant, and it won’t supply the country with the long-acting HIV prevention medication, lenacapavir, amid a deepening political row between the two countries.

While US Ambassadors throughout the continent have initiated meetings with African Health Ministers to discuss Memorandums of Understanding (MOU) to set out new terms for the continuation of their US President’s Emergency Plan for AIDS Relief (PEPFAR) grants from April 2026, South Africa has not received such an invitation.

“The Department of Health has not received any correspondence from the US government regarding PEPFAR discussions,” Foster Mohale, South Africa’s Health Ministry spokesperson, told Health Policy Watch.

A US State Department spokesperson told Health Policy Watch that the US government “is still deliberating future health assistance to South Africa pending broader bilateral discussions”.

“The State Department approved the PEPFAR Bridge Plan for South Africa for a six-month implementation period, spanning from 1 October 2025, to 31 March, 2026.  The $115 million allocated under this plan supports core life-saving HIV services,” according to the US State Department spokesperson.
“The Bridge Plan prioritises service continuity with minimal programmatic changes, focusing on country-specific needs and maximising life-saving impact.”

In relation to whether the US would provide lenacapavir to South Africa, a US Embassy spokesperson provided a comment by Jeremy Lewin, Under Secretary for Foreign Assistance, Humanitarian Affairs, and Religious Freedom, stating that the US “will not be contributing doses to South Africa”.

“Obviously, we encourage every country, especially countries like South Africa, that have significant means of their own to fund doses for their own population of this innovative American-made drug that Gilead has developed. US-funded doses will not be going to South Africa,” Lewin told a media briefing on 17 November, the day the first 1,000 lenacapavir doses were delivered in Eswatini and Zambia.

The US will provide lenacapavir to Eswatini, Kenya, Lesotho, Malawi, Mozambique, Philippines, Uganda, Ukraine, Zambia, and Zimbabwe.

Largest HIV+ population

A patient getting an HIV test at Witkoppen Clinic, which received PEPFAR for HIV-related services.

Around eight million South Africans are living with HIV, around 13% of the population – the largest HIV positive community in the world.

In 2024, South Africa received $453 million in PEPFAR funding, and $439 million had been allocated for 2025. But this was suspended when Donald Trump became president on 20 January.

In October, the US government approved a $115 million “PEPFAR Bridge Plan” for South Africa for six months from 1 October to 31 March 2026.

Relations between the US and South Africa have been rocky since Trump took office, signing an executive order in February to “halt foreign aid or assistance delivered or provided to South Africa”.

The order incorrectly claims that South Africa is persecuting white Afrikaners, and has “taken aggressive positions towards the United States and its allies, including accusing Israel, not Hamas, of genocide in the International Court of Justice”. 

The US has offered white Afrikaners refuge in the US, and Trump has made several disparaging remarks about the country, including at a meeting at the White House with South African President Cyril Ramaphosa. 

Earlier this month, the US pulled out of the G20 meeting being hosted in South Africa this weekend, with Trump repeating incorrect claims of discrimination against whites as the reason. 

All 2026 lenacapvir stock bought

Lenacapavir, packaged as Sunlenca in the US, where is sells for $42,250 for two injections.

The US government and the Global Fund have bought all of Gilead’s 2026 stock of lenacapavir, a twice-a-year injectable that is almost 100% successful in preventing HIV transmission.

The Global Fund’s HIV head, Izukanji Sikazwe, told Health Policy Watch that her organisation will supply South Africa and all countries in need with lenacapavir “based on evidence of need”.

But eight patient advocacy groups described the rollout of 500 lenacapavir doses each for Eswatini and Zambia as a “public relations stunt” in a media release on Thursday.

“Africa and the Global South are being offered merely symbolic handouts, while Gilead and donors shape markets to serve corporate and geopolitical interests, not urgent public health needs,” said Fatima Hassan, director of the Health Justice Initiative (HJI).

“By procuring a minuscule number of doses, Gilead can claim that [lenacapavir] is ‘introduced’ in Africa, creating demand and laying the path for commercial bullying instead of introducing the product at actual cost and at scale. This is a profit-seeking, corporate strategy dressed up as solidarity,” she added.

Gilead announced in October 2024 that it has authorised six generic manufacturers to sell lenacapavir in 120 low- and middle-income countries, although none are from sub-Saharan Africa. It also excluded several Latin American countries including Brazil and Colombia.

The medicine is licensed in the US as Sunlenca for people with drug-resistant HIV, and currently costs $42,250 a year for two injections.

The generics are only likely to be available in 2027 at the earliest, and the advocacy groups claim Gilead is “frustrating the speed at which generic entries are possible”, as it has not yet filed an application with India’s drug regulatory authority and has prioritised registration in only 22 countries. 

‘Insulting’

The advocacy groups estimate that at least 10 million Africans need lenacapavir to achieve the global goal of a 90% reduction in new HIV infections by 2030, with two million of these being South Africans. 

However, the US will only provide doses for 325,000 people in 2026 – an “insulting” amount in comparison to the need, said Bellinda Thibela, Health GAP’s International Policy and Advocacy coordinator.

“Instead of crumbs, the US should be providing millions of lenacapavir doses, to alter the course of the HIV pandemic and to repair the harms caused by their illegal and deadly cuts to HIV programmes since January,” added Thibela.

However, Brad Smith, US Senior Advisor for the Bureau of Global Health Security and Diplomacy, told a media briefing this week that Gilead’s available volume in 2026 is 600,000 doses, but that the US and the Global Fund are committed to buying two million doses.

“We anticipate a continued increase in demand and production capability over time to enable us to meet the two million doses sometime in mid-2027,” said Smith, adding that the doses were being split 50/50 between the US and the Global Fund.

“We are working out between ourselves exactly who will distribute and procure for which country,” Smith added.

Speaking at the same media briefing, Gilead CEO Daniel O’Day said his company was able to “provide Lenacapavir at no profit to Gilead to the countries with the highest burden of HIV”.

US official Brad Smith (right) at a meeting to discuss a bilateral agreement with Kenya.

Political decisions

Citing the US Executive Order against South Africa, the advocacy groups say that the US  has made the country “the target of harsh foreign policy decisions based on the Trump administration’s racism, lies, and conspiracy theories”.

Nigeria is also being “pushed out” of lenacapavir support “after being criticised by US government officials, including for refusing to imprison US detainees extracted during US immigration raids”, they claim.

“In contrast, Eswatini has accepted the offer of not just the 500 lenacapavir doses ahead of World AIDS Day, but also $5.1 million in funding from the US government in exchange for imprisoning US detainees,” they note.

Sibongile Tshabalala, Chairperson of the Treatment Action Campaign (TAC), called for either Gilead to license South African generic companies to make lenacapavir, or for the South African government to “use its lawful powers to issue compulsory licenses”.

“Now that the Trump administration has openly tied the global rollout of lenacapavir to a political standoff rewarding ‘compliance’ but punishing African political autonomy and sovereignty, South Africa must step forward with principled global leadership,” the groups add.

  • This story has been updated to include the US State Department’s comment.

Image Credits: The Global Fund/ Saiba Sehmi, International AIDS Society, Witkoppen Clinic, Gilead.

Deborah and her 10-month-old daughter Catherine at the Baylor College of Medicine Children’s Foundation in Lilongwe, Malawi. Deborah is living with HIV and Catherine is on preventive treatment.

JOHANNESBURG – The Global Fund (GF) has only raised $4 billion of its $18 billion budget for the next three years – so much is riding on its Replenishment Summit in Johannesburg on Friday (21 November) as it seeks the balance to advance progress against HIV, tuberculosis (TB) and malaria.

The United States has been the largest donor to the Global Fund, contributing around one-third of its budget – but whether it will still contribute generously is an open question, given the Trump administration’s “America First” focus.

“We have been in almost constant dialogue with the US since the beginning of the year, and we have not received any stop-work order or any sort of notification that the funding will be stopped,” Francoise Vanni, the Fund’s external relations and communications director, told a media briefing in Johannesburg on Thursday.

“We are confident that they will pledge to the Replenishment tomorrow,” added Vanni, pointing out that the US and the GF are working closely to roll out the long-acting HIV prevention medicine, lenacapavir, in several African countries.

South Africa and the United Kingdom (UK) are co-hosting the Replenishment, but that did not prevent the UK from cutting its contribution by 15%.

The Fund provides 73% of all international financing for TB, 60% for malaria and 24% for HIV.

Médecins Sans Frontières (MSF) has described initial pledges as “deeply concerning”. “Germany and the United Kingdom – the only major traditional donors to pledge so far – have both decreased their commitments compared to the last cycle. Specifically, Germany has pledged €1 billion instead of €1.3 billion and the UK has pledged £850 million instead of £1 billion,” MSF noted on Thursday.

“No donor has increased their pledge when considering inflation. If other major donors follow Germany and the UK’s examples, the results would be catastrophic for people impacted by TB, HIV, and malaria worldwide,” MSF said.

“Failure to meet this [$14 billion] goal would risk catastrophic cuts to essential services, threaten the resurgence of HIV, TB, and malaria – the world’s top three deadliest infectious diseases – and put the financial burden of health care onto the world’s most vulnerable patients.”

Members of a spray team prepare their equipment before spraying homes with insecticide to protect families from malaria in Kaukira, Honduras.

Saving 70 million lives

The GF is the world’s largest funder of global health, and it has saved an estimated 70 million lives since its establishment 22 years ago, according to its Results Report 2025.

Around $103 billion has also been saved in reduced hospitalisations, freeing countries’ health systems to address other diseases and other health needs, Vanni noted.

While it works in over 100 countries, its effect has been felt primarily in Africa, where 73% of its budget has been spent.

In 15 priority countries in sub-Saharan Africa, life expectancy has increased from 49 years old in 2001 to 61 in 2021 – mostly thanks to people with HIV getting access to antiretroviral medicine. In Zambia, for example, life expectancy has increased by 19 years from 43 to 58 years.

Since the GF was launched in 2002, AIDS-related deaths have been reduced by almost three-quarters in the countries where the Global Fund operates, and new infections have been reduced by 62%. 

Without these interventions, AIDS deaths would have increased by 90% and new HIV infections by 75% over the same period.

In 2024 alone, Fund-supported TB programmes treated 7.4 million people with TB. 

Between 2002 and 2023, GF efforts have reduced TB deaths by 40%. Without these, TB deaths would have increased by 134% and TB cases by 40% over the same period. 

Malaria deaths were reduced by 29% between 2002 and 2023, “even though the population in these countries has increased by 46%”, the Results Report notes. “Without malaria control measures, deaths would have increased by 94% over the same period.”

Malaria ‘way off target’

Despite progress, HIV, TB and malaria remain the world’s deadliest infectious diseases. The $18 billion budget could save 23 million lives between 2027 and 2029, avert 400 million new infections and result in a 1:19 return on investment across the three diseases, according to Fund modelling.

“Malaria is way off track, with 600,000 people a year dying,” admits Kate Kolaczinski, the Fund’s senior specialist on the disease.

“Malaria is the leading cause of outpatient visits in sub-Saharan Africa,” she adds, with 263 million malaria cases in 2023.

Between 2002 and 2023, malaria cases in countries supported by the Global Fund increased by 8%

“Rising conflict, disruptions from extreme weather events and increasing resistance to antimalarial drugs and insecticides have complicated efforts to combat malaria in 2024,” according to the Results Report 2025.

“The goal of ending [malaria] by 2030 looks daunting. Reductions in global health funding could undermine progress against malaria. A widening funding gap, combined with existing crises and an expected population growth in areas at high-risk of malaria, could threaten the lives of millions.”

President Duma Boko of Botswana has urged countries to support the Replenishment, noting in an exclusive article for Health Policy Watch: “If the world retreats now, an additional 750,000 children in Africa could die by 2030, and our economies could lose $83 billion in GDP if funding is so low that all prevention interventions are halted.”

HIV resurgence?

“There’s a risk of HIV resurgence, especially now that we have funding challenges that we’re facing,” says the Fund’s HIV head, Izukanji Sikazwe, pointing out that 9.2 million people living with HIV still need access to treatment.

“We are off target for HIV prevention. In 2024, there were 1.3 million new infections. We need a fourfold reduction to meet the 2025 target of 370,000.”

Meanwhile, TB surged during the COVID-19 pandemic and but 2024 brought new progress against the disease.

“Robust funding commitments in 2025 are absolutely critical to maintaining our momentum against TB and preventing a resurgence that could undo decades of hard-won progress,” according to the Results Report 2025.

It describes an “exciting pipeline of innovative tools”, including new TB tests, better treatments and “at least five TB vaccines in phase III efficacy trials”. 

Private sector contributions

While the bulk of the Fund’s budget comes from country contributions, the private sector also contributes – with the Gates Foundation being the biggest and most consistent private donor, contributing $3.91 billion since 2002.

“The Global Fund will go down in history as one of humanity’s biggest achievements. It’s also one of the kindest things people have ever done for each other,” according to Gates Foundation chair Bill Gates.

The Global Fund’s track record proves it is an excellent investment for our global health dollars. Its work is critical to achieving the goal of ending AIDS, TB and malaria, and making our world a more equitable place for people everywhere.”

The Children’s Investment Fund Foundation (CIFF) has significantly increased its contribution recently, focusing on expanding access to lenacapavir by both supporting procurement and the development of generics.

John Fairhurst, who heads the Fund’s private sector mobilisation, says that the sector has contributed over $5.3 billion in the past 20 years – often playing a “catalytic role” in innovation.

Unlike countries, which give unrestricted funds, private donors can earmark their contributions.

Image Credits: Tommy Trenchard/ Global Fund, Global Fund.

Hassana Sa-adu with her children, holds a free mosquito bednet delivered to her household during a door-to-door mosquito distribution in Gabasawa, Kano, Nigeria.

The Global Fund to Fight AIDS, Tuberculosis and Malaria provides nearly 60% of international financing for malaria. Ahead of its Replenishment campaign on Friday, the President of Botswana appeals for world leaders to continue to support the Fund.

As President of the Republic of Botswana and Chair of the African Leaders Malaria Alliance (ALMA), I have witnessed the toll of malaria across our continent, killing a child every minute. Additionally, I have seen how it keeps children out of school, weakens workers in the fields and factories, and drains our hospitals. 

Malaria is preventable and treatable. Yet if the world retreats now, an additional 750,000 children in Africa could die by 2030, and our economies could lose $83 billion in GDP if funding is so low that all prevention interventions are halted, as documented in Malaria: The Price of Retreat, a report commissioned by ALMA and Malaria No More UK.

 At the African Union, leaders have been clear: Africa must invest to drive its own prosperity. But we also call on our international friends to continue to partner with us in the fight against malaria to unlock a healthier and more prosperous Africa.

Africa is not standing still. Governments are mobilising domestic resources for health including malaria. National End Malaria Councils have raised $166 million from public and private sectors. Countries in Africa fund more than a third of all malaria treatments, a clear proof of our commitment to shared responsibility. 

Communities, businesses, and leaders are stepping up.  But, we cannot succeed in ending malaria alone. 

If we fail to act, malaria could steal Africa’s children, and $83 billion of our future GDP.

Children’s lives at risk

The Global Fund to Fight AIDS, Tuberculosis and Malaria provides nearly 60% of international financing for malaria. Without this support, prevention programmes risk collapse, and many more children’s lives will be lost.

We know what is at stake. Agriculture, the backbone of Africa’s economies, could lose $4.3 billion in productivity by 2030 if malaria were to resurge. Tourism, a sector forecast to create millions of jobs, could lose more than $2 billion in revenue. 

In mining, malaria once cost AngloGold Ashanti’s operations in Ghana 7,500 workdays every month through absenteeism until prevention efforts, supported by the Global Fund, transformed outcomes.

 Malaria is not just a health issue. It is an economic brake on our prosperity.

Our health systems are already under strain. Between 2025 and 2030, malaria could cost $67 billion in healthcare spending if funding flatlines – and $20.7 billion more if prevention collapses. That means crowded hospitals, exhausted health workers, and fewer resources for mothers in childbirth or children needing vaccines.

Above all, malaria threatens our children and our future. Missed school days, weakened learning, and the deaths of so many young lives could cost Africa $19.7 billion in earnings by 2030.

But with full investment in prevention and treatment, Africa’s youth could gain $171 billion in lifetime earnings by 2040. That is the demographic dividend we must protect.

Africa is stepping up. But solidarity is essential. The upcoming replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria – co-hosted by South Africa and the UK – is a moment of truth. Will the world support us as we push forward, or will it step back and watch progress unravel?

We call on world leaders, especially our G7 partners, to fully fund the Global Fund. This is not about charity. It is about shared responsibility and shared prosperity. Ending malaria will unlock growth, strengthen health sovereignty, and safeguard the future of our children.

We can end malaria in our lifetime. Africa is ready to lead. But the world must stand with us, now.

Duma Gideon Boko is the President of Botswana and chair of the African Leaders Malaria Alliance. He has a Master’s in Law from Harvard University.

 

Image Credits: Ben Moldenhauer/MMV, Global Fund.

There is immense innovation in AI-driven robots, like this ARI -V2 robot, for use in healthcare, yet regulatory frameworks and ethical standards are lagging.

Technological advances in Artificial Intelligence applications for healthcare are quickly outpacing regulatory and ethical safeguards, creating a dangerous gap in patient safety, warns a milestone report on AI in Health Systems, published Wednesday by the World Health Organization’s European Region (WHO/EURO). 

Paradoxically, the WHO’s urgent call for tighter AI regulation coincided with a far-reaching European Commission (EC) proposal Wednesday to loosen certain AI regulations in the European Union’s 27 member states – as part of a new  “Digital Omnibus” package. The package aims to cut red tape for AI and other digital industries in the EU, but critics argue that it would severely water down data protection for individuals. 

The WHO report’s findings are based on the first comprehensive survey of AI-implementation conducted in the WHO European Region from 2024-2025. The results culled from 50 out of 53 WHO European Region member states – whose borders extend from the United Kingdom to Russia, and through Central Asia to Turkey and Israel – highlight how countries are struggling to keep up with the pace of change. 

“The rapid rise of AI in healthcare is happening without the basic legal safety nets needed to protect patients and healthcare workers,” warned Hans Kluge, WHO Regional Director for Europe.

The report comes at a time when AI is fundamentally transforming healthcare, helping doctors, nurses and other health workers diagnose and track diseases, and communicate better with patients. The high costs involved in developing and adopting AI in public healthcare systems also threaten to deepen the digital divide.

The report identifies “legal uncertainty” (reported by 86% of the states) and “financial affordability (78% of the states) as the biggest barriers to AI adoption. But along with the barriers to uptake, loose or non-existent regulatory standards pose new issues in terms of patient safety, liability and privacy.

WHO warning collides with EU deregulation moves

EU Commissioners Henna Virkkunen, Valdis Dombrovskis, and Michael McGrath present the “Digital Omnibus” package in Brussels.

In terms of the proposed “Omnibus” package, the Commission, the EU’s executive branch, claims it would simplify digital regulations, reducing administrative costs of AI uptake, particularly for small and medium-sized enterprises, as well as improving rules harmonisation amongst EU member states.

But a key element of the proposal involves amendments to the 2018 EU General Data Protection Regulation (GDPR), trumpeted as the “toughest data privacy and security law in the world,” to alter the definition of sensitive data. 

Critics claim that this will also have a negative impact on the protection of health data. Prior to the Commission’s announcement, over 120 civil society organisations had strongly criticised the Omnibus package, labelling it the “greatest setback for digital fundamental rights in the history of the EU”.

‘Our DNA could be used to train the AI systems of big companies’

Another proposed amendment to the GDPR would allow companies to use personal data to develop and operate AI systems based on “legitimate interest”.

Ella Jakubowska, EDRi

“According to that change, a giant healthcare company could simply declare the use of sensitive data to train their AI systems as legitimate interest,” said Ella Jakubowska, an AI policy expert with the NGO European Digital Rights (EDRi), an association of civil and human rights organisations from across Europe.

“Our DNA could be used to train the AI systems of big companies,” Jakubowska warned in an interview with Health Policy Watch. 

The Commission, meanwhile, maintains that under the new Omnibus rules, companies would still have to adhere to specific transparency criteria, as well as preserving the unconditional right for persons to whom the data relates to object.

European Commission also aims to postpone rollout of new AI rules specific to medical devices

In another move that worries patient advocates, the Commission also has proposed postponing  the rollout of new rules specific to medical devices in the EU’s new EU Artificial Intelligence Act, which came into force last year. The rules aim to safeguard health, safety, and fundamental rights of patients with respect to high-risk AI systems used in certain medical  procedures.  

The rules were supposed to come into effect in August 2026, but the Commission wants to delay that by up to 16 months. The AI Act is the world’s first comprehensive set of AI regulations by a major regulatory authority.

European Union AI Act, which came into force in 2024.

Industry groups had lobbied for an even longer delay, arguing that applying the AI Act alongside existing medical device laws would create overlapping requirements. They claimed that this “dual regulatory burden” would stifle innovation and drive the development of life-saving technology out of Europe.

The Commission did not respond to a request from Health Policy Watch to respond to the WHO report or elaborate on the logic of the Omnibus package, with respect to the health sector, prior to publication. 

In a statement from the EU’s Brussels headquarters, however, Michael McGrath, the EU Commissioner for Democracy, Justice, the Rule of Law and Consumer Protection defended the new EU Omnibus legislation, saying: “The proposed amendments fully respect the high level of protection of personal data that we are committed to.” 

He added that the “Digital Omnibus” proposal would still require approval from the EU Council of government ministers, as well as from the European Parliament.

Lack of liability rules puts patients at risk 

Gaps in existing laws and in liability standards for the use of AI are widespread, with only four countries with health-specific AI rules in place.

The EU’s push to ease regulatory burdens for companies comes as the WHO report highlights the stark consequences of an already existing legal vacuum in healthcare both within the EU as well as across the wider WHO European Region. The failure to regulate AI strictly has left vulnerable populations exposed to critical risks, particularly in areas of liability and ethical standards, the report charges.

In the absence of clear regulations, hospital staff and patients are faced with critical liability issues, such as: who is responsible when an AI system makes a mistake? 

Only four countries in the WHO European Region have established liability standards for AI in healthcare, the report reveals, with three more in the process of introducing legal requirements. This lack of clarity leaves doctors exposed and patients vulnerable to shouldering the burden alone of erroneous diagnoses and treatments.

Beyond liability related to a mistaken individual diagnosis or treatment, lurks dangers of algorithmic bias, the report states. For instance, if AI systems are trained using unrepresentative data, they can discriminate against vulnerable populations systematically. Critics say that distortions frequently occur along lines of gender, origin or social status, leading to patients either being invisible to the system or being unfairly targeted by it.

Other critical  ethical concerns highlighted include the lack of safeguards around data privacy.

Governments are also failing to listen to the public. While most nations consult AI developers and healthcare providers, only 42% of countries included patient associations in the conversation. Just 22% of countries consulted the general public. The report warns that this “limited engagement” could result in the development of tools that do not meet real-world needs.

A deepening digital divide in regulation as well

The broader public was only conuslted by 22% of WHO/EURO member states in developing policies on the use of AI-driven technologies in health systems.

In terms of regulatory processes, per se, the European region is also suffering from severe fragmentation, with a clear divide between nations that are ready to govern AI, such as the United Kingdom and high-income nations in the EU and the European Economic Area, and less developed nations in central Asia and elsewhere, which are only just beginning to consider the issue. In addition, the vast majority of countries that have regulations (33) rely on cross-sector measures that often lack the specificity required to address risks to the health system.

Wealthier nations are, meanwhile, pushing ahead. The UK, for example, is proactively addressing regulatory gaps by testing AI medical devices in controlled clinical environments through initiatives like the AI Airlock system. 

According to the WHO analysis, this ensures that new AI-based devices meet safety and efficacy standards before full deployment. This baseline requirement  for medical devices  is also preserved even in the looser regulatory measures of the  EU’s “Digital Omnibus” proposal.

By contrast, countries such as Georgia report facing obstacles on every front, ranging from legal uncertainty to basic infrastructure deficiencies. 

Financial constraints were identified as a major hurdle by 78% of Member States. The high cost of infrastructure and steep subscription fees for advanced systems risk turning AI into a luxury rather than a public service.

Kluge stressed that “equity must remain our guiding principle, ensuring that the benefits of AI extend not only across Member States but also within them, reaching all communities regardless of geography, income or digital capacity”.

WHO calls for strengthening funding and cross-border harmonisation

Private sector investments are concentrated in wealthier regions.

With private investment largely concentrated in Western and Northern Europe, the WHO is also calling on countries to clearly define what AI-related healthcare responsibilities should remain public and what is or will be delegated to private actors. Countries also need to ensure transparency in all public-private partnerships and secure access to AI technologies to uphold rights.

To overcome implementation challenges and harmonise regulation across the region, cross-border partnerships must also be strengthened, WHO says. 

Dedicated financing streams and AI-sensitive public health reimbursement models similar to those used for medicines or medical procedures are needed to ease the AI financing gap. Under such models, healthcare providers such as hospitals and clinics would be compensated for using an approved AI system in patient care, for instance.

The WHO emphasises the importance of adhering to core principles when integrating AI. These include placing patients at the centre of care, upholding equity and human rights, ensuring system safety and public well-being, maintaining transparency, and establishing clear lines of responsibility and accountability.

“We stand at a fork in the road,“ said Natasha Azzopardi-Muscat, WHO Director of Health Systems. “Either AI will be used to improve people’s health and well-being, reduce the burden on our exhausted health workers and bring down health-care costs, or it could undermine patient safety, compromise privacy and entrench inequalities in care. The choice is ours.”

Image Credits: European Union, European Union , EDRi, EU , WHO/European Union , WHO/European Region , WHO/European Region.

Around 840 million or roughly one in three women globally have experienced intimate partner or sexual violence in their lifetime, according to the latest WHO estimates.

Nearly 840 million women, or roughly one in every three globally, has experienced intimate partner or sexual violence during their lifetime, according to a landmark report released on Wednesday by the World Health Organization (WHO) and six other United Nations (UN) partner agencies.

In the past 12 months alone, 11% or 316 million women who have ever been partnered were subjected to physical and/or sexual violence by an intimate partner, experts involved with the report said.

“Worryingly, this violence starts early, affecting 16% of adolescent girls aged 15 to 19. That is 12.5 million adolescent girls around the world are subject to this violence by a husband or an intimate partner before their 20th birthday,” said Lynnmarie Sardinha, Technical Officer at WHO’s Department of Sexual, Reproductive, Maternal, Child and Adolescent Health and Ageing.

Progress on reducing intimate partner violence has been painfully slow with only 0.2% annual decline over the past two decades, the report found.


“Violence against women is one of humanity’s oldest and most pervasive injustices, yet still one of the least acted upon,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “No society can call itself fair, safe or healthy while half its population lives in fear. Ending this violence is not only a matter of policy; it is a matter of dignity, equality and human rights. Behind every statistic is a woman or girl whose life has been forever altered,” he said.

While there are some geographical differences in rates, violence against women and girls happens in virtually every country. Elderly women, women with disabilities, and those living in humanitarian settings are especially vulnerable.

For the first time, the report also includes national and regional estimates of sexual violence by someone other than a partner. An estimated 8% of women and girls globally have been subjected to sexual violence by someone other than a husband or partner, or non-partner sexual violence, the report found.

Non-partner violence affects a large number of women globally.

While this might seem a small number compared to intimate partner violence, it translates to 263 million girls and women worldwide.

“We know that the actual prevalence of this violence is much higher because of the stigma that is related to reporting on this violence, the negative repercussions of reporting, the victim blaming attitude, and also the additional measurement challenges, because we know that surveys in different countries measure sexual violence in different ways,” said Sardinha.

Widespread, lifelong and intergenerational risks

Dr Jeremy Farrar, Assistant Director -General, Health Promotion and Disease Prevention and Control.

 The new WHO report synthesizes data between the years 2000 and 2023. It includes data from 168 countries on intimate partner violence and from 140 countries for sexual violence by non-partners, involving women and girls aged 15 years and older.

“The availability of data across these many countries is a real milestone,” said Dr Jeremy Farrar, Assistant Director-General, Health Promotion and Disease Prevention and Control, WHO at a press briefing.

Violence against women prevalence estimates, 2023.

Women and girls who are subjected to sexual violence face unintended pregnancies, carry a higher risk of acquiring sexually transmitted infections and experiencing depression.

In addition, children growing up in homes where the mother is at the receiving end of emotional, physical and sexual violence are more likely to face mental and physical challenges, according to latest research.

“Children who are exposed to watching their mothers be abused, or they themselves are abused, are much more likely to grow up… to either experience violence or perpetrate violence themselves,” said Avni Amin, Unit Head for Rights and Equality across the Life course at WHO.

See related story: How Intimate Partner Violence Affects Children

Funding cuts make solving the global problem a challenge

Avni Amin, Unit Head for Rights and Equality across the Life course at WHO.

While violence occurs in every country, women in the least-developed, conflict-affected, and climate-vulnerable settings are disproportionately affected. For example, Pacific island nations (excluding Australia and New Zealand) reported a 38% prevalence of intimate partner violence in the past year, more than three times the global average of 11%.

Even as evidence is mounting on the effectiveness of strategies to prevent violence against women, the funding for such initiatives is declining.

Even before this year’s recent crisis, as of 2022, only 0.2% of the global development aid was allocated to programmes focused on the prevention of violence against women.

The crisis has become all the more acute with the sharp cutbacks in global health funding by rich donors, including but not limited to the United States’ dismantling of USAID.

Moreover, some of the hardest hit services have been programmes on sexual and reproductive health, which are an important entry point for survivors of violence to access the care that they need.

“In a shrinking aid climate, governments must step up allocation of domestic financing for prevention and response and response to violence against women must be integrated into budgets of health education and social protection sectors to ensure sustainable financing at scale,” said Amin. He echoed calls for national governments to fill in more of the gap.

A call for action — and accountability

Violence against women starts early and affects both young and old.

While more countries than ever are now collecting data to inform policies, significant gaps remain, WHO said.

The report was accompanied by the launch of the second edition of the ‘RESPECT Women: preventing violence against women framework,’ that is a framework meant to guide policymakers on policies to deal with violence against women and girls.

Among other actions, the framework asks countries to strengthen survivor-centered health, legal and social services. It also asks countries to invest in data systems to track progress and reach the most at-risk groups. Enforcing laws and policies already in place to empower women and girls is another priority area.

This is the second such report by the WHO. The first one looked at the data between the years 2000 and 2018 and was released in 2021.

“These are the second available estimates for violence against women in the reporting period of the SDGs 2015 to 2030. The results highlight a tragic reality for women and girls worldwide,” said Farrar.

The report has been released ahead of the ‘International Day for the Elimination of Violence against Women and Girls’ that is marked on 25 November.

“Empowering women and girls is not optional, it’s a prerequisite for peace, development and health. A safer world for women is a better world for everyone,” said Tedros.

Image Credits: Unsplash/PaaZ PG, Violence against women prevalence estimates, 2023.

WHO Director-General Dr Tedros Adhanom Ghebreyesus and Raul Thomas, Assistant Director-General for Business Operations at the World Health Assembly in May, where member states approved a stripped-down $4.2 billion budget for 2026-27.

WHO will have terminated, retired or separated by agreement an estimated 2371 staff worldwide by mid-2026 – shedding about 25% of a workforce that numbered 9,457 in December 2024 – a 15-year peak. 

That’s according to a new report that is to be presented and discussed with WHO member states on Wednesday. 

Despite the huge cuts, there remained a $141 million gap in 2025 salary costs as of September 2025 – and a projected $1.05 billion funding gap for 2026-27. That, as compared to a $1.7 billion gap in May 2025, according to the report, posted on the WHO website Tuesday morning with no announcement. It was shared Tuesday evening by WHO Director General Dr Tedros Adhanom Ghebreyesus in a message to all staff worldwide.   

The $1.7 billion funding gap for 2026-27 has been reduced to $1.05 billion.

Significantly, the report also provides no data as to the number of non-staff consultants who continue to be employed by the organization – sometimes described as WHO’s “shadow workforce.” 

And that represents a significant gap in the reporting, in light of the more than 8,000 consultants who were engaged by WHO globally in 2024. 

Biggest absolute cuts among junior and mid-level staff 

In terms of sheer numbers, professional staff at low and mid-level are among those hit hardest by the staff cuts.

In terms of regular staff, the biggest proportionate impacts of the cuts are falling on the highest and lowest levels in the system, according to the report, dated 24 October and labeled as “provisional and preliminary.” 

The number of senior directors, D2s, will have been reduced by 42% as of June 2026, in comparison to January 2025. Athough their numbers had swelled in recent years, the focus of a Health Policy Watch investigation in March,  those reductions are still tiny in absolute terms – representing cuts of 27 out of 65 posts.  Proportionately, entry-level P1s and P2 staff, the lowest members of the professional brackets, are the other hard hit category, reduced by 37%. Nearly one-third of mid-level P3 positions are also being slashed. 

And in terms of absolute numbers, it is the lower- and mid-level professionals, P3s and P4s, that are losing the most positions overall (283 & 342 positions respectively) – along with senior administrative staff G5 (381).  

Most dramatic cuts in Geneva Headquarters 

Projected cuts by WHO regions.

The cuts are most dramatic in WHO’s Geneva office where the workforce will be cut by 28% as of June 2026, a point at which separations of even long-term staff will have taken effect.  The African and European regions will take the second-largest hit with reductions of 25% and 24% respectively.  The regional comparisons date from 1 January 2025  when total staff numbered 9401, already slightly lower than the 31 December 2024 peak. This, and other data shared reflects small discrepancies in reporting on percentages of staff cutbacks, and baselines used for comparisons.  

The report however, makes it clear that by June 2026, some 1089 positions will have been shed through what WHO described as “natural attrition” – said to include retirements and early retirement, but also, seemingly, the non-renewal of short-term staff contracts. In addition, another 1,282 posts were abolished outright – with staff in those positions failing to be mapped or matched with alternative positions.  That makes for the net reduction of 2371 posts. 

Anticipated staff terminations by June 2026 cite 1089 positions cut through ‘natural attrition’ and 1,282 posts abolishesd.

Staff headcount would be lowest since 2014

Evolution of global headcount – with reference to some margin of uncertainty as to overall totals in 2026, and thus the total net proportion of positions cut (between 22-28%).

The combined effect of terminations of short-term staff, early retirements and separations of longer term staff, as well as limited new hiring or reassignments, should bring WHO’s global staff headcount down to about 7360 professional and administrative positions by mid-2026, the analysis projects. 

That’s a level not seen since 2014, under the tenure of former WHO Director General Margaret Chan. Staff levels increased by about 728 posts  between 2014-2017, when Chan retired. 

The election of WHO Director General Tedros Adhanom Ghebreyesus saw an even more major expansion of staff by another 1,429 positions – triggered to some extent, but not all, by the COVID 19 pandemic.   

Balance in gender, age and region of origin

Gender and geographic balance of staff, would however, be maintained.

Despite the lopsided impacts of the staff cuts on junior staff, the cuts have preserved a gender balance with even a slight margin for women workers as compared to previously, the report suggests. WHO’s 2026 workforce will also be slightly younger with a slim 51% majority of staff aged 30-49, as compared to 49% in the past.   

The report also shows significant new savings in travel and procurement costs in 2025, as compared to 2024- with a 50% reduction in travel costs as of end October.  

‘Shadow workforce’ undisclosed to Member States

Non-staff contracts in all categories and full-time equivalents for part-time engagements (consultants and APWs).

Despite the very detailed breakdowns provided on staff cuts and costs, as well as travel and procurement, there’s no information in the report on the projected numbers of consultants and consultancies for 2026 at Headquarters – or globally. 

These non-stafff contracts in three different categories numbered over 8000 full-time-equivalent positions in 2024 – almost as many as regular staff.  

“Contractual services” largely made up of consultancies also represent about 28% of total budgeted organizational costs – in a draft 2026-27 budget that was part of a White Paper shared by the WHO administration in a  Planning, Budget and Advisory Committe (PBAC) meeting of member states in May, held behind closed doors. The paper was obtained by Health Policy Watch. 

HPW rendering of projected WHO budget, by category, as per a White Paper presented in May to a WHO Planning, Budget and Advisory Committee (PBAC).

Internal organizational charts obtained for some departments also reflect the heavy, ongoing use of non-staff personnel – even as staff are slashed. 

In the organizational chart of one small department, seen by Health Policy Watch, there are 4 staff posts (including the head), but close to 20 consultants – roughly a five-fold multiplier over what is visible in the staff-only chart presented to member states.

The internal organizational chart of another department shows just two fixed staff in a unit including over two dozen consultants or staff on contracts of under 60 days – which grants employees almost no staff rights at all. 

Said one insider, “the “headcount reduction” being marketed to Member States focuses on staff posts only and hides a large, parallel workforce.

“The prioritization and realignment process targeted established staff posts, with fixed-term staff receiving abolishment notices and three-month terminations. Yet there is no evidence of a comparable, systematic reduction in consultancies,” one staff member observed. 

Restructuring process – orderly and rationale or arbitrary and capricious?

Overall, the presentation to member states presents a picture of the WHO restructuring as a systematic process, with carefully established checks and balances, including regular staff engagement, Staff Association inputs, and an Ad Hoc Review Committee (ARC) of all department reorganization plans. 

Strikingly, none of the new organizational charts, organigrammes, are enclosed in the member state presentation or its annexes, making their review impossible.   

“The Member State briefing claims the process was guided by “transparency, fairness and humanity”, with “lessons learned integrated”;  “year-round engagement with Staff Associations”;  and “process co-design”, one staff member, who asked to remain anonymous. “But three Extraordinary General Assemblies (EGAs) of the HQ Staff Association formally adopted: a Motion of No Confidence in the 2025 prioritization process; a demand for an Immediate Freeze of separations and new recruitments; a demand for an Independent Review.”  See related story:  

WHO Staff in Geneva Call for Freeze In Layoffs and Independent Review of Downsizing Plans

“Administration emphasises that the process was ‘deliberate and thoughtful’, with a ‘co-designed process,’ another staff member said. 

But at the grassroots, post abolitions and reclassifications, as well as staff mapping and reassignments, were often tainted with favoritism and political patronage as well as considerable confusion, staff members subject to layoff and reassignment have claimed.

WHO’s Administration also ignored Staff Association-proposed alternative pathways for cost savings including: caps on salaries at the highest levels and a freeze on new senior hires; more decentralization of HQ functions to lower-cost duty stations; and a rollback of  consultancies before staff were hit, they say. 

“Member States are not being told that staff put forward a comprehensive, alternative savings plan focused on senior-level burden sharing and reduced reliance on consultants – and that this package has not been adopted,” one staff member observed.

“WHO is now on a path that staff themselves have flagged as likely to end in mass litigation. That omission is critical to Member States’ understanding of risk.”

Image Credits: United States Mission Geneva, WHO , WHO, WHO Workforce Data, December 13 2024, WHO .