There is mounting rage amongst World Health Organization’s (WHO) staff about planned workforce reductions, as new financial data suggests that low- and mid-level personnel are bearing the brunt of cuts—while high-ranking executives, whose real costs far exceed their published salaries, remain largely protected.

In an email to WHO staff last week, WHO Director General Dr Tedros Adhanom Ghebreyesus said that he anticipated some 600 jobs would be shed from WHO’s Geneva headquarters for the coming 2026-2027 biennium.

At the beginning of 2025, 2,938 WHO staff were employed at headquarters, and 9,452 worldwide, not including the Americas region, which has its own separate budget. But in January, the United States, WHO’s largest donor, pulled the plug on its contributions immediately after US President Donald Trump took office thrusting the agency into a deep crisis. 

“With a 21% reduction in the 2026-2027 budget, we are now realigning our structures with our core mandate,” Tedros told staff in an email on 19 August, coinciding with a management briefing to member states. 

“Some activities are being sunset, others are being scaled down, and those directly linked to our mission are being maintained,” he continued. “At headquarters, based on the final approved structures, we anticipate approximately 600 separations.  Regional offices will provide their figures as their processes advance.” 

While the picture is still evolving, anecdotal reports of the emerging new departmental structures at headquarters suggest that a higher proportion of more senior P5 and P4 professionals could be retained in Geneva, in comparison to more junior counterparts at P3 and P2. 

If junior posts are disproportionately abolished across the organisation, that will slam shut the doors to a younger generation for years to come. 

‘Majority of high-cost positions have been kept’ – anonymous letter

In an anonymous staff letter to Tedros shared with Health Policy Watch, and published in full by the New York-based agency Pass Blue and one high-ranking UN official, the authors charged that the WHO realignment has hit the lowest ranks hardest, due to the process being followed: 

“Many senior or technical roles are reviewed individually, reassigned early, or preserved outright,” they complained. “The majority of high-cost positions have in fact been kept, while other posts, deemed ‘standard or generic’, are discontinued, the majority of those held by lower-ranking people.

“The cuts have fallen not on cost, but on people, specifically those in lower-paid roles that are already filled,” the letter continued. “This isn’t about efficiency, it’s about who is shielded and who is sacrificed.”

Additionally, new data and disclosures suggest that some of the budget cuts may be falling hardest on frontline teams that had fewer staff and budget to begin with, while historically large departments and teams with greater political clout suffer less. There is no clear linkage between the organisation-wide prioritisation exercise and actual budget envelopes granted to departments.

At department level, rather than an interactive and iterative process, directors have held the reins, with staff largely only able to react once a new structure, with deep cuts, has been established. In several cases, staff allege that retaliation and personal score-settling taint the process.

Meanwhile a new P7 grade is quietly being created which would offer the same salary scale as D2 directors. That raises questions about whether the reduction in D1- and D2-level directors at headquarters from 76 to 34 announced on 1 July will in fact result in real budget savings, or if most former directors will merely be embedded into other HQ operations with the same salary as before. 

On a more positive note, plans are being finalised to move four WHO teams from headquarters to less expensive locations in Lyon, Berlin, Dubai and India, saving jobs and some budget in the process.  However, the net initial savings, after relocation costs, remain modest amounting to only about $8.2 million in the coming biennium budget year, according to costs presented to member states last week. That remains a drop in the buck of the gaping $1.7 billion budget hole.     

The relocation of 33 Geneva-based staff from health workforce and nursing to Lyon would be the largest savings, at $2.1 million a year, followed by $600,000 in savings from the relocation of 17 staff to Berlin; $700,000 from the relocation of 22 WHO emergencies staff to a logistics hub in Dubai; and $600,000 from relocating nine traditional medicines posts to India.

Real costs of top jobs are even higher than previously disclosed

Underlining the challenges, the real costs of positions in Geneva for the years 2026-27 are increasing yet again in comparison to the previous 2024-2025 biennium, according to WHO’s official Post Cost Average (PCA) scales, obtained by Health Policy Watch.

An analysis of the PCA also largely confirms our previous estimates of enormous gaps between actual salaries and real costs, further revealing that the gap is highest at the top of the salary scale. For instance: 

• The Director-General (UG3) will cost WHO an estimated $799,500 per year in the next biennium, nearly three times his published 2025 gross salary of $293,000 —  around 172% more.
• Deputy Director-General (UG2) and Assistant Directors-General (UG1) will cost between $530,000 and $500,000 respectively, compared to a published 2025 gross salaries of $235,000 and $213,000 — or 125–134% more.
• A Senior Director (D2) post will cost roughly $450,000 per year, on average, more than double the published 2025 figure of $205,942 – at the uppermost step on the salary scale – where many senior staff fall due to their long tenure in service.
• A Director (D1) post will cost $410,000 per year, more than double the published salary figure of roughly $193,000 for the uppermost step of the scale.
• Even a senior professional (P5) will cost about $360,000 per year, more than double  the published top step salary of $165,000.

 

At the General Service (G2-G7 levels), PCA costs for 2026 are consistently 70-90% more than the last published net base salaries (2024-25 biennium). 

Transparency gap 

Based on standard UN  “cost accounting” principles, PCA is a tool used internally for WHO budget and resource allocation. During reorganisation exercises (like the ongoing workforce reduction), PCA is the reference cost used when comparing the financial implications of abolishing, retaining, or adding positions.

The large gap between the PCA and published salaries is due to the many statutory entitlements embedded in UN staff positions, including pension contributions, health insurance, education grants, and other allowances. But the largest element is the locational post adjustment, which for Geneva is now at 66.7% of the net base salary.  The PCA thus illustrates the very high budgetary weight of Geneva-based posts, in comparison to posts at regional or country level. 

For Member States and observers, the gap can create confusion as official salary scales suggest much lower remuneration than what is actually budgeted for in PCA costing. The divergence underscores the importance of clarifying to stakeholders the real budgetary impact of maintaining a post in Geneva.

Health Policy Watch and others have flagged this discrepancy as critical for understanding WHO’s staff expenditure, especially during times of financial retrenchment and workforce prioritization. 

Yet WHO still does not publicly disclose the PCA of positions by grade and location with Member States and the public. Last week’s closed door member state briefing did refer to the PCA, perhaps for the first time ever, in estimating the savings from the relocation of teams out of Geneva. 

The 19 August briefing referred to the PCA cost of positions in Geneva in comparison to that of Lyon, Berlin, Dubai and India, in comparing the final impact of relocating positions.  and elsewhere in simulations of relocation options. 

“The transparency gap is striking,” said one senior insider. “Member States are asked to approve cuts, but they never see the real cost of retaining top management.”

Asked to comment on why the PCA is still not publicly disclosed in more routine WHO staff, budget reports and documents, a WHO spokesperson said:  “Post Cost Averages are estimates and not real costs.” 

The WHO spokesperson added, “WHO reports to Member States on actual expenditures. But during the consultations with countries to develop WHO’s Programme Budget, extensive information on costings – including requests for details on how PCAs are developed and used – has been provided and discussed.”

 A “Top-Heavy” WHO staff structure emerging in Geneva?

At headquarters, meanwhile, the brunt of the anticipated cuts in staff have yet to hit home. As of August, WHO’s Geneva headcount had been reduced by 192 people over January 2025, according to a member state briefing last week. That’s only one-third of the cuts anticipated by the end of this year, paring down the Geneva-wide staff from 2900 to about 2300 members.  

The member state briefing and other communications so far have provided no breakdown on grades associated with the staff reductions. 

But WHO’s own online workforce records show that, as of July 2025,  ten out of 11 former senior management members appeared to still be on the payroll at headquarters. Officially, the Director General’s senior leadership team was slashed  to just six in mid-May.  

Meanwhile, 69 D1-D2 directors were on the headquarters’ payroll as of end June, when a reshuffle was announced to reduce their ranks by nearly half to 36. 

Most of those who lost positions have either fixed term or continuing WHO contracts, positioning them for re-assignment in Geneva or less costly locations – and months of compensatory pay if there is no reassignment at all.

Among Professional (P) ranks, meanwhile, the restructuring of departments is nearly complete  but the organigrams for new structures have not yet been disclosed and it’s not clear if and when they will be publicly. 

However, anecdotal reports illustrate how restructuring has produced an even more top-heavy staff structure in some teams, which undermines both the credibility and the sustainability of WHO’s reform agenda.  

One example is the new Department of Data, Digital Health, Analytics and AI. The new department is a merger of WHO’s former Division of Data, Analytics and Delivery for Impact, and the Department of Digital Health and Innovation (DHI)  to create a single entity dealing with the fast-changing digital health space. 

Diamond-shaped staff structure

The approved organigram for DDA reveals a striking anomaly in public-sector workforce design. Traditional organizations are built on a pyramid structure with many junior staff at the base, fewer mid-level professionals, and a handful of senior leaders. In the private sector, cost-cutting would typically mean investing in younger, and less expensive staff.  But DDA’s new structure is instead diamond-shaped, including:

• Senior professionals (P5): 10 posts;
• Mid-senior professionals (P4): 21.5 posts;
• Mid-level professionals (P3): 16 posts;
• Junior professionals (P2): 2 posts;
• Entry-level professionals (P1): 0

During the DDA restructuring, 20 long vacant posts were eliminated showing a much larger savings on paper than in reality. 

However, of the 66 occupied posts, seven P2 and P3s were eliminated along with four G staff roles, while two additional P5 posts and 1.5 P4 positions were created. 

This actually added to the top-heavy, unbalanced structure, with managers managing managers while the operational staff base collapses. 

As one staff member observed wryly: “This is no pyramid. It’s a diamond –bloated at the top, hollow at the base.”

Minimal net savings 

The net result is a reduction in actual costs of less than 2% – or about $275,000 a year, according to a HPW analysis of the PCA for the posts retained for  2026–27, in comparison to costs for the last biennium.  In parallel, a large activity budget, which historically paid for consultants as well as field work in countries, is being sliced by nearly half, according to a July DDA presentation of the new budget alignment, seen by Health Policy Watch.  

Despite reduction in staff positions, there are almost no savings in staff costs. Activity costs, which typically fund consultants and field work, have been pared by nearly half. 

This asymmetry has fueled perceptions that in some departments, restructuring may be less about strategic prioritization and more about political protection for favored directorates and staff members.

“It feels like we’re paying for Geneva’s top jobs with our careers,” said one mid-level staffer from another department whose post was abolished. “I was told to train consultants who now replace me, while the director who spent nearly half of his working days traveling last year keeps his role untouched.” 

Between departments – a disproportionate burden of cuts 

The emerging profile of WHO’s budget and workforce reductions also appears to be profoundly uneven between the newly consolidated departments. 

Corporate-heavy units such as Partnerships, Finance and Delivery (PFD), as well as DDA (Division of Data, Digital Health, Analytics and AI) also seem to have faced relatively modest budget or staffing reductions, while frontline divisions with the heaviest mandates have absorbed far deeper cuts. Some examples: 

• ECO (Environment, Climate and Migration) – created largely from the merger of the former WHO Department of Environment, Climate Change and Health (ECH) with the Programme on Health and Migration (PHM), and One Health. Despite this expanded portfolio, ECO is seeing its staff cut by around 36%, from 72 to 43 positions as part of a budget reduction from $53 to $34 million. Yet it carries responsibility for climate change, which WHO’s 2025-2028 strategic workplan frames as the first of six leading strategic priorities, as well as for environmental determinants of health, which represent about 25% of the disease burden.

• HTH (Health Threats: HIV, TB, Hepatitis and STIs) – staff are being reduced by around 29%, from about 102 positions in 2024-25 to 73. Although the cuts could harm WHO’s ability to respond to epidemic-prone diseases, the fact the new department incorporates several previously large teams to begin with, provides some cushion against the expected shock. As with DDA, the emerging structure is dominated by P5 and P4 posts, with Unit heads potentially earmarked for P6 professionals (equivalent to a D1, Director’s rank). 

• PFD (Partnerships, Finance and Delivery) – is cut by around 22%, reducing WHO’s ability to engage externally and sustain resource mobilization.
• DDA (Division of Data, Digital Health, Analytics and AI) – While 20 vacant positions were eliminated, actual staff were reduced by only 14% and staff budget declined by less than 2%, leaving the department  relatively protected despite being a primarily corporate entity.

While each department has been given a budget envelope representing the proportion of money that it has to cut, those proportions have not been disclosed. This means that departments with outsize political power or weight may retain staff – while other weaker teams do not.

Case studies of retaliation and score-settling

Despite WHO’s claims that the workforce review was a fair and transparent process, many staff describe a very different reality. Across departments, they recount an exercise dominated not by evidence or dialogue, but by unchecked directorial power.

“The directors were gods – and now they are super-gods. The consultation was an absolute farce,” said one staff member. “They promised a blind HR process. It absolutely was not.”

Multiple accounts suggest that the downsizing became a vehicle for retaliation and score-settling. Staff who had raised concerns about governance, accountability, or excessive spending were disproportionately targeted.

In one team, for instance, a mid-level professional who had complained about allegedly exorbitant travel spending by senior managers saw their post abolished.

Records seen by Health Policy Watch reveal that the director of that team, now head of a powerful new department, was on mission for over 200 days in 2023 and 2024 – wracking up more than $200,000 in travel costs in those two years alone. 

Another staff member in the same team generated a travel bill of more than $20,000 for a single US–Riyadh round trip, despite being officially based in Geneva, according to the travel records, seen by Health Policy Watch.

In other departments, technical experts with years of institutional knowledge were released, replaced by consultants hand-picked by senior managers. 

In sother cases, individuals with pending allegations of funds mismanagement, harassment, or abuse of authority were retained while whistleblowers and dissenting voices were shown the door.

These accounts deepen staff fears that WHO’s restructuring is less about efficiency than about entrenching power, silencing critics, and shielding those at the top, leaving the organization more vulnerable to politicization, reputational damage, and future scandals.

The net result tends to reinforce observations like those in the anonymous WHO staff X post, which stated:   

“This restructuring has also created opportunities for certain senior managers to consolidate power. By absorbing entire teams, retaining as many high-grade posts as possible under their authority, and eliminating lower-cost positions, they expand their influence while reducing diversity of voices. In some cases, positions have been reclassified or renamed to allow individuals to move into higher roles, while their previous posts are formally abolished, on paper, a cut; in reality, a promotion.

”New ‘P7’ category quietly emerging

The PCA data also reveal the quiet emergence of a new P7 grade—with costs equivalent to a D2 post, a parallel arrangement to the longstanding P6, which has an equivalent pay grade of a D1. 

As of June, there were 69 D1 and D2 directors at Headquarters – two weeks after the announced cutback to just 34 such managerial posts. But there were another 46 P6 professionals on the payroll in Geneva,  a pay grade equivalent to a D1. 

Now, observers suspect that the inclusion of a P7 into the paygrade system is designed to facilitate the evental reassignment of former senior directors (D2s) into high-paying roles without formally calling them “directors,” thus sidestepping political scrutiny. 

“This is institutional engineering to protect elites while cutting staff at the base,” one staff association representative commented.

In previous years, WHO had floated the idea of a P7 scale as a mirror of the World Bank model – allowing senior professionals to rise on the salary scale without having to become managers, “which is a different skill,” as one HR expert observed. 

“But this was never implemented, and what’s happening now is something else entirely. 

“Former ADGs and Directors removed from managerial posts are being re-planted elsewhere in the organization as P7s shielded from scrutiny, their costs untouched, while the axe falls on junior staff.”

WHO says process has been driven by organizational priorities 

In response to multiple inquiries by Health Policy Watch, WHO spokespeople urged patience – until the restructuring is complete before drawing conclusions.  

Departmental restructuring plans have largely been completed, but some have yet to be reviewed by an Ad Hoc Review Committee (ARC) followed by Director General’s approval. In the case of staff positions abolished, staff still have the opportunity to be “matched and mapped” elsewhere. 

“WHO structures are still being finalized. Structures and mapping / matching of staff are ongoing and shape and grades of the new organizational structure will be shared based on facts, once the organizational  structure is final and staff have been informed,” a WHO spokesperson told Health Policy Watch. .

The spokesperson rejected allegations that staff members have been excluded, or organizational priorities have not been closely followed in the department reductions, saying: 

“The prioritization process has (i) shaped the Programme budget; (ii) informed the budget envelopes of ADGs (divisional budget envelopes) and is also (iii) driving directors’ decisions on their respective departmental organigrams.

The prioritization process has been thoroughly discussed with Member States during the Programme budget development process.

The spokesperson pointed to Box 2 on Page 16 of the Programme budget 2026-2027 for a summary of what will be safeguarded and sunset:

But the spokesperson did not give any explanation as to why some, politically weaker or poorer departments, representing major strategic priorities such as climate change, are still getting cut more heavily than others, saying only that: 

“All departments will have a reduced budget with variations based on the output of the prioritization.” 

The spokesperson also affirmed that member states were informed along every step of the way in briefings such as last Tuesday’s event.  Although that briefing still provided more details about the process than about the content of the reorganization – with a placeholder of XX for the estimated count of staff layoffs, both in headquarters as well as in regions.  

No space for next generation

Perhaps most worrying, is the looming risk that WHO’s new structure will leave little future at the agency for early career  professionals. 

Cuts that have disproportionately eliminated not only temporary P1–P3 staff – but also fixed term junior positions – effectively slam the door on entry into the organization, let alone advancement.

“This is a death blow for young people who want to serve in global health,” one insider warned. “WHO is becoming a gated community of senior managers and consultants.”

“This is not just a question of staff ratios or technical restructuring—it is a question of WHO’s very identity at a time of existential crisis. Will the organization become an exclusive club of entrenched elites, protected through opaque salary engineering and endless travel budgets, while the next generation is pushed out? Or will it restore fairness, transparency, and a true pyramid of opportunity?

“At stake is not only WHO’s reputation but also the legacy of the Director-General himself. Staff across the Organization are asking whether he will allow this course to stand—or whether he will seize the moment to correct it before it is too late.”

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