The Trump administration has abolished the US Agency for International Development (USAID) and slashed its global health funding, exposing the vulnerability of many African countries’ health systems.

On the eve of the African Union’s annual meeting, leaders need to secure their countries by increasing spending on health.

The year 2025 will go down in history as the moment the traditional model of global health financing ruptured. Sudden, sweeping aid cuts exposed a reality African policymakers have warned about for decades: while foreign aid can save lives, it cannot sustainably build strong health systems. 

In a split second, the shock reverberated through HIV clinics, vaccination campaigns, maternal health services, mental health and health information systems – critical infrastructure largely financed by resources beyond national control.  

For Africa, the lesson is unmistakable. Health security cannot rest on external priorities or volatile funding cycles. It must be anchored in Africa’s sovereignty and predictable domestic financing.

Months following the aid cuts, African leaders and policymakers have been exploring  permanent solutions that can protect lives and livelihoods today while laying the foundation for resilient health systems in a post-2030 development era.

Stronger domestic financing

President Paul Kagame of Rwanda has led continental efforts to increase domestic spending on health.

One such solution has been with us for years. In 2019, African Heads of State, led by Rwanda’s President Paul Kagame, convened the first-ever African Leadership Meeting (ALM) on Investing in Health in Addis Ababa. 

It was a defining moment of collective introspection where leaders acknowledged that Africa could not build strong health systems dependent on donor priorities or external timelines. They affirmed that health is not merely a development issue but a strategic investment foundational to economic, human security and long-term development.

The ALM Declaration, adopted unanimously, called for stronger domestic financing, enhanced mutual accountability and a new partnership between Ministries of Health and Ministries of Finance – two institutions that had too often approached healthcare challenges from opposing perspectives.

That foundation is now bearing fruit and should be among the first frameworks policymakers turn to as they confront the current financing crises and seek durable solutions for the years ahead.

To date, 12 African Union Member States including Burundi, Kenya, Malawi, Mauritius, Mozambique, Namibia, Nigeria, Rwanda, Tanzania, Uganda, Zambia and Zimbabwe have convened national health financing dialogues under the ALM framework in alignment with African Health Strategy (2016–2030). 

These dialogues, co-led by Finance and Health Ministries, are breaking long standing silos and developing more coherent approaches to mobilising domestic and blended finances, prioritising pandemic preparedness and increasing local manufacturing and innovation. Critically, they are translating political commitments into concrete budget reforms, parliamentary oversight and fiscal accountability.

Health is a pillar of national security

The US President’s Emergency Plan for AIDS Relief (PEPFAR) funded 80% of the costs of Luyengo Clinic in Eswatini, putting the HIV treatment of 3,000 clients in jeopardy when President Trump paused aid.

Anchored in the African Union’s Agenda 2063 and its vision of self-determination, the ALM takes a long-term view of Africa’s health agenda. It positions health spending not as a humanitarian cost vulnerable to shifting geopolitical shifts but as a pillar of economic resilience and national security.   

The tools now emerging from the ALM process are already reshaping decision-making across the continent. Regional health financing hubs, a continent-wide ALM tracker, the AU scorecard and new digital platforms for financing data are introducing levels of transparency, coordination and evidence-based planning that were once unimaginable. These mechanisms enable governments to track progress, monitor reforms and gaps that have long been obscured by fragmented systems.

Early results are beginning to emerge, with several countries – including Ghana, Nigeria and Rwanda – registering increases in domestic health spending and improved efficiency in allocation.

Yet the central vulnerability remains. External financing and out-of-pocket payments by patients account for most of Africa’s health financing. 

In the case of HIV, foreign aid makes up roughly 70% of financing — a figure that leaves households and national programs dangerously exposed to global political and economic shocks. Achieving universal health coverage will require confronting this structural risk directly, not tiptoeing around it.

Increased and smarter spending

The ALM offers one of the clearest paths forward. It calls for increased and smarter spending, with primary health care at its core. It embeds accountability in the flow of public funds and reframes domestic health financing as a high-return investment in productivity, stability and social cohesion.

The decade ahead will test Africa’s resilience more severely than the last. Climate shocks, emerging pathogens and demographic change will continue to strain already fragile systems. As the world approaches the final years of the SDGs, Africa must define its post-2030 agenda in its own terms. ALM shall become the backbone of that vision.

Success will require more than technical reforms or political goodwill. The ALM implementation must be people-centred. 

Citizens must have a meaningful voice in shaping, monitoring and scrutinising health budgets. Communities should become the active drivers of the process, holding governments accountable and ensuring that commitments translate into improvements in quality care.

Africa stands at a pivotal crossroad. The era of donor-driven health investment is ending. In its place, the continent must build systems capable of withstanding political transitions, economic volatility and shifting alliances.

Through the ALM, Africa has begun constructing that foundation — a continental pathway from vulnerability to sovereignty, from dependency to sustainability.

What remains is to strengthen it, scale it and ensure it delivers results for every African.

Ambassador Amma Adomaa Twum-Amoah is the African Union’s Commissioner for Health, Humanitarian Affairs and Social Development.

 

Image Credits: USAID Press Office, UNAIDS.

The US and Burundi signed a health MOU on 6 February.

Burundi has become the 16th African country to sign a five-year bilateral health Memorandum of Understanding (MOU) with the United States.

The US “intends to provide more than $129 million of health assistance in Burundi for HIV/AIDS, malaria, and infectious disease surveillance, response, and preparation”, according to a statement from the US State Department.  

In return, Burundi has pledged to increase domestic health expenditures by $26 million, to assume greater financial responsibility for its citizens’ healthcare.

US support will include support for “surveillance and outbreak responses, laboratory commodities, frontline health care workers, and data systems”. 

It will also “continue to improve access to malaria prevention, diagnostic tests and treatments, as well as HIV rapid diagnostic tests and antiretroviral HIV treatment regimens”.

As with the other 15 MOUs, Burundi has agreed to share “information and data” about infectious disease outbreaks with epidemic or pandemic potential, according to the US State Department.

The pace of signings has slowed after a flurry of MOUs the US signed late last year under its “America First Global Health Strategy”.

However, the health MOUs have given way to a flurry of US trade agreements, focusing on critical and rare earth minerals – with at least 21 MOUs related to minerals being signed in the past five months, including 11 signed last week alone alongside a Ministerial meeting on critical minerals, according to the US State Department.

The US has also chosen Hungary as its partner in advancing religious freedom in sub-Saharan Africa and the Middle East.

An MOU between the two countries was signed last week between US Deputy Secretary for Management and Resources Michael Rigas and Hungary’s Tristan Azbej, State Secretary for the Aid of Persecuted Christians and the Hungary Helps Program. It aims to “facilitate cooperation in supporting Christians and people of faith facing persecution, particularly in the Middle East and sub-Saharan Africa.”

A child getting a measles vaccination. 

Measles cases in Europe and Central Asia dropped by three-quarters in 2025 compared to the previous year – but the decline is partly due to the virus running out of people to infect after spreading rapidly through under-vaccinated communities.

Preliminary data from 53 countries in the World Health Organization (WHO) European Region reported 33,998 measles cases in 2025 and 127,412 in 2024, according to the WHO and UNICEF.

“While cases have reduced, the conditions that led to the resurgence of this deadly disease in recent years remain and must be addressed,” warned Regina De Dominicis, UNICEF Regional Director for Europe and Central Asia.

“Until all children are reached with vaccination, and hesitancy fuelled by the spread of misinformation is addressed, children will remain at risk of death or serious illness from measles and other vaccine-preventable diseases.”

In 2024, 19 countries had ongoing measles cases – up from 12 the previous year, according to the European Regional Verification Commission for Measles and Rubella Elimination.

“This represents the most significant setback in measles elimination in the region in recent years,” according to the two UN bodies.

WHO Regional Director for Europe, Dr Hans Henri Kluge, warned that over 200,000 people in our region have contracted measles in the past three years. 

“Unless every community reaches 95% vaccination coverage, closes immunity gaps across all ages, strengthens disease surveillance and ensures timely outbreak response, this highly contagious virus will keep spreading,” Kluge warned.

“In today’s environment of rampant fake news, it’s also crucial that people rely on verified health information from reliable sources such as WHO, UNICEF and national health agencies. Eliminating measles is essential for national and regional health security.”

Two doses of the measles vaccine provide up to 97% life-long protection against the virus and a vaccination rate of 95% with both doses in every community each year is needed to prevent measles outbreaks and achieve herd immunity. 

This protects infants too young for measles vaccination and other people for whom it is not recommended due to medical conditions, like those who are immunocompromised.

Measles is one of the most contagious viruses with every infected person able to infect up to 18 unvaccinated people.

It can cause serious illness, death and damage to the immune system, including by “erasing” its memory of how to fight infections, leaving measles survivors vulnerable to other diseases and death.

Image Credits: WHO.

While the total EU Commission commitments would remain near €700 million, the shift from a three-year cycle to a four-year period means that they reduce their support.
While the total EU commitments would remain near €700 million, the shift to a four-year period means that they reduce their support compared to previous cycles.

The European Commission intends to significantly cut its contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria, ending a decades-long trend of increasing contributions to the multilateral health organisation.

According to research by Health Policy Watch, the Commission plans to pledge €700 million over a four-year span from 2026 to 2029 at the Global Fund Board meeting starting on Wednesday (11 February).

As the overall sum stretches a smaller amount of money over a longer period of time compared to previous commitments, this would mean a reduction of roughly €60 million per year  – a cut of 26.5%.

During the previous replenishment cycle, the Commission pledged €715 million over three years from 2023 to 2025, which at the time marked a 30% increase over the prior commitment.

The Commission did not respond to a query by Health Policy Watch before publication of the article.

Asked for a comment, a Global Fund spokesperson confirmed that several donors who are not yet in a position to make public announcements have provided “strong assurances of their continued support”. The Global Fund is still in “active discussions” with several partners, including the European Commission, to finalise their commitments.

However, they refrained from sharing any further details of the negotiations.

Cuts in step with broader global funding pull-back

Following the pledging conference in November 2025, the Global Fund faced a $6.6 billion shortfall against its $18 billion target. The 8th Replenishment total is projected to land significantly below previous cycles, mirroring the European Commission's move toward reduced annual support.
Following the pledging conference in November 2025, the Global Fund faced a $6.6 billion shortfall against its $18 billion target.

This drastic pull-back would line up with a broader retreat by major Western donors. At the Global Fund’s pledging conference in November 2025 – at which the Commission failed to submit a commitment due to ongoing internal negotiations – the United States reduced its contribution by $1.4 billion under its “America First” strategy. Germany cut its funding from €1.2 billion to €1 billion amidst a broader shift in budgetary priorities.

As a result, the Global Fund had only raised $11.4 billion in November, $6.6 billion short of its $18 billion target for the next three years with key countries and groups, including France and Japan, still missing at that time. The 8th Replenishment total amounts are likely to land well over $12 billion for 2026 to 2028, short over $2 billion compared to the previous cycle, sources confirmed.

Emergency money for foreseeable expenditures

Barry Andrews, Chair of the Committee on Development, raised concerns regarding the Commission's decision to use emergency reserve funds for predictable expenditures like the Global Fund.
Barry Andrews, chair of the Committee on Development in the European Parliament, raised concerns about the Commission’s decision to use emergency reserve funds for predictable expenditures like the Global Fund.

With its annual budget for 2026 already spread thin, the EU Commission is mobilising €150 million from a reserve fund designated for unforeseen crises to cover this year’s contribution to the Global Fund.

But this use of an “emergency cushion” within the Neighbourhood, Development, and International Cooperation Instrument (NDICI) to fund a predictable replenishment cycle is concerning, said Barry Andrews, chair of the Committee on Development, at a budget hearing on 5 February.

He reminded the Commission that the cushion is legally reserved “to respond to unforeseen circumstances, new needs, or emerging challenges.”

With the €150 million now allocated to the Global Fund and other money attributed to developments in Greenland and Syria, the cushion is already “nearly depleted,” as Myriam Ferran, Deputy Director-General at the Directorate-General for International Partnerships, admitted. It leaves only €159 million for the next two years to handle any genuine unexpected global crises.

Remaining funds not yet approved

In a hearing last week, Miriam Ferran, Deputy Director-General for International Partnerships, announced that the Commission intends to pledge €700 million to the Global Fund for the 2026–2029 period.
In a hearing last week, Miriam Ferran, Deputy Director-General for International Partnerships, declared that the Commission plans to commit €700 million to the Global Fund for the 2026–2029 period.

The remaining €550 million until 2029 “will be factored in the new Multiannual Financial Framework (MFF),” said Ferran at the European Parliament’s Budget Committee meeting last week.

The MFF is the EU’s long-term budget that sets the limits on spending over a seven-year period. The current MFF ends in 2027, and the next one (2028 to 2034) has not yet been adopted.

This approach drew sharp rebukes during committee oversight. Right-wing parliamentarians characterised the move as “budgetary madness,” noting that for 2026, the Commission is creating debt and pushing it into future years as it is “spending money that you don’t have”.

No long-term budget for global health

The Berlaymont building in Brussels, Belgium, serves as the official headquarters of the European Commission.
The Berlaymont building in Brussels, Belgium, serves as the official headquarters of the European Commission.

With the MFF already under pressure, European global health funding is facing a precarious future, raising fears among health advocates that it will be stripped of priority in the EU’s long-term strategy.

In its proposal for the next MFF, the Commission confirmed there will be “no dedicated health window”, making sure that budget appropriations are ringfenced.

Instead, it is to be split between a “global” pillar and “geographic” pillars – essentially regional accounts assigned to specific areas like sub-Saharan Africa, the Middle East, or Asia – sparking concerns over a shift away from multilateralism.

The Commission argues that this allows funding to be more flexible and better linked with the EU’s strategic goals. A Commission spokesperson stated that while there is no health window in Global Europe, there will be a health budget in the new European Competitiveness Fund dedicated to increasing economic growth.

Critics warn that contributions to global health initiatives will have to keep pace with infrastructure, digitalisation, and security projects. In the “sub-Saharan Africa” pillar, for example, a proposal to fund community health workers would have to compete directly for the same Euros against a project to build a highway or equip border guards, an EU official close to the negotiations told Health Policy Watch.

Editorial note: The article has been updated to reflect that Germany’s funding for the seventh replenishment was €1.2 billion (not €1.4 billion).

 

Image Credits: Felix Sassmannshausen, European Union/Christophe Licoppe.

The WHO has failed to recognise the health harms caused by firearms.

For nearly three decades, the World Health Organization (WHO) has recognised violence as a major public health concern. Since the landmark World Health Assembly (WHA) resolution of 1996, violence has been framed not only as a cause of injury and death, but as a driver of long-term physical, psychological, and social harm, as well as a significant burden on public-health systems. 

Over this period, WHO has issued technical guidance, developed prevention frameworks, and supported countries to strengthen health-system responses to violence against women and children, youth violence, and other forms of interpersonal harm.

Yet one of the most lethal drivers of violence globally, firearms, remains largely absent from the WHO’s governance architecture.

A multi-method analysis, Tracking WHO Attention to Firearm Violence, 2000–2025, co-published on Tuesday (10 February) by a consortium of Global North and Global South academic institutions and NGOs working on public health and violence prevention, examined WHA resolutions, WHO violence-prevention frameworks, and key institutional trends over 25 years. 

The finding is straightforward. Violence appears repeatedly in WHO resolutions, strategies, and technical documents. Firearm-related harms do not.

This absence shows up across WHA resolutions, flagship prevention frameworks, and the national policies that rely on them. It is a governance blind spot with practical consequences.

Silence at the World Health Assembly

Since the WHA first met in 1948, more than 3,200 resolutions have been adopted. Only a small fraction address violence and none explicitly mention firearms, small arms, or gun violence.

Yet firearm-related harm has accounted for over a million deaths over the past five years, with millions more injuries, many leaving permanent disabilities, each year, most of them occurring outside armed conflict.

The downstream effects of this omission extend well beyond injury and death. Exposure to firearm violence, whether direct or indirect, is associated with anxiety, depression, post-traumatic stress, and substance use, particularly among children and adolescents. 

In high-violence settings, the effects are cumulative. Teachers, caregivers, and health workers absorb the strain. Schools struggle with attendance and concentration. Academic performance suffers, and dropout rates rise. These impacts shape life chances long after the violence itself.

Because firearm-related harm is largely absent from WHO’s violence-prevention frameworks, these mental-health, substance-use, and educational harms are weakly integrated into prevention strategies, if they appear at all.

This is not because the evidence is missing. WHO produced substantial work in the early 2000s explicitly addressing small arms as a public-health concern, including analysis of firearm injury, disability, and trauma.

Tracking WHO Attention to Firearm Violence shows how that early engagement steadily narrowed, with firearms increasingly folded into broader violence agendas or dropped altogether.

Interviews with global-health experts point to familiar constraints. Firearm-related harm is politically sensitive. Some member states resist explicit attention. WHO is donor-dependent. New resolutions carry costs. In that environment, firearm violence repeatedly falls below the line of what is considered feasible.

Global policy omission

Firearm harm is not mentioned in key WHO resolutions and policies.

INSPIRE, the WHO-led framework guiding global action to end violence against children, is widely used by governments, UN agencies, and donors.

RESPECT, developed to prevent violence against women, plays a similar role in the gender-based violence (GBV) field. Both focus on social norms, family-level interventions, and service responses.

But neither meaningfully addresses firearm-related harms.

In INSPIRE, guns appear only in passing, despite being a leading cause of death among adolescents in many countries. 

RESPECT does not engage with firearm access as a risk factor in intimate-partner homicide, even though the link between gun availability and lethality in domestic violence is well established.

These omissions matter. INSPIRE and RESPECT shape donor priorities, technical assistance, indicators, and national action plans.

The pattern was visible at the 2024 Interministerial Meeting on Ending Violence Against Children in Bogota. Nearly 100 governments made pledges aligned with INSPIRE to address violence against children.

None mentioned firearms or firearm-related harm. This was not because gun violence is irrelevant to children and adolescents in those countries. It reflects how global frameworks define what counts as legitimate prevention policy.

Men at risk

A similar narrowing appears in the growing number of national men’s health strategies.

In many regions, men, particularly young and marginalised men, account for the majority of firearm homicide victims and survivors. 

Gun violence drives premature mortality, disability, and long-term psychological harm. Yet emerging national men’s health policies tend to emphasise non-communicable diseases, mental health, encouraging norms’ changes to increase health-seeking behaviour, while neglecting firearm violence entirely.

Most international NGOs working on men’s health mirror this framing. The focus is on norms, behaviours and services, not on structural drivers of injury, death and chronic mental health challenges. This reflects prevailing policy architectures rather than intent. Nonetheless, the result is men’s health policies and programmes that do not correspond to epidemiological realities in high-violence contexts.

Taken together, these patterns point to a broader governance problem. Firearm violence sits in a policy no-go-zone, too political for violence-prevention frameworks, too securitised for health, and too structural for the prevailing approach to men’s health.

Commercial determinants contradiction

This fragmentation stands out given WHO’s expanding work on the commercial determinants of health.

WHO has been explicit about the role of tobacco, alcohol, ultra-processed foods, and other industries in driving ill-health. It has documented how corporate practices shape exposure, risk, and inequity. It has also excluded both the tobacco and arms industries from engagement under its Framework of Engagement with Non-State Actors.

Yet firearms remain largely absent from the commercial-determinants agenda.

Guns are plainly commercial products. They are manufactured, marketed, and distributed by powerful global industries. Marketing, increasingly online and often gender-exploitative, shapes norms around risk and protection. Availability is shaped by regulation, trade, and enforcement choices.

WHO’s leadership on tobacco did not emerge because the issue was politically easy. It emerged because the health burden was undeniable and the commercial drivers clear. Firearms and the ammunition they carry, present a similarly preventable source of injury and death.

Beyond agenda-setting, the WHO has a well-established role in generating and consolidating the types of health data that inform national regulatory decision-making.

Evidence from international reviews of firearm legislation consistently indicates that more comprehensive and effectively implemented firearm regulations are associated with lower firearm mortality, while permissive regulatory environments correlate with higher rates of lethal violence. 

WHO leadership in improving surveillance, harmonising indicators, and translating this evidence into technical guidance could strengthen member states’ capacity to assess where and how firearms contribute to preventable death and injury.

Such an approach would also support more informed policy responses in contexts such as intimate-partner and gender-based violence, where the presence of a firearm markedly increases lethality.

Why this matters now

WHO is under acute financial pressure following funding withdrawals and delayed contributions. At the same time, it is reasserting its role on social and commercial determinants of health and revisiting questions of mandate and prioritisation.

A growing group of research institutions, public-health bodies, and civil-society organisations has responded by forming the Global Coalition for WHO Action on Firearm Violence. WHO Action, as its name suggests, is calling on the WHO to recognise firearm violence as a preventable public-health harm that warrants clearer better data, clearer technical guidelines to health ministries and coordinated prevention strategies.

At this point, the continued exclusion of firearms from WHO’s core health frameworks is hard to justify. Addressing firearm violence as a public-health issue would not expand WHO’s mandate. It would clarify it by bringing violence prevention, gender-based violence, child protection, men’s health, and commercial determinants into closer alignment.

The WHO has done this before with other health issues. The question now is whether the organisation can afford to keep treating one of the world’s leading drivers of violent death and disability and one of the most disruptive and costly health matters as though it isn’t a public health problem.

Dean Peacock is affiliated with the School of Public Health at the University of Cape Town and the Gender Centre at the Geneva Graduate Institute. 

Dr Stephen Hargarten is Professor of Emergency Medicine at the Medical College of Wisconsin, (MCW) and the Founding Director of the Comprehensive Injury Center at MCW, where he currently serves as the senior injury and policy advisor. 

They are Co-Commissioners of the Lancet Commission on Global Gun Violence and Health and serve as Founding Directors of the Global Coalition for WHO Action on Firearm Violence

 

Image Credits: Maria Lysenko/ Unsplash, Max Kleinen/ Unsplash.

Indonesia delivering a statement at IGWG5 on behalf of the Group of Equity.

Powerful member state blocs at the World Health Organization (WHO) stressed on Monday that they will not compromise on the final outstanding piece of the Pandemic Agreement simply to meet the May deadline.

The Group of Equity and the WHO’s Africa, Eastern Mediterranean and South-East Asia regions stated that they wanted a Pathogen Access and Benefit-Sharing (PABS) system with legal certainty at the second-to-last meeting of the Intergovernmental Working Group (IGWG).

“PABS is the heart of the Pandemic Agreement. If the heart is weak, the body cannot function, and the agreement will not deliver equity,” said Indonesia on behalf of the Group of Equity, and the three regions – collectively representing over 80% of the world’s population.

The PABS system aims to set out how countries can share information about pathogens and their genetic sequence data and ensure that those sharing this information get access to the benefits developed as a result, such as vaccines, diagnostics and therapeutics.

But the current PABS draft contains “major loopholes” that will prevent the system – an annex to the Pandemic Agreement – from functioning effectively, Indonesia added.

“The annex must articulate the operational details of the PABS System, and provide legal clarity on the rights and obligations of the providers of PABS material and sequence information, as well as various users of the system. We also question how any terms and conditions can be enforced when users are permitted to remain anonymous,” stressed Indonesia.

“We understand the pressure of timelines. But we should be clear about the choices and decisions in front of us: We are aiming for an annex by [the World Health Assembly in] May, that can actually deliver a functioning PABS System in totality. But if we cut too many corners now, we will pay for it later in credibility and implementation.”

Zimbabwe – speaking for the Africa Group – stated that “a system that safeguards some while leaving others exposed is not only unjust, it is ineffective”.

“For the Africa Group, equity and benefit-sharing must be operational, enforceable and central to Pandemic Agreement, including the PABS annex. These elements cannot be aspirational, deferred or left to voluntary implementation. Past experiences has shown the consequences of such approaches.”

Pragmatism and speed

The EU representative and France’s Anne-Claire Amprou.

However, the European Union, backed by G7 leader France, called for pragmatism and speed.

“We remain deeply committed to work towards an effective, workable and implementable PABS system in the remaining 12 Days of negotiations that we have at our disposal,” said the EU representative.

“We hope that a sense of pragmatism and common sense will help to guide us towards convergence on the key remaining outstanding areas for the purpose of bringing this process to a successful conclusion within the timeframe.”

Speaking for France, Anne-Claire Amprou, a former co-chair of the Pandemic Agreement negotiations, urged “quick progress” to adopt the annex by the World Health Assembly in May. 

“Given the time remaining, we need to be reasonable in terms of the amendments we make to the text,” said Amprou. “We invite member states not to reopen subjects or provisions which were already adopted as part of the Pandemic Agreement.”

The Pandemic Agreement cannot be endorsed or operationalised without the PABS annex, which means there is no global agreement on how to approach the next pandemic – which can strike at any time.

Benefit-sharing demands

India warned against adopting an ambiguous annex.

But for many low- and middle-income countries (LMICs), the bitter memory of being unable to get access to vaccines during the COVID-19 pandemic – even for health workers and their most vulnerable citizens – was a sobering lesson.

Some indicated that they would be prepared to miss the May deadline rather than budge on their demand for a legally binding PABS system that balances access and benefit-sharing.

India, speaking for the South-East Asia region, stated that “it is essential that quality is not compromised by the pressure of timelines”. 

“Our priority must be an annex that provides clear legal certainty with minimum room for interpretive ambiguity. Such clarity is critical for effective implementation and long-term trust in multilateralism, “ said India.

“Benefit-sharing obligation must be proportionate to access and cannot be voluntary, aspirational or based on ‘best endeavours’. 

Non-monetary benefits

Some LMICs also stressed – as India did – that benefit-sharing must extend “beyond monetary contributions and donations of vaccines, diagnostics and therapeutics”. 

“Non-monetary benefits, including timely capacity development, technical assistance and non-exclusive manufacturing licences for developing countries, must be clearly specified and applied both during pandemics and during the inter-pandemic period,” said India, for the South-East Asia region.

Indonesia said that, while equitable access to vaccines, therapeutics and diagnostics (VTDs) is essential, “we should also be serious about benefits that support timely diversified regional and local production, including non-exclusive licensing to manufacturers in developing countries, transfer of technology, and meaningful collaboration in R&D.”

“Benefit sharing cannot depend on purchasing power, ad hoc arrangements or discretionary decisions taken during emergencies,” said Namibia.

“It must be triggered by access, governed by multilateral rules and delivered when it matters most. Namibia also places strong emphasis on technology transfer and regional manufacturing capacity. Strengthening local and regional production is essential to reducing dependency and building real resilience.”

Way forward

The IGWG meeting – the fifth of six – ends on Saturday, and while it plans four evening sessions, co-chair Tovar da Silva Nunes reminded delegates that the meeting’s access to interpreters is limited, a casualty of WHO budget cuts.

There are 100 days to the deadline, and by the end of this week’s talks, it should be clear whether the annex is on track for adoption in May.

Mexico, meanwhile, indicated that it is available to facilitate “dialogue between blocs of countries”.

“We are convinced that, with political will and pragmatism, we can reach the necessary consensus so that we can allow this process to conclude successfully and strengthen our multilateral stance for future pandemics.” said Mexico.

Egypt leads the charge Friday against renewing WHO relations with NGOs working in the sexual and reproductive health rights space.

After fits, starts, hours of back room negotiations and hesitations, the closing day of WHO’s Executive Board session Friday saw agreement on a number of small – but potentially meaningful – efficiency measures aimed at saving booth member states and the financially-strapped agency a time and money in preparing for and responding to member state mandates.  

The changes come amidst mounting geopolitical and social tensions amongst member states, with an increasing share of discussion time consumed by a handful of highly politicized items, including the wars in Ukraine and Gaza, as well as sexual and reproductive health rights. 

At the same time, the Executive Board and the annual World Health Assembly (WHA) have become overloaded with a growing volume of draft decisions and resolutions – many costly to implement and not always aligned with established strategic plans.

Among the key reforms is an initiative to streamline timelines and criteria for the submission of proposed draft resolutions and decisions by member states. This could curb the proliferation of proposals seen over the past several years.

Streamlining discussion on Palestine and de-escalating flashpoints

WHO Director General Dr Tedros Adhanom Ghebreyesus Friday evening in emotional appeals for streamlining debates around divisive issues such as reproductive health rights and Palestine.

Another small efficiency steps for the upcoming WHA include a compromise on language, which enabled the approval of  WHO’s continued engagement with five NGOs working on sexual and reproductive health rights.

In addition, a plan to consolidate discussion around two overlapping reports on the thorny question of health conditions in the “Occupied Palestine Territory (OPT)’’ into a single WHA agenda item avoids duplications that have consumed hours of WHA time since 2024. That is when the Israel-Hamas war led to the development of a second WHO report on health conditions in the OPT, in addition to the annual report that has been a perennial feature on the WHA every year since Israel occupied the territories in 1967. 

Addressing the Executive Board on Friday, WHO Director-General Dr Tedros Adhanom Ghebreyesus framed the latter consolidation as both an efficiency gain and a confidence-building measure.

“As you know, the UN Security Council welcomed the comprehensive plan to end the Gaza conflict last November through Resolution 2803. This holds the real promise for advancing peace and …in a region with such urgent needs, peace is built one brave step at a time. It’s a commitment we renew every day. Peace endures only when we carry it forward together. Each of us can contribute through our decisions in the EB and the WHA,” Tedros said.

“Today, I propose one concrete step combining the two WHA agenda items… into a single discussion. …By taking this step together, we not only foster a more constructive environment for our governance deliberations, but also contribute, in a small way, to the success of the peace initiative.” 

More efficient process for advancing WHA resolutions  

Administratively, the Board also backed proposals to enforce stricter timelines for submitting draft resolutions and decisions, along with closer WHO Secretariat supervision to ensure their alignment with agency priorities and budgets, and manageable meeting agendas.

While current rules hold that zero drafts should be submitted several months before a session – and final drafts no later than 15 days ahead – in practice, many proposals have arrived late, leaving little time for review by the WHO Secretariat or member states.

In a draft decision Friday, Board members also agreed to advance a proposed rule change whereby three WHO member states from at least two regions must agree to co-sponsor any new decision or resolution. The innovation aims to curb member states’ debate on measures with little real backing. 

But the provision remains bracketed  in the draft text, which also refers to the  “piloting” of the reform measures, signalling the long road that remains to actual approval.  

Opposition to WHO’s engagement with reproductive health NGOs 

Norway’s EB representative, Cathrine Lofthus, Ministry of Health Director General, led negotiations with the Egyptian-led bloc on WHO collaborations with reproductive health NGOs.

The Executive Board also reached a time-saving agreement on another topic of frequent WHA conflict – WHO engagements with non-state actors that work on sexual and reproductive health rights (SRHR). 

Egypt, where abortion is illegal unless a woman’s life is at risk and is even subject to a jail sentence,  has long been a leader in opposing WHO’s engagements with NGOs working in this space. 

This year, that included opposition to WHO collaborations with five groups whose terms of engagement with WHO are due to be renewed this year, as part of a routine, triennial review process.

The groups are the International Planned Parenthood Federation, American Society for Reproductive Medicine, Family Health International, the Population Council and the World Association for Sexual Health. 

Speaking for the Organization of Islamic Cooperation (OIC), which includes states from WHO’s Eastern Mediterranean Region as well as countries in North Africa and Asia, Egypt’s delegate declared that continued engagement with the five NGOs is “contrary” to WHO’s Framework of Engagement with Non-State Actors (FENSA), which aims to ensure the agency’s “integrity, independence and credibility is not compromised” and that non-state actors do not wield undue “influence” in setting “policies, norms and standards.”

Norway, leading the EU and other supportive member states, spent several hours negotiating an addendum that effectively renews collaboration while taking “note” of reservations and affirms that “member states have full sovereign rights over which non-state actors operate within their national territories,” in line with their “national context and legislation.”

Addendum to EB decision renewing WHO’s collaboration’s with reproductive health NGOs de-escalated potential controversy at the upcoming World Health Assembly.

Here too, Tedros added his own support, recalling how parliamentary reforms liberalizing Ethiopia’s abortion laws during his tenure as health minister helped cut maternal mortality fivefold, as many deaths were linked to unsafe abortions.

“I myself invited not only WHO, but other international organizations for help, and it’s during that time, our Parliament passed a bill on how to handle unsafe abortion, because nobody wanted for our mothers to die, our sisters to die,” Tedros said.  

“We don’t allow our norms and standards to be influenced by anyone. We take sides with science,” Tedros affirmed. “Any country has sovereignty, either to invite us or not invite us [to support them]. But whatever relationship we have, it will not be forced on any country.” 

The EB negotiations and word-smithing, while tortuous and time-consuming, may help avert an even larger debate at the WHA.

Temporary fixes? 

Palestinian EB representative Ryad Awaja: consolidated discussion on health conditions in the Occupied Palestinian Territory is an “exceptional” move.

Despite the budget pressure that helped push member states toward incremental reforms, most changes remain tentative—preliminary or applicable only to the upcoming WHA.

Agreeing to combine discussions on the two overlapping WHO reports on “health conditions in the Occupied Palestine Territory (OPT)” into one dedicated discussion on the WHA agenda, Palestine’s EB representative Ryad Awaja stressed that the arrangement was temporary. 

He attributed it to logistical constraints facing this year’s WHA, with some meetings shifting to WHO headquarters during renovations at Geneva’s UN Offices in the Palais des Nations.

“To know this is exceptional,” Awaja said of the consolidated discussion. “It’s not …forever. It’s just an exception from Palestine to help for this time.”

An infographic titled Global Maternal and Child Health Targets “Off Track” showing six key nutrition indicators. From left to right: Anaemia in women (rising from 27.6% to 30.7%), Childhood overweight (stagnating/rising at 5.5%), Low birth weight (stagnating at 14.7%), stunting (improving but off track at estimated 136.3 million by 2030), wasting (off track at 6.6%), and Exclusive breastfeeding (improving but off track at 47.4%).
The current status of six global maternal and child health targets as of 2023.

The World Health Organization (WHO) Executive Board faced a grim reckoning on Thursday in a report detailing how global progress on maternal, infant and child nutrition has largely stalled or even regressed.  Notably, six critical nutrition targets remain “off track,” with rising rates of anaemia and childhood obesity sliding back, threatening to reverse years of development gains, according to a report reviewed by the EB.

“Malnutrition is really a silent epidemic today in Africa,” stated the representative of Cameroon. “Despite all that has been done, we still see stunting, anaemia, and lack of certain nutrients.”

International commitments aim to halve the prevalence of anaemia in women of reproductive age by 2030, as part of Sustainable Development Goal 2 (Zero Hunger). However, rates have climbed from 27.6% in 2012 to 30.7% in 2023. Driven by factors ranging from food insecurity and infectious diseases to poverty, this leaves millions of women without enough healthy red blood cells.

Global targets for tackling the double burden of malnutrition, which includes both undernutrition and overweight, are similarly off-track.

The global prevalence of childhood overweight has crept up to 5.5%, as food systems struggle to provide healthy options, the WHO report notes. Stunting, a measure of undernutrition, still affects 150.2 million children under five, with an estimated 136.3 million more children likely to face stunting by 2030. And low birth weight rates have barely improved, inching down just 0.3% to 14.7% of newborns between 2012 and 2023. Meanwhile, childhood wasting remains stubbornly high at 6.6% of children under the age of five years of age – well above the 5% threshold required to ensure child survival.

Maternal and child health is crisis of inequality 

Delegates from Cameroon, Cabo Verde, and Algeria seated at a World Health Organization Executive Board meeting, discussing the global crisis in maternal and child health.
The delegation from Cameroon highlighted the ‘silent epidemic’ of malnutrition and the urgent need to prioritise maternal and child health amidst stalling global progress.

In the first comprehensive debate since member states pledged to extend and accelerate action on maternal, infant and young child nutrition in a 2025 World Health Assembly resolution, delegates called out the stagnation as a systemic crisis of inequality deepened by conflict and climate change.

Speaking on behalf of the 47 Member States of the African Region, the delegation from Lesotho warned that the continent bears the highest global burden of stunting and anaemia, a situation that persists, despite ongoing interventions, delegates from Cameroon added.

Somalia, speaking for the Eastern Mediterranean Region, highlighted the devastating impact of climate and conflict-driven instability, noting a “complex nutrition burden driven by conflict, displacement, and climate shocks.”

The delegation reported that 24.3 million children under five in the Africa region are currently stunted, urging prioritised support for fragile and conflict-affected settings.

Outrage over ‘savage marketing’ of formula

A medium shot of a female delegate with long brown hair and glasses, wearing a white blazer. She sits behind a laptop and microphone.
The Norwegian delegation joined the European Union and African nations in calling for stricter regulations on the formula industry’s digital marketing following recent safety recalls.

A major point of contention during the session was the aggressive commercialisation of infant nutrition. In a sharp rebuke of the formula industry, the Central African Republic condemned “savage marketing for breast milk substitutes.”

The delegate noted that these practices are “undermining breastfeeding and taking advantage of communities that are already poor and fragile”, putting industry interests over public health.

This concern bridged the divide between the Global South and wealthy donor nations. Norway joined African nations in demanding stricter regulation, specifically targeting the digital sphere. The Norwegian delegation raised alarm over “recent large-scale recalls of breast milk substitutes,” arguing that food safety and robust monitoring must be paramount.

Advocacy groups demand industry accountability

In the foreground, a man representing the Central African Republic speaks into a microphone while holding a document. To his left sits a woman representing Chile working on a laptop, and to his right is a man representing Cameroon. The table features official nameplates and microphones for each delegate.
The delegate from the Central African Republic condemned ‘aggressive’ and ‘savage marketing for breast milk substitutes.’

The tension between public health priorities and commercial interests was palpable in statements from non-state actors.

The International Baby Food Action Network (IBFAN) hit back at the formula industry. The advocacy group warned that recent contamination cases exposed “systemic failures” in formula production. IBFAN argued that cross-border social media marketing exacerbates food safety risks by allowing unregistered products to enter countries, demanding that governments take the lead in verifying safety rather than trusting manufacturers.

Meanwhile, the Global Self-Care Federation, representing the consumer health industry, argued that policymakers also “must prioritise the provision of micronutrient supplements”  to women. A statement by the group noted that iron, folate, iodine, and calcium supplementation can help reduce anaemia prevalence, and therefore maternal mortality and pre-term birth, as well as some “life-long NCD risks.” Such supplementation is thus a “cost-effective public health investment”, the group stated.

Rising stakes in a climate of receding aid

A wide-angle view of the World Health Organization (WHO) Executive Board meeting in a circular assembly hall, where delegates are gathered to debate global progress on maternal and child health.
The WHO Executive Board convenes in Geneva to address a critical report revealing that most global maternal and child health targets are currently off track.

The United Kingdom called the report “sobering,” noting that “no country is on track to meet the targets” and flagging worsening trends in minimum dietary diversity even within its borders. Canada emphasised the need to “step up nutritional interventions” that are based on evidence and take gender into account.

Speaking for the 27-member European Union, Bulgaria admitted the world is “far off track.” However, the bloc reiterated its financial commitment, noting that Europe has pledged €6.5 billion to fight malnutrition up to 2029. The EU called for increased coordination on data collection to better target the most vulnerable populations.

While officials figures are yet to be finalised, international development assistance for nutrition declined by an estimated 9% to 17% in 2025. In light of this, the Board faces the difficult task of reversing these trends in a constrained financial environment.

Such reductions in donor aid threaten to “reverse hard work and increase preventable child deaths,” warned Nigeria, saying that nutrition needs to be considered an “essential” organising principle of primary health care.

Image Credits: Felix Sassmannshausen, HPW/Felix Sassmannshausen.

In the foreground, a man representing the Central African Republic speaks into a microphone while holding a document. The delegate from the Central African Republic advocated for slower, more meaningful consultations on the global indigenous health plan.
The delegate from the Central African Republic advocated for slower, more meaningful consultations on the global indigenous health plan.

The World Health Organization (WHO) has slowed the pace on the development of a Global Plan of Action to advance the health of indigenous peoples globally, with the Executive Board voting on Thursday to delay the plan’s final consideration until May 2027.

The draft strategy aims to address the stark health inequities faced by many indigenous communities, focusing on priority areas such as access to services, recognition of traditional knowledge, and climate resilience.

The decision to extend the deadline of the indigenous health plan by a full year reflects a consensus among member states to prioritise the legitimacy of the process over speed. By stepping back from the original 2026 target, the Board aims to ensure the “free, prior and informed consent” of the very populations addressed by the policy – indigenous communities that may be harder to reach or become engaged.

“Strengthening consultation mechanisms that are tailored to cultural and linguistic realities remains vital to guarantee effective participation,” stated the delegate for the Central African Republic, speaking on behalf of the 47 Member States of the African Region.

Fighting ‘digital barriers’ to enable real inclusion

A medium shot of two delegates seated behind a desk labelled at a World Health Organization meeting. A woman with long reddish-brown hair is on the left, looking toward a speaker while holding a tablet.
The Brazilian delegation expressed concerns that relying exclusively on online consultations could silence Indigenous voices due to digital divides.

Delegates in favour of the delay of the global indigenous health plan argued that a program built on a more limited engagement would fail.

Brazil reinforced the African Group’s stance, warning against the exclusion inherent in modern diplomatic processes. The Brazilian delegation noted its concern regarding the “limitations of consultations conducted exclusively online,” arguing that digital divides could silence the very voices the plan aims to empower.

Non-state actors also urged the Board to use the additional time to bridge the gap between western medicine and traditional practices. Médecins sans Frontières (MSF) welcomed the proposal but stressed that the delay of the indigenous health plan must be used to centre “social participation and meaningful leadership.”

“Failure in protecting health holistically can result in severe health consequences,” the MSF representative stated, calling for a plan that respects “traditional medicines and knowledge encouraging dialogue with traditional healers”.

Indonesia rejects fixed ‘indigenous’ label, citing colonial history

An infographic titled “Trading Speed for Legitimacy” showing a timeline for the Global Indigenous Health Plan. The graphic illustrates a shift from an original 2026 target to a revised consideration date of May 2027 to allow for an extended consultation window. Three panels below the timeline outline the rationale, the mandate for inclusion, and regional support from the Central African Republic.
A new timeline for the Global Indigenous Health Plan extends the consultation window to May 2027, aiming to secure “free, prior and informed consent” from affected communities.

While the delay was driven by a desire for inclusion, the session also exposed deep-seated political fault lines regarding what is an ‘indigenous’ community in the first place.

In a pointed intervention, Indonesia challenged the applicability of the term within its national context. As a multicultural and multi-ethnic country that obtained independence in 1945 after nearly 350 years of Dutch colonial rule, the concept of “indigenous peoples” does not fit their demographic reality, Indonesia’s delegate stated. The country is one of the world’s most ethnically diverse nations with over 1,300 ethnic groups that are largely native to the archipelago, but also significant minorities of Chinese-, Indian- and Arab-Indonesians.

While Indonesia voted in favour of the UN Declaration on the Rights of Indigenous Peoples (UNDRIP) in 2007, it did so with a formal explanation that it would limit the declaration’s application within its borders.

“There is no one fixed definition of indigenous people and that concept is not applicable in our national context,” the Indonesian delegate to the EB stated, he underscored their position regarding the indigenous health action plan.

This statement has strong political implications, as conflicts between land claims put forward by local Indonesian communities faced with massive deforestation by the palm oil industry have intensified recently, human rights groups point out. Communities across Africa and Latin America’s Amazonia region also face massive health challenges due to incursions by the oil and gas industry, leaving health impacts not only from the loss of food sources and biodiversity due to deforestation but also from gas flaring, contamination of waterways and more.

The debated reflected the complexities the WHO Secretariat faces in drafting a global strategy that satisfies protects some of the world’s most vulnerable communities – facing challenges from powerful economic interests and political constituencies.

Image Credits: Felix Sassmannshausen.

Argentina’s Ambassador to the UN in Geneva, Carlos Mario Foradori, affirms his country will remain involved with WHO’s regional arm, PAHO,

Although Argentina is withdrawing from the World Health Organization’s global body, it intends to remain an active member in WHO’s regional affiliate, the Pan American Health Organization (PAHO),  the country’s representative told the WHO Executive Board on Friday. 

His comments came in the course of a discussion on the legal and policy impacts of Argentina’s declaration in February 2025 that it would leave WHO, following that of the United States last January. Argentina’s official notice, made in March, is due to be discussed at the May World Health Assembly along with the United States withdrawal. 

But the two countries are in somewhat different legal positions vis a vis any WHA response.  In terms of Argentina, there is no explicit provision in WHO’s  Constitution for member states to withdraw, with the exception of the United States, which reserved that right explicitly when it joined in 1948. As for the United States, the US also owes WHO some $260.6 million in unpaid dues for 2024-2025, on which WHA member states could feasibly demand payment before its withdrawal is legally “accepted.”   See related story.

Stars and Stripes No Longer Flying at WHO – But US Can’t Really Leave Until Dues are Paid, Agency Says

Argentina will continue to abide by International Health Regulations on Emergencies

Regardless of the formalities, Argentina’s Ambassador to the UN in Geneva, Carlos Mario Foradori, affirmed that the country would continue to abide by International Health Regulations whereby WHO must be notified of an infectious disease outbreak of epidemic potential. 

“We will not be isolated from the world. We will continue to respect all the rules that exist. We cooperate very closely with the Pan American Health Organization, and we will strengthen this even further,” Foradori said, adding that PAHO’s Director Jarbas Barbosa, is in fact visiting Argentina next week. 

“And it should be clear to the whole membership that we’re not leaving this world. To be very clear, as was mentioned, the pandemic knows no borders, and as a Western civilized country, we understand that we need to respect rules, and work with the whole world.”  Some WHO observers called out Foradori’s reference to a “western civilized country” was as a slight on non-western regions of the world.

So far, the US also has remained in PAHO, of which it was a founding member, and whose existence predates the 1948 formation of WHO by nearly half a century. Historically, the US is also PAHO’s largest funder. 

However, currently the US owes PAHO some 78.5 million in unpaid dues for the 2024-25 fiscal year, and a total of $136.5 million including 2026 dues. In August, meanwhile, the White House ordered cuts in some $45 million to already approved PAHO allocations in protest over a now-discontinued PAHO programme supporting the deployment of Cuban doctors to rural areas of Brazil at sub-market wages and with Cuba’s government reaping financial benefits.  See related story: 

Pan American Health Organization Targeted in New Round of US Funding Cuts

This week’s Congressional passage of a $9.42 billion global health appropriations bill , meanwhile, contained no explicit mention of funding to PAHO. And so it remains to be seen the cutbacks previously ordered by the White House are indeed implemented – as well as how PAHO will be funded for 2026. 

Legally, PAHO is an anomaly amongst WHO’s six regional offices insofar as it operates with its own budget and decision-making structure as a semi-autonomous entity – even though it also serves as a WHO Regional Office. This anomaly, in turn, opens up the unique possibility for nations in the Americas to retain their affiliation with PAHO as a regional organization, whilst disassociating themselves from WHO as a global body.  

No clear way forward on response to member states that withdraw 

Costa Rica’s delegate at the EB was one of several member states that expressed regret at Argentina’s withdrawal from WHO.

The EB discussion did not yield a unanimous recommendation on whether the World Health Assembly should actively ‘accept’ Argentina’s withdrawal – or how to respond to the US withdrawal at a time when Washington stills owe WHO some $360 million in past dues. 

While many WHO member states at the EB meeting stressed that countries had the sovereign right to determine whether they remain in an international organization – others stressed the legal complexities around the issue and the need for further consideration before the WHA must take a position in May.    

Ultimately, the EB agreed to pass onto the WHA a draft resolution co-sponsored by Argentina and Israel, calling on WHO member states to formally acknowledge Argentina’s withdrawal. But some leading member states reserved their final position, asking for further legal analysis and clarification. 

“Argentina’s notification of withdrawal raises numerous issues that do require careful consideration,” said Australia’’s delegate.

Said Switzerland, “We hear that there are still different legal, political, technical questions on the conditions and the implication in this context, on this agenda. ..We would all benefit from additional clarity for the WHA to be able to take an informed decision.”

A report submitted to this Executive Board meeting has already has laid out the key issues relateld to the withdrawal of both Argentina and the US. Effectively, there is no legal provision in the WHO Constitution for a member state to withdraw  – with the exception of the United States, which made that right an explicit condition of its joining in 1948, WHO’s paper notes. 

At the same time, Argentina and other member states argued that broader international legal principles guarantee a country the sovereign right to determine its affiliations in multilateral organizations like WHO.

Australia, Costa Rica, Zimbabwe and other member states also expressed regret over Argentina’s departure from the global body, asking for continued dialogue over its decision and describing Argentina as a valued partner in global health. 

“We request them to reconsider in view of global health security,” said Zimbabwe. 

China says US withdrawal shows lack of ‘leadership’

China’s EB delegate describes US withdrawal from WHO as a lack of leadership.

No such regrets were expressed at Friday’s meeting regarding the US departure. But China described the US move as a lack of leadership, saying:  

“As the most representative and authoritative intergovernmental, international health organization, the WHO bears a significant responsibility in global health governance….Major countries in particular, should lead by example. They should not treat the WHO as something to be used as it fits and abandoned when it does not. Nor should they bypass the WHO and set up alternative mechanisms,” China’s delegate said. 

“Countries should adhere to the rule of law and should not selectively fulfill their international obligations and commitments, and should not place [their] domestic political agenda above international law and governments.”

At the same time, China called for a re-evaluation of WHO rules around the entry and exit of member states from the organization, for which WHO’s 1948 constitution made few provisions, saying: 

“The issue of withdrawal is complex and sensitive. Members cannot enter or exit at their will. At present, there are certain gaps and ambiguity in the WHO’s rule regarding membership changes based on fairness and transparency, necessary adjustments and improvements should be made to better respond to the new circumstances and requirements on global health governance.” 

Israel, meanwhile, said that WHA members should accept the US notice of withdrawal without hinging it to other issues – an indirect reference to the unpaid US dues for 2024-2025.

Said Israel, “Any attempt to compel states against the national decisions is an infringement of their sovereign rights. There is no valid reason to further discuss this matter in any WHO forum. Further discussions only consume the limited resources this organization has without carrying any actual impact on the ground. Other issues of dispute between a member state and the organization do not affect the right of withdrawal in the context of the WHO,” Israel’s delegate said, an apparent reference to the outstanding, unpaid WHO dues still owed by the US.

At Monday’s Executive Board opening, Israel’s EB Representative, Asher Salmon, warned that his country, a close ally of the US, is also under pressure to withdraw from WHO, saying, “in Israel, there are also, unfortunately, strong public voices calling for us to leave the organisation.” 

Claiming that the WHO had become “too politicised,” he called for a “brave conceptual overhaul” of the organization. See related story: 

Days After US Leaves WHO, Israel Warns it Faces Pressure to Withdraw

 

Image Credits: DavidRockDesign/Pixabay.