World Health Organization member-states greenlighted a budget of $6.83 billion for 2024-25 for the global health agency – an 11% increase over the 2022-23 budget. 

Implicit in the budget is member-state implementation of a stepwise increase in assessed contributions. 

The groundbreaking reform, which aims to have one-half of WHO’s spending financed more sustainably by fixed member state contributions by 2030, was approved in principle at the May 2022 World Health Assembly (WHA). 

But it still required a nod from member states for the increased assessments to be applied this year. And that was not a foregone conclusion until a closed door meeting last week between member states, observed former WHO chief legal counsel Gian Luca Burci at a WHA preview event on Sunday. 

The WHO budget for the previous biennium 2022-23 was $6.12 billion. 

The gradual increase in country assessments aims to correct WHO’s current over-dependence on earmarked “voluntary contributions” – money that is donated by a member state or philanthropy. 

Such voluntary contributions now make up around 84% of the WHO’s total budget. WHO Director General Dr Tedros Adhanom Ghebreyesus, along with other senior officials, have  long complained that such designated funding makes strategic planning hard to control.  

“WHO’s over-reliance on voluntary contributions, with a large proportion earmarked for specific areas of work results, in an ongoing misalignment between organizational priorities and the ability to finance them,” the WHO had mentioned in a statement during WHA 2022.

Focus shifts towards countries

Roughly $2 billion of the 2024-25 budget will go towards furthering WHO’s goal of Universal Health Coverage, and around $1.35 billion will be channeled into a “more effective and efficient WHO”.  

The latter includes greater support to countries, including co-financing for United Nations Resident Coordinators.  While WHO will continue to maintain its own country offices in over 100 developing countries, the UN-wide Resident Coordinator system, aims to improve coordination between UN-affiliated tasks at country level.  

But the new 2024-25 budget allocation to countries and regions is, in fact, only marginally larger than the allocation of $1.25 billion from the previous 2022-23 biennium.   

Countries welcomed the gradual increase in country allocations, however modest. But , African member-states re-asserted demands that at least 75% of the budget should go to offices outside of the Geneva headquarters. 

“We wish to see the efforts to continue increasing the share of countries and regions from the program budget according to an agreed phased timeline for 2024 to 2027 with an aspiration to reach at least 75% budget allocation to countries and regions,” said the delegate from Ethiopia, speaking on behalf of the group of 47 sub-Saharan African member states.  

Of the $6.83 billion budget allocation, a little over 50% will be spent towards achieving the WHO’s triple billion targets of universal health coverage ($1.96 billion), protecting people from health emergencies ($1.21 billion). The third pillar aiming to ensure “healthier lives and well-being” for 1 billion people received the least funding with only $0.43 billion for the two years. 

Polio eradication, meanwhile, received an allocation of $0.69 billion, 23% higher than the previous biennium. Polio, which had resurfaced sporadically in Africa and North America over the past year, along with the typical Asian hotspots of Afghanistan and Pakistan, remains the only public health emergency of international concern (PHEIC) designated by the WHO as of Monday.

WHO’s Special Programmes (for Research and Training in Tropical Diseases, the Special Programme of Research, Development and Research Training in Human Reproduction, and the Pandemic Influenza Preparedness Framework) received an allocation of $0.17 billion as against the allocation of $0.19 billion the previous time. 

Main ask: flexible funding and transparency in spending

Member states, meanwhile, rallied to emphasize on the need to continue working for a flexible funding mechanism that prioritizes the causes of spending based on specific situations. 

“The lack of flexible funds remains a continued concern. We hope to witness an increase in flexible funds over the long run by steadily introducing replenishment mechanisms, which are currently being discussed,” the delegate for the Republic of Korea noted.

Calls for greater transparency in WHO spending also rang across the room. Countries ranging from the Philippines, to Namibia and Brazil demanded that WHO disclose more specific details about projects and programmes in which it is engaged at country-level. 

“Improvements in transparency, accountability and administrative measures are essential. In the absence of clear improvements in those areas, it will be impossible to adopt, let alone justify any increase in assessed contributions,” the delegate for Brazil told the floor. 

“The practice of complete disclosure of information on expenditures of member states to member states in order to ensure transparency is not only indispensable, but also something customarily adopted by the UN agencies, and it is high time the WHO follows this path.” 

Image Credits: Twitter/Dr Tedros Adhanom Ghebreyesus, WHO.