WHO’s budget crisis is even bigger than previously thought. The global health organization is short nearly $1.9 billion from a planned $4.2 billion budget for 2026-27, along with a $600 million deficit through end-2025, senior WHO officials revealed at a global ‘Town Hall’ meeting of WHO staff on Tuesday, heard by Health Policy Watch.

The $1.9 billion gap means that WHO is short nearly 45% of the funding it needs to run even on a the reduced budget of $4.2 billion that had been planned for the upcoming 2026-2027 budget period, Imre Hollo, WHO official in charge of Planning, Resource Coordination, and Performance Monitoring, told staff at the Town Hall meeting. 

The outgoing administration of United States President Joe Biden never paid the US 2024 dues of $130 million owed before leaving office, Raul Thomas, Assistant Director General of Business Operations, revealed at the meeting.  Withdrawal of the United States, WHO’s largest donor historically, has been the key factor in the crisis. The US gave WHO nearly $1 billion in fixed as well as voluntary contributions in 2022-23,

Altogether, the United States owes $260 million in dues for 2024-25 – funds that WHO is unlikely to ever receive from new US President Donald Trump despite a legal obligation to pay. Trump announced in January that he is pulling out of the global health agency, but the withdrawal will only be effective January 2026 as the US is obliged to give a year’s notice.  

Reductions ‘starting with senior leadership’ Tedros pledges

Speaking to WHO staff worldwide via Zoom, Director General Dr Tedros Adhanom Ghebreyesus pledged that the reductions in staff will be made, “starting with senior leadership, but will reflect all levels and regions.

“The reduction will be done carefully and strategically based on a prioritization exercise that we are now conducting to ensure we focus on 0ur core functions, leveraging our comparative advantage and delivering the greatest possible impact with our reduced resources. 

“Everything is on the table, including merging divisions, departments and units, and relocating functions,” Tedros said. 

“We aim to complete the prioritization exercise in the second half of this month, At that point, we will be able to provide more clarity about the size of the reduction and how it will be done. 

“They [cuts] will be made according to the outcome of prioritization, and not according to contract type, grade or anything else,” he stressed. 

A “prioritization working group” is being led by Deputy Director General Dr Mike Ryan, together with the Regional Director for Europe, Hans Kluge, and the Regional Director for the Eastern Mediterranean Region, Hanan Balkhy, Tedros said. They are being supported by Thomas, of business operations, as well as Jeremy Farrar, currently WHO chief scientist and former head of the multi-billion philanthropy, Wellcome Trust.

Despite management transparency pledge, Staff Association hasn’t been included 

While Tedros has said that the WHO Staff Association would be engaged in the process, Staff Association President Catherine Kirorei Corsini told meeting participants that to date they have not been engaged, as reported in Health Policy Watch on Monday. 

“Just to make a disclaimer of the Staff Association, we appreciate feedback that we have received so far from management. But we want to inform you that up to this point, the Staff Association has not taken part of the decisions that have been made. That was done by the prioritization exercise working group,” Corsini said, while also posing questions about staff rights in the event of inevitable layoffs.

“Can management ensure a three months’ period for all staff, regardless of contract type? How will you prioritize existing staff for vacant positions that are currently in the house?” Corsini demanded.

“How do you ensure not pushing our younger people on more precarious contracts? What are the implications for staff on parental leave? Will staff be prioritized over contracts, over contractors?”

Corsini also asked why WHO did not even receive the 2024 assessed US contribution of $130 million. That could have been paid before the January 2025 departure of US President Joe Biden, who was highly supportive of WHO, from the White House. 

 “They traditionally always pay late,’’ replied Thomas.  “So we were under the impression, up until the end of this year, that we would have been paid. And even early this year, there were indications that they were going to pay. Then, in the exercise in Washington, nobody received any funding in terms of international organizations.”

Fact check: Tedros denies nearly $100 million spent on directors and senior leadership 

In his comments at the Town Hall, Tedros also denied that WHO is spending nearly $100 million on the contracts of 215 directors at D1 and D2 grades along with the organization’s senior leadership; the latter includes the DG and his 11 member team at headquarters as well a five WHO regional directors.

Commenting directly on a Health Policy Watch assessment published 10 March, Tedros claimed the “nearly $100 million” cited in the report also included some 86 P6 staff members, who are on the same salary scale as the D1s but play a very direct role in managing many WHO teams and units. 

However, that is not a correct. In the Health Policy Watch analysis, published on 10 March, costs of directors and senior leadership were separately assessed  – with an estimate of $92 million attributed to the 215 officials holding D1 posts, on up to the level of the Director General himself.  

A separate assessment was made for some 86 P6 positions, amounting to costs estimated at $37.5 million, for a total of $127.6 million – as per the breakdown in the table below. 

Without an official, transparent disclosure by WHO of the average, per capita costs of all staff positions, at all grades and at all locations – it’s difficult to derive more refined estimates, a point noted in the original article. 

Notably as well, the Health Policy Watch estimates also did not include senior leadership, directors or staff at the Pan American Health Organization (PAHO).

The PAHO budget is managed separately by member states of the Americas region, and so data on PAHO staff and their costs are not typically included in the global WHO HR reports. 

Even so, PAHO, also known as the Region of the Americas (AMRO), receives some budget from WHO headquarters, and stands to be affected by the overall crisis. But the extent of those impacts could be more limited if the US remains a member of the storied organization, founded in 1902.

PAHO’s 123 year-history pre-dates WHO’s creation in 1948 after World War II. And the US, which played a pivotal role in PAHO’s creation, so far has not announced any move to pull out. 

Pledges new top-level organogram – but no details on existing structure  

At the Town Hall, Tedros also pledged to provide a new top-level organigram of WHO’s proposed new structure as soon as the prioritization process was completed. 

However, unless the current organigram of the entire organization is also disclosed – it’s impossible for staff or member states to assess the efficiencies proposed as a result of the current prioritization exercise against any baseline, WHO experts told Health Policy Watch. 

A complete mapping of WHO’s teams, departments and stafffing has not been published since 2019, when Tedros led the WHO “transformation” aimed at making the organization more responsive and fit for purpose.

In that exercise, existing and proposed mappings of all WHO teams, at least at headquarters, were made available to the Staff Association, as well as to individual department teams, for review and inputs. 

Retrospectively, it’s now apparent that the 2019 WHO transformation also led to an expansion in the number of WHO divisions, directors and senior leaders in  subsequent months and years. But  organizational mappings were never updated in line with the many ad hoc changes made.

During the COVID pandemic, when many donor countries expanded voluntary contributions to WHO, as well as in the post-pandemic period, there was also a doubling in the numbers of temporary contractors worldwide, to over 7,500 in July 2024.

South East Asia Regional Director absent from the meeting 

At the town hall, WHO’s South East Asia Regional Director Saima Wazed was noticeably absent from the meeting. Regional Directors from all other WHO regions – including Africa, the Americas, Eastern Mediterranean, Europe and the Western Pacific  –  were present and spoke. 

Wazed is the object of two criminal cases filed in late March, by Bangladesh’s Anti Corruption Comission (ACC) for fraud, forgery, and misuse of power in connection with her campaign to become the WHO’s top official in the South East Asia region, as reported by Health Policy Watch on 22 March. See related story:

WHO Regional Director Saima Wazed Accused of Fraud and Forgery by Bangladesh Authorities

The charges against Wazed, who took office as WHO Regional Director in January 2024 following her election by SEARO member states, are the culmination of an ACC investigation that began in January 2025.

Her  2023 WHO election campaign also was overshadowed by charges that her influential mother, former Bangladesh Prime Minister Sheikh Hasina, had used her influence to gain her daughter’s election to the post a few months before widespread protests prompted Hasina’s resignation and flight from the country in 2024.

The SEARO region, which Wazed heads, faces a salary shortfall alone of about $12 million in 2025, according to a breakdown presented to WHO directors this week. But the largest gap, by far, is in  headquarters, facing a whopping $173 million salary gap, followed by the African region, according to a presentation made to WHO directors this week, and seen by Health Policy Watch.

It was unclear if those figures include all salary costs. And while staff salaries comprise the largest component of the budget, costs for consultancies, operations and maintenance, travel and also medical supplies, in the case of emergency operations, are other significant components.

Image Credits: WHO / Yoshi Shimizu, WHO HR and EB records, 2023-2024, WHO .