GENEVA – The World Health Assembly is poised to decide on an “investment round” in late 2024 to boost the World Health Organization’s (WHO) finances  – but not the establishment of a  “replenishment fund”. 

 Member states and donors will be able to continue to provide funds to the WHO earmarked for specific health programmes – something that the WHO’s Working Group on Sustainable Financing advised that the organisation moves away from as this skews the work of the global body.

This is according to a copy of the draft text leaked to Health Policy Watch, based on member state discussions late on Wednesday. The US is widely believed to have pushed for the continued inclusion of earmarked funds as a condition of its support for the resolution.

The formation of a WHO Investor Forum has also been mooted ahead of the investment round, according to those close to discussions.

Members’ fees to cover 20% of budget

The text also urges member states to pay their membership fees – which the assembly earlier resolved would now cover 20% of the budget (up from an estimated 14%).

While the text proposes that the WHO should continue to accept, “alongside unearmarked voluntary contributions, voluntary contributions that are earmarked and/or single-year contributions from member states and other donors” it urges an increase in “transparency of reporting on voluntary earmarked contributions and on their impact and allocation”.

In the lead-up to planning the investment round in the last quarter of 2024, the WHO is directed to provide member states with regular updates and to provide the Executive Board with “a full plan that includes modalities and anticipated costs”  for approval.

Various efforts to improve the financial viability of the WHO have hammered on the importance of the organisation having access to flexible funds – rather than funds donated by philanthropies and wealthier member states that are tied to programmes that might not be top global health priorities. 

Civil society condemnation

Four civil society organisations condemned the new text, describing it as “nothing but the institutionalisation of the earmarked contribution that has led to the dismal functioning of the WHO at various levels,  including the increasing penetration of the private philanthropic sector in the organisation”.

“The draft decision goes against the very objective of the recommendation of the Working Group,” said Lauren Paremoer of the People’s Health Movement.

“As per the approved budget of $6834.1 million for the 2024-25 biennium, $5685.8 million is to be funded through voluntary contributions. The institutionalisation of earmarked funding would further stabilise donor-driven priorities and compromise the credibility, independence and integrity of WHO.” 

Nicoletta Dentico of Society for International Development (SID) condemned “the multilateral development community’s fixation with leveraging the private sector in healthcare, using public money to de-risk investments”. 

Third World Network’s KM Gopakumar condemned the idea of a WHO Investors’ Forum, saying it would “seriously undermine the role of the vast majority of Member states in WHO’s governance”. 

“The  Forum participants, consisting of a rather impenetrable network of philanthropic foundations and the private sector, would de facto control WHO’s priorities,” he added.

Image Credits: Twitter/Dr Tedros Adhanom Ghebreyesus.