WHO’s Director General Dr Tedros Adhanom Ghebreyesus appealed for a second time to the United States to “reconsider” it’s decision to withdraw from the UN global health agency.

Speaking Tuesday at the close of a fractious meeting of WHO’s 34-member Executive Board, the WHO DG said, “we regret the announcement by the United States, of its intention to withdraw, and it was also sad to see them participating less this week. I think we all felt their absence.

“We very much hope they would reconsider, and we would welcome the opportunity to engage in constructive dialogue,”  Tedros said.  While the US delegation attended the proceedings they remained silent throughout almost all of the proceedings – with the rare exception being a statement in support of Taiwan’s re-admission as a WHO observer.

The final hours of the eight-day long session  were wracked by some of the same geopolitical and culture wars that have shadowed recent WHO proceedings.

African and Middle Eastern member states, backed by Russia, protested WHO’s recognition last year of the US-based reproductive health rights group, the Center for Reproductive Rights, as a group in “Official Relations” with WHO as well as the renewal of ties with a second NGO “Women Deliver”  – saying that the groups contradict their values.

“We have some reservations of few names on the list, one of them is, Woman Deliver,” said Somalia. “Unfortunately, after revising the engagement report, 2022, 2024 and reviewing these organizations, interpretation to some terminologies and ideologies, it has came clear to us that we cannot accept this organization’s advocacy and promotion, fields of work. And hence we came to conclusion that such engagements with this organization would contradict gravely with our region’s values, culture and principles.”

‘Protecting sexual rights is a very contentious issue’

Added Russia: “The issue of protecting sexual rights is a very contentious issue within the WHO, and this concept is not acceptable for the majority of countries and this affects a whole host of spheres of activity. We would draw attention to the fact that one area of work, the association Women Deliver, talks about is gender diversity, which contradicts with the priorities that have been agreed on by all member states for this organization. So in this regard, we would ask for solidarity. We would express a solidarity with the position as expressed by Somalia” said the Russian Federation.

Egypt’s delegate said that it would raise the issue again before the World Health Assembly, the full member state body, at the annual meeting in May.

Meanwhile, Israel also protested the continuation of WHO relations with the International Federation of Medical Students Associations (IFMSA), in light of the global group’s decision in August 2024 to suspend relations with its Israel-affiliate body, The Israel Medical Students Association, in protest over the Gaza war.  However, the matter was set aside after WHO’s administration said that the IFSMA had recently written to the WHO, saying that it will table a motion to lift the suspension of the Israeli affiliate at the upcoming IFMSA General Assembly, scheduled for March.

The eight-day long meeting saw frequent geopolitical sparring over the Israel-Hamas war in Gaza as well as over remarks by some member states supporting Taiwan’s re-admission to the WHA as an observer.  The initiative, hotly opposed by China, was the sole issue that drew a United States statement during the entire EB session.

Budget crisis overshadows proceedings

But beyond the geopolitical and cultural rifts, the 8-day meeting was haunted, even more profoundly, by the budget crisis facing WHO, due to the imminent loss of US financial support – which in 2024-25 amounted to nearly $1 billion, including voluntary and assessed contributions. Although legally, the withdrawal only takes effect in January 2026, some of the assessed 2025 US contribution, however, also remains unpaid – raising questions over if and how WHO will be able to collect the fees.

With the exception of a resolution on Gaza emergency aid, EB approval of about three dozen other WHO initiatives on issues ranging from rare diseases to air pollution was made conditional on a “prioritization” of the most important and affordable activities, due to take place before the full WHA meets in May.

Along with the financial pain of the US withdrawal, China continued to oppose a planned 20% increase in assessed contributions by all WHO member states  – casting an even bigger pallor over the agency’s financial future.

Against this background, the EB approval of a 9.5% pay raise for WHO’s senior leadership team raised eyebrows and private concerns among some member states. But it was ultimately approved after WHO’s Tedros said it was a “no-gain, no loss” alignment of WHO with UN salaries – and came with a simultaneous reduction in a cost-of living allowance that Geneva-based officials receive.  And at the same time, member states said the specialized UN agency still needs to do more to in terms of financial transparency – with inadequate data provided to them on staff costs and their evolution. See related story:

China’s 2026 WHO Fee Could Match US Levels Today – But Beijing Resists Planned Increase

“We’ve had to face new realities with the announcement of the withdrawal of the US from the WHO,” the EB Chair, Jerome Walcott Minister of Health of Barbados, told the 34-member board, “Amidst all of this, you continue to demonstrate the true meaning of multilateralism, moving away from entrenched positions towards compromise for the greater good, or collective well being.” Looking forward to the May WHA, he said, “Our work over the next few months will not be easy, but we have learned that anything that is worthwhile comes with some sacrifice. “