The World Health Organization (WHO) is introducing immediate cost-cutting measures including a freeze on all but critical staff recruitment, according to an email from the Director-General to staff sent late Thursday.

The body is also prioritising activities related to health priorities, “significantly reducing” travel, limiting procurement and suspending office upgrades.

All meetings will be virtual except in “exceptional cases” and only essential missions to provide technical support to countries will go ahead, according to the email.

This comes in response to Monday’s announcement by President Donald Trump that he is pulling the United States out of the global body.

“This announcement has made our financial situation more acute” and “created uncertainty for the WHO workforce,” said Tedros.

The US is the WHO’s biggest donor, both in “assessed contributions” (membership fees) and “voluntary contributions” (donations, usually earmarked for specific health programmes). The combined US contribution amounts to around 18% of the WHO budget.

The WHO’s budget for the two-year period 2024-2025 is $6.83 billion. The US is due to pay over $261 million in “assessed contributions” during 2024/5 and has often given over double that in voluntary contributions. In 2023, it contributed over $367 million. 

The US is obliged to give a year’s notice of its withdrawal to the United Nations, which confirmed that it had received this and the withdrawal will officially come into effect next January. The effect will be massive.

More cuts lie ahead

Tedros’s email warns that the immediate cost-cutting measures are “not comprehensive” and more cuts lie ahead.

“Change is a constant, and we are committed to continuous improvement. Navigating the challenges we face will require solidarity across who shared responsibility for good stewardship of our financial resources, flexibility to adjust to the needs of our member states, and creativity in finding solutions at every level,” said Tedros.

“I thank those staff who have already sent suggestions for mobilizing resources and further improving our efficiency and cost effectiveness, and I invite all staff to do the same,” he added.

“WHO’’s people have always been and remain our greatest asset, and we will do everything possible to support and protect you.”

Financial reform process

The WHO been engaged in a process of reforming its finances and performance for over five years in response to pressure from powerful member states for improved efficiency and less donor reliance.

After lengthy deliberations led by Germany’s Björn Kümmel, the 2022 World Health Assembly adopted a raft of financial reforms, including that there should be a substantial increase in member states’ “assessed contributions”, from covering merely 16% of the budget at that time to 50% of the budget by 2030.

With over 80% of the WHO budget covered by grants and voluntary contributions – usually earmarked for specific activities – the body’s activities were skewed towards donor priorities rather than member states’ needs.

Aside from increased members’ fees, the WHO also launched its first Investment Round late last year to fundraise for flexible funds for its day-to-day operations.

Kümmel told the EB that the WHO was managing 3,300 grants “with individual reporting requirements”. 

“The average length of a grant in WHO is 13 months. This is everything else but predictable,” Kümmel added.

Last year, Tedros told the WHO’s executive board (EB) that he was embarrassed by the fact that the many WHO staff members were on 60-day rolling contracts due to financial restraints, which made them vulnerable and undermined stability.

“If you talk about motivated and fit-for-purpose workforce, retaining and attracting talent without sustainable financing is impossible,” said Tedros.

Meanwhile, WHO Africa director Dr Matshidiso Moeti told a 2022 WHA roundtable that “many of our staff members are spending a disproportionate amount of their time processing these grants”.

In addition, the earmarked funds for Africa were mainly for communicable diseases, so there was a lack of funds for non-communicable diseases, Moeti added.

The shock decision by the US will undermine the reform process of the past five years. This will introduce even more precarity for staff at the global body as they battles to respond to a growing tide of health challenges, that are worsening with climate change.

Image Credits: US Mission in Geneva / Eric Bridiers via Flickr.