By hosting a high-level “investor round” to raise flexible funding for its operations, the World Health Organization (WHO) will address one of its “greatest overall risks, namely dependency on the very few number of donors”.

This is according to Germany’s Björn Kümmel, chair of the WHO Working Group on Sustainable Financing, who told the WHO’s executive board meeting on Monday that there is “completely fragmented resource mobilisation” throughout the global body.

Executive board members supported the proposal for an investor round – likely to be held in November – with uncharacteristic enthusiasm on Monday.

The idea of a WHO investment jamboree similar to those hosted by the Global Fund and Gavi, was accepted in principle by last year’s World Health Assembly, but it charged the WHO Director-General with investigating how it would operate, including costs versus potential income.

Dr Tedros Adhanom Ghebreyesus reported back to the board that the “expected benefits outweigh the additional costs of the investment round”.

Currently, the majority of WHO funding comes from donors for earmarked projects which can distort the global programme of work.

To correct this distortion, the WHA resolved that member states need to increase their  “assessed contributions” – currently barely covering 16% of WHO’s budget – and the WHO needs to raise more flexible donor funding.

Not sustainable

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

“There are 3,300 grants in this organisation with individual reporting requirements with the consequence that the technical staff, that needs to provide norms and standards for the world, is raising earmarked funds for their units in order to be paid and to be able to run the programmes. This is not effective, and this is certainly not sustainable,” added Kümmel, whose working group has been working on reforming WHO’s financing since 2021.

Meanwhile, Tedros told the board 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.

 Kümmel asserted that the investment round has the potential to be “truly catalytic” for all reforms that the board is pushing, and  has the potential to introduce more flexible and predictable financing.

The WHO Working Group on Sustainable Financing’s report to the 2023 WHA highlighted that WHO’s budget is “up to 86 % dependent on generous donors and that only roughly 14 % of WHO’s finances are truly predictable”.

“This situation has put WHO at severe risk, including its independence, its integrity, its agility and certainly also its mandated role to be the world’s leading and coordinating authority in global health,” said the report.

While board members accepted the proposal for an investor round, they want input on the investor case due to be developed by May, and urged that the case should be closely linked to the WHO’s 14th global programme of work (GPW), which was also discussed on Monday.

Image Credits: WHO.