WHO’s budget for 2026-27 could reduce the agency’s global footprint by about 20% from a total of 9,463 staff as of December 2024, to 7,525  – with the biggest cuts in entry-to mid-level professional staff who are ranked as P1 to P3. 

Some 30% of staff P 1-3 in 400 positions would be terminated, according to initial estimates of staff allocations by grade, contained in a confidential white paper presented this week to the WHO’s Planning, Budget and Administration Committee (PBAC) of the WHO Executive Board, and seen by Health Policy Watch.

The PBAC meeting came ahead of next week’s World Health Assembly (19-27 May), when member states will consider a draft resolution approving a base budget of $4.2 billion and a total budget of about $6.2 billion, including voluntary donations for polio eradication and emergency appeals.  

Only six D2 directors would leave the agency—just a 9% reduction in the agency’s most senior directors—according to an “indicative summary staffing table” in the white paper presented to PBAC, covering the $4.2 billion base segment of WHO’s 2026–27 budget. The estimates, like all published WHO HR data, do not include staff in the Regional Office of the Americas (Pan American Health Organization/PAHO), which has a separate budget—except for the head of PAHO’s Regional Office, who is paid by headquarters.

The number of senior directors nearly doubled between July 2017 and July 2024 as WHO Director General Dr Tedros Adhanom Ghebreyesus expanded numbers of both staff and senior management, while promoting many existing directors from D1 to D2 grades, during a period of rapid WHO expansion.   

If the white paper projections were indeed implemented, there would be only a net global reduction of just 32 directors at D1 to D2 levels, according to a comparison of current and planned 2026-27 staffing levels by Health Policy Watch.   

The number of staff in senior leadership positions, so called “ungraded” (UG1-UG2), would, meanwhile, decline from 16 to 13. That would include the heads of WHO’s six regional office as well as a deputy director general in a seven-member leadership team at WHO’s Geneva headquarters.

That contrasts with the latest organigram presented to WHO member states, which noted a leadership team of only six alongside the director general himself. In that array, there was no deputy director general earmarked at all, a position estimated to cost more than $500,000 a year. No deputy director general was named, as well, in the recent announcement by Tedros’ of his new senior leadership team.

The global staffing plan, seen by Health Policy Watch, also seems to anticipate a net reduction of D1 and D2 directors that is far less than had been promised for headquarters alone.  

In his presentation Wednesday to the PBAC, Tedros told member states that the number of departments at headquarters would be reduced by more than half from 76 to 34. That should, in principle, lead to 42 fewer directors in headquarters. 

“Decisions about which directors will lead which departments will be made following the World Health Assembly. That, I know, will also be tough, given the downsizing from 76 to 34 departments,” Tedros said in his message to PBAC members, which was published by WHO.

At the same time, 90% or more of directors have long term contracts that protect them from sudden layoffs, complicating such reductions. According to UN rules, those who see their programmes at headquarters slashed or eliminated would have to be offered positions elsewhere in the global system – or alternatively a year’s salary – with all of those associated costs. 

All short term professional and administrative staff eliminated 

In contrast, short-term professional and administrative staff would be eliminated almost entirely from the organization’s ranks in the new staff planning, as they have almost no protection from layoffs whatsoever. 

But cost forecasts also contained in the white paper suggest a continued heavy reliance on WHO consultants over the coming two years. 

The paper estimates the cost of “contractual services” – meaning consultants – at some $1.19 billion – or around 52% of total staff costs of $2.26 billion for the same period. And that does not include contractual services for general operating expenses, such as building maintenance, or equipment, vehicles and furniture. 

The budget total adds up to $4.267 billion, equal to the base budget that WHO member states will be asked to approve for the coming biennium at the upcoming WHA, in a draft resolution published on WHO’s WHA website.  On top of the base budget are WHO’s polio eradication effort, Special Programmes, and Health Emergency appeals, which depend heavily on voluntary contributions and add another $2 billion, for a total of $6.206 billion, not including PAHO, included in the draft  2026-27 Programme budget resolution that will go before member states.  Currently, however, some $1.7 billion of even the base budget remains unfunded. 

From July 2017 to the end of 2024, the number of WHO consultants in all categories increased from 3,798 to nearly 7,600, according to a Health Policy Watch analysis of the data in March. 

WHO’s end-year 2024 HR data, however, reflected a reduction in “non-staff” positions as compared to the previous year. As of end 2024, there were some 7582 “non-staff affiliates” in all categories, up just three positions from July, but down by nearly 15% from the all-time WHO peak of 8818 non-staff affiliates in 2023.

Asked to comment on the White Paper and its consequences, a WHO spokesperson said:

“The HPW article is misleading. The paper it refers to is a modelling exercise done primarily for budget modelling purposes. It is also missing some elements—e.g., country data from Europe. Under no circumstances should this be viewed or considered to pre-empt the actual managerial decisions which are about to take place in the coming months. Those decisions will be made based on prioritization, looking at synergies and eliminating duplications. The only layer where decisions were made is at the Assistant Director-General level so far. We haven’t gone through any other functional review. It would be more appropriate to wait for these decisions—we will report everything properly—and analyse them then. To draw any conclusions from this at this point is not meaningful or helpful.”

Indeed, along with the routine exclusion of PAHO, the data “does not include country level positions for the regional office for Europe,” the White Paper states.

The White Paper also states that the staffing and expenditure breakdown are “solely for indicative purposes. Staffing figures will evolve once operational planning has been concluded. The actual implementation of the workplan plans will be subject to the availability of funding.”

However, the fact remains that with large proportions of higher-level staff on long-term contracts that make lay-offs difficult, large reductions of staff in the organization’s lower ranks are much easier legally and financially.

WHA will review latest updates on the budget crisis

Next week’s World Health Assembly will review a summary report from the closed-door PBAC session, along with the latest updates from the WHO’s leadership on the budget crisis, triggered by the withdrawal of the United States, WHO’s largest donor, from the global health agency in January.

The member state group will also discuss the ongoing “prioritization” exercise aimed at determining which WHO programmes and activities are deemed less essential and should therefore be discontinued in light of the pending budget and staff reductions.

Strikingly, the PBAC White Paper—as well as other documents presented to PBAC on WHO’s financial outlook—only discloses total staff costs to the organization in the aggregate, rather than providing any assessment of costs by staff grade, type of contract, and geographic location.

Knowledge of the real costs of staff at different levels would enable nuanced member state assessment of the tough financial tradeoffs faced, analysts say—for instance, between offering early retirement versus relocation to senior directors and high-ranking professionals; options for retaining more staff in mid- or lower-level ranks; and costs of consultants versus staff for certain types of tasks.

So, amidst the extensive documentation prepared for PBAC and the upcoming WHA, the lack of detailed cost disclosure remains a glaring omission.

• Updated on 17.05.25 to include WHO’s response and the exclusion of PAHO from the budget and staffing estimates in the exercise. 

Image Credits: WHO/Pierre Albo , WHO HR Update 31.12.2024 & PBAC White Paper , WHO, White Paper, PBAC.