WHO Secures $1 Billion at First European Investment Round

BERLIN – The World Health Organization secured $1 billion in pledges at a landmark fundraising event in Berlin on Monday, kickstarting a major campaign by the UN agency to overhaul its funding model and enhance its ability to tackle global health emergencies.

The billion-dollar total includes $700 million in new pledges from European nations and philanthropies at the World Health Summit. The remaining $300 million comes from previous commitments by the European Union and African Union.

German Chancellor Olaf Scholz, speaking alongside European health ministers from the German capital, stressed the importance of sustainable financing for WHO.

“The WHO’s work benefits us all. What it needs for this work is sustainable financing that gives it the certainty to plan ahead and the flexibility to react,” Scholz said. “With the money we collect at this pledging event today, we can enable many women, men, and above all children to live healthier lives.”

For WHO, long plagued by financial uncertainty, this funding marks a first step toward sustainability as the agency – and the world – faces overlapping health threats from conflicts, poverty, pandemics, noncommunicable diseases, antimicrobial resistance, and climate change.

“For far too long, WHO has operated with unpredictable, inflexible, unsustainable funding,” said Director-General Dr Tedros Adhanom Ghebreyesus. “That prevents us from delivering the long-term support that countries need.”

The $1 billion, however, is just the start. WHO aims to raise $7.4 billion by next May’s World Health Assembly to address the budget gap in its $11.15 billion strategy for 2025-28, known as the General Programme of Work 14 (GPW-14).

This four-year plan could save over 40 million lives through progress on health-related Sustainable Development Goals, stronger health systems, and enhanced emergency responses, WHO figures project. 

“Meeting these complex and overlapping challenges requires a clear plan, and the resources to implement it,” Tedros said. “Tonight, we have taken a huge step toward mobilizing the resources we need to implement that plan.”

As the echoes of applause fade from the ballroom in Berlin, the work to raise the remaining $6.4bn the agency needs to operate through 2028 begins.

“Saving as many lives as possible is what the World Health Organization aspires to,” Scholz said. “One number reflects just how lofty this aspiration is: 40 million lives. That is how many lives the WHO will be able to save over the next four years.”

Major donors yet to commit

The “investment rounds” format aims to foster competition among nations, encouraging increased stakes in the agency’s operations. Several key European players, including Spain, the United Kingdom and France, have yet to make commitments, indicating they will announce their contributions later this year.

Further WHO funding appeals are planned in Asia, the Middle East and the Americas. Potential donors from Australia, Japan and South Korea to oil-rich Gulf states are expected to help the organization edge closer to its $7.4 billion goal.

Behind Monday’s success, concerns loom about the potential impact of the US elections on contributions from Washington, traditionally one of WHO’s largest donors. During his previous term, former President Donald Trump, once again a candidate in the November race, formally disavowed the WHO and moved to suspend US funding during his previous term. 

President Joe Biden reversed this decision upon taking office in January 2021, but the potential for another policy shift worries WHO officials.

“That’s a huge fear factor,” Catharina Boehme, who leads the WHO investment round. “We would go into a dramatically bad crisis” if U.S. support were withdrawn again in January, she told Health Policy Watch.

A step towards financial stability

Member states’ vote to reform WHO’s funding last year, championed by nations like Germany seeking more stable financing for the UN global health body, led to the current “investment round” approach.

In May, the 194 member states of the World Health Assembly agreed to incrementally increase their membership fees to fund up to 50% of WHO’s annual budget by the 2030-31 cycle, up from the current 30%. This commitment requires renewal in future WHA resolutions to take full effect.

“This strategy is designed to mobilize upfront the predictable and sustainable funding we need over the next four years,” Tedros said. “It’s also designed to put WHO on a more stable financial footing, so we are less reliant on a handful of large donors.”

In 2022-23, only 4.1% of voluntary donations, about $320 million, were fully flexible. Just 14 funders contributed flexible funding, with the UK being the largest contributor at $230,000.

Germany led Monday’s pledges with $360 million, followed by the European Union with $250 million, Norway with $100 million, and Ireland with $30 million. The combined unrestricted funds from Germany and Norway alone surpassed WHO’s entire 2022-2023 budget for self-directed initiatives addressing urgent global health priorities.

“This is an investment in the future of health and in the future generations to come,” said German Health Minister Karl Lauterbach. “In a time of wars, civil wars, epidemics, pandemics, climate change and catastrophes, it is important that WHO can rely on funding which is up to the ever-increasing tasks [asked] of the agency.”

Smaller nations step up

Smaller nations and emerging economies also joined the WHO’s funding drive. Montenegro made its first-ever donation to the agency, contributing $80,000.

“From a receiver, we are becoming a contributor,” Montenegro Prime Minister Milojko Spajic said. “It’s not always the population size or the GDP size that matters – it’s also a country’s actions that matter.”

WHO has found similar enthusiasm elsewhere. Seventeen African countries habr pledged a total of $47 million, with Niger committing $2 million despite significant economic challenges. Mauritania’s president announced new African Union funds from Berlin on Monday, adding more African countries are expected to follow.

“We know that we are making this ask at a time of competing priorities and limited resources,” Tedros said. “Every contribution counts.”

Philanthropies join the effort 

Philanthropies and foundations also contributed to the WHO’s fundraising drive, with Wellcome Trust and Sanofi Foundation each pledging $50 million.

“It is member states that have the core responsibility for ensuring sustainable financing for WHO. However, as a philanthropy, we also have a role to play,” said Jan Arne Rottingen, Executive Director of the Wellcome Trust. “Given the scale and the urgency of impacts on climate change on health, we urge other philanthropies and member states to invest in WHO’s critical work.”

Some donors designated funds for specific issues, including noncommunicable diseases, mental health, and substance abuse. These targeted contributions, while less flexible, aim to bolster WHO programs in traditionally underfunded areas.

“We maintain that one of the soundest investments in global health is in WHO,” Tedros and health ministers from across Europe said in an op-ed as the summit began. “Countries are doing so, already, through their regular contributions. But there is a clear understanding that in times of crisis, this is not sufficient.”

‘Budget of a mid-size hospital’ 

The World Health Organization flag above its headquarters in Geneva.

The investment round comes against a backdrop of long-standing financial constraints that have hindered WHO’s operations for years, despite its responsibility for advancing the health of 8 billion people worldwide.

In 2022-2023, WHO’s annual budget for its operations in over 150 countries was only $6.7 billion — a mere 33 cents per person globally. The Gates Foundation spent more than $15 billion during the same period.

“WHO has the annual budget of a mid-size hospital,” said Boehme, who is leading the WHO investment round. “Two and a half billion is not enough given our reach in basically all countries in the world.”

Even if funding goals are reached, the agency’s 2025-28 budget won’t be any larger. Yet it might be more predictable, flexible, and equitably distributed if member states cooperate.

In 2022-23, 88% of WHO’s funding came from voluntary contributions, with 60% of the agency’s budget controlled by just nine donors.

WHO’s expanding role

Despite its limited budget, WHO’s roles and responsibilities have expanded over the decades. It operates as a de facto second health ministry in many impoverished regions, financing primary-care clinics, managing vaccine programs, and providing training to local health authorities.

Conflict and climate change-driven natural disasters have forced WHO to take on larger emergency response roles in more affected countries – from Ukraine to Gaza, Sudan and the Democratic Republic of Congo.

As WHO continues its fundraising efforts, the challenge remains to secure not just more funding, but more flexible funding that allows the agency to independently address global health priorities.

“The COVID-19 pandemic demonstrated that when health is at risk, everything is at risk,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus at the close of the pledge announcements. “Investments in WHO are therefore investments not only in protecting and promoting health, but also in more equitable, more stable and more secure societies and economies.”

Tedros has personally campaigned for more reliable, long-term and flexible funding since taking over the helm of the organization in 2017. Even so, he seemed satisfied with the outcomes of the first salvo of the new funding drive.

“The COVID-19 pandemic made it definitely clear that an outbreak of infectious disease anywhere in the world affects us all,” Scholz said. “Pandemics do not stop for borders. This represents a global challenge that we can only properly tackle together.”

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

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