The World Health Organization has reduced its global headcount by about 221 people since January, down to 9,231 as compared to 9452 at the start of January – largely through a termination of temporary contracts and a freeze in renewals. 

Most of the cutbacks have been at the Geneva Headquarters, WHO’s largest office, where 2,938 positions in January 2025, shrunk to about 2,782 as of July.

Another 194 staff worldwide are expected to leave in coming weeks, due to voluntary retirement and initial separations, according to a presentation made by senior WHO officials to staff at a global “Town Hall” on Thursday. 

But this remains a drop in the bucket of what is likely to come next – with potential retrenchment of some 20% of staff globally, and even more at headquarters, according to previous WHO modeling estimates.

Even after the initial $150-165 million in payroll savings as well as another $140-260 million in travel and procurement cuts this year – the Organization still needs to reduce spending by another $390-490 million by year’s end in order to meet a $4.2 billion budget target for the 2026-2027 biennium. 

And that $4.2 billion two-year budget also remains underfunded – with an estimated $1.7 billion revenue gap as of May. 

After Headquarters, WHO’s African Region has the largest number of staff positions – and also faces the largest salary gap for 2025, according to other previously published data.  But it, along with several other WHO regions, has hardly begun the retrenchment process, to date – even though new organizational plans have by now been designed. The AFRO headcount has declined by a mere 47 people – from 2,561 in January to 2,514 as of July, data shared at the meeting Thursday indicated. 

In the case of the WHO Regional Office of the Americas/Pan American Health Organization (PAHO), decisions on staff cuts remain formally suspended until September – by which time the Trump administration is expected to make a final decision on whether it will continue to fund PAHO, which it co-founded over a century ago. PAHO  operates as a semi-autonomous entity from WHO -with a separate governing body and a budget 70% funded by member states in the Americas region.

The decision of the United States, WHO’s largest donor, to withdraw from the WHO global entity in January, didn’t technically apply to PAHO, whose relationship with the US is being deliberated separately in Washington DC.  

Hard work begins – matching and mapping rank and file staff

On 1 July, WHO Director General Dr Tedros Adhanom Ghebreyesus announced the appointment of 36 directors at the Geneva Headquarters to oversee a consolidated set of programme departments – whose numbers have been slashed by nearly half.  See related story. 

EXCLUSIVE: WHO Chief Names New Team of Directors – Mostly Familiar Faces

At Thursday’s Town Hall, Tedros and senior management also unveiled the first concrete set of proposals to move some WHO/Geneva teams and departments to other, less expensive locations.

Those include the relocation of: some Health Emergencies functions to Dubai; laboratory surveillance to WHO pandemic surveillance hub in Berlin; and certain financial and Human Resources functions to Lyon, France, where WHO already has an office. A series of staff consultations will now take place on the plan, before a final decision is made, the WHO leadership said.

Following these moves, however, the really hard work is beginning to map positions at department level – and then “map” existing staff.

Against this massive challenge, many staff seem unclear about how strategically linked-up the new department organization is to WHO strategic priorities, to date. 

In WHO’s Geneva Headquarters, for instance, some staff expressed concerns that the traditional “vertical” infectious disease departments would still fare better than departments covering a wide range of less well-funded topics, such as noncommunicable diseases (NCDs)- which nonetheless represent the majority of the world’s disease burden today. 

“I’m worried that there won’t be a fresh look at priorities in line with the General Programme of Work,” one staff member observed, noting that the first two priorities of the GPW are 1) climate change response and 2) so-called environmental and lifestyle risks that are the “root causes” of ill health. 

At present, such priorities are not well reflected in current WHO staffing balances, another scientist observed:

“For instance, TB, alone, is a department of about 55 staff; HIV, Hepatitis and other Sexually Transmitted Infections also has roughly 55 staff and consultants – and at the same time, you have GAVI, UNAIDS and The Global Fund covering many of these same priorities.”  

“In the NCDs team, on the other hand, you have about 50 staff. But they deal with all of the major NCDs that represent 74% of the world’s disease burden, including  cardiovascular diseases, chronic respiratory diseases, cancers, oral and eye health, as well as disability and rehabilitation.”

In WHO’s European Region giving up on communicable diseases and cancer?  

Meanwhile, some staff in WHO’s European region voiced somewhat different concerns.  

In contrast to headquarters, where infectious and noncommunicable dieseases (NCDs) are now part of the same division, most of the EURO regions’s infectious disease teams, as well as AMR, have been dismantled and merged into the Region’s Health Security division – which traditionally focused on emergencies.

“The current proposed organigram eliminates dedicated, unique units, and teams in HIV, TB and viral hepatitis and anti-microbial resistance,” one EURO team member, who asked to remain anonymous, noted. 

“The fact that communicable diseases have been shrunk, this is a major strategic pitfall, and goes against the European Programme of Work,” the staff member added, noting the high rates of TB, HIV and hepatitis in the EURO Region’s eastern and central Asian member states. 

“It also eliminates teams in cancer, cardiovascular disease and metabolic diseases,” the team member noted. 

“I think the worrying, the worrying aspect is some of these are actually, if you take, for example, cardiovascular disease, cancer and AMR, these are diseases that kill the most based on the data we have. And they will become bigger and bigger health challenges. 

“So the organization is either completely dropping or downsizing the effort and investment on this, on these topics, while at the same time keeping a very big Emergencies Programme, which also seems to be the one that had the highest deficit.”  

BCG and the consultancy conundrum 

Along with staff cuts, senior WHO officials said that they are cutting back on contracts for consultants but without presenting any supporting data on that measurement. The number of consultants has swelled exponentially, pushing out regular staff positions in many case.  However, without further former disclosures, concrete data on actual consultancy numbers  is only likely to become available at the end December, when the bi-annual public HR database is updated. 

Meanwhile, WHO officials did not deny that a new $4.295 million contract with the Boston Consulting Group to support the next phases of the global reorganization, is pending in WHO’s global management system, as per an exclusive Health Policy Watch report, published Wednesday.   

WHO’s head of business operations, Raul Thomas, said that the Organization is re-evaluating the pending contract in light of recent news reports about the involvement of two former BCG staff with the highly controversial Gaza Humanitarian Foundation’s food distribution scheme as well as another Gaza population relocation plan. 

“Indeed, this has come to our attention, and we are having discussions with BCG. We are very alarmed at what we have read. They are having an external review,” Thomas said. “And between now, and I would say the end of next week, the organization will take a decision on whether or not we’ll proceed with engaging with BCG.

“But it is under careful consideration,” he said, adding that senior management were “alarmed” about the reports that appeared to be in “contravention of the values of the organization.” 

At the same time, other staff have said that regardless of reputational issues at stake, large and expensive consultancy contracts divert resources from the funding of staff positions – in a setting where every $1 million spent on external consultancies could fund 3-5 rank-and-file WHO staff for about a year.

See related story here:

https://healthpolicy-watch.news/exclusive-who-has-a-new-4-2-million-contract-pending-with-boston-consulting-group/

Image Credits: WHO Town Hall, 10 July , WHO , https://cdn.who.int/media/docs/default-source/documents/about-us/general-programme-of-work/who-strategy-2025-2028-at-a-glance.pdf?sfvrsn=de60054d_3, WHO, European Region .