The US-based Boston Consulting Group has been working with WHO’s senior leadership, under contract, to develop the major reorganization and cost-saving plan, now pending final presentation to staff and member states next week, Health Policy Watch has learned. 

Members  of the Staff Association Committee confirmed to WHO staff members on Thursday, that BCG has been involved in the strategic planning for dramatic cutbacks in the agency’s workforce. The cutbacks come on the heels of recent revelations of a $2.5 billion WHO budget gap between 2025-2027, including a $600 million shortfall in 2025, following the announced withdrawal of WHO’s largest donor, the United States, in January.     

The Staff Committee members were speaking at a Staff Association Open House, excerpts of which Health Policy Watch later heard.  

The Staff Association representatives did not confirm the amount of the BCG contract – although other informed sources suggested it was several million dollars, or more.  Asked to comment, a WHO spokesperson said, “What Staff Association President Corsini said is correct regarding earmarked funds for support to the restructuring.” 

Monies for private consultancy were earmarked 

The consultancy’s costs are being covered by a dedicated grant from the Bill and Melinda Gates Foundation, Staff Association leaders said, quoting WHO Human Resources officials, at the Open House.  

“These are voluntary and earmarked funding from Bill and Melinda Gates to HRT [WHO Human Resources and Talent Management] for restructuring,” asserted WHO Staff Association President Catherine Kirorei Corsini. 

“And this because it’s voluntary and earmarked, it cannot be used for anything else. And what they are doing now is a request of member states.  

She said WHO HR officials also assured the Staff Association “that a due process was followed. There was bidding…. There was a committee that sat down to review, because they were also questions of, how was this done? So they assured us that the usual detailed process of hiring someone on an LTA [long term consultancy agreement] was followed.”

Even so, some WHO staff have expressed dismay with the fact that large consultancy grants are being awarded to expensive private firms at a time of budget crisis. It was the expansive plans laid by outside consultancy firms during WHO’s 2019 “Transformation” that set the stage for the present crisis, noted one staff member, in a comment at the Open House.

“Why?… I do not have an answer, but the thing that we can say is that, again, this is not going to be a matter of core funds of WHO that could be used for staff being sent elsewhere,” Corsini answered.

Other staff were not so sure. 

“Why do we need a consulting firm?” one staff member asked, speaking anonymously to Health Policy Watch, noting that within the WHO’s 9473-strong global staff, including nearly 4000 professionals, there should be sufficient expertise to carry forward a reorganization plan.

“If you spend $6 million on a big consulting firm, then you have to let 20 people or more go. The money is spent in a matter of weeks, not in a whole year,” the staff member pointed out. 

Final version of proposal for top-level reorganization due to be presented next week 

A final draft of the top-level reorganization is due to be presented by WHO’s Senior Leadership to Staff in a Town Hall on Tuesday. Presentation of the proposed draft to member states was also reportedly delayed until next week, due to the long Easter weekend that begins Friday in Geneva, sources told Health Policy Watch.  

According to the two options on the table last week, the number of departments at Headquarters would be reduced by nearly half, from nearly 60 as of January to about 32. That would presumably also reduce the number of high-cost directors, who numbered nearly 80 at headquarters as of July 2024 – more than the departments they are supposed to lead.  Some headquarter functions would also be moved to lower-cost regional offices or other European cities where WHO also has a presence.  See related Health Policy Watch Story here:

EXCLUSIVE: WHO Poised to Halve Divisions and Directors at Geneva Headquarters in Response to Budget Emergency 

There were, however, reports that WHO Director General Dr Tedros Adhanom Ghebreyesus had this week presented his own plan to senior management – with significant variations in the existing drafts now circulating.

The final result, therefore, risks boosting the number of departments and directors upwards again – due to intense pressures from senior managers, some sources feared.   

The explosion in directors’ positions was the focus of a 10 March Health Policy Watch investigation – which found that the number of directors, in the most senior, D2 grade, had nearly doubled since 2017.  

Taken together, the cost of D1 and D2 directors, along with five regional directors and a 12-member “senior leadership team” at WHO’s Headquarters cost the organization about $92 million annually, the Health Policy Watch analysis found, basing its estimates on published WHO salary and salary-to-total cost scales. 

Already senior leadership is offering some of the directors facing cuts a relatively high-paying parachute – jobs as the WHO reprsentative in a country office.  An email sent by HRT to senior management this week sought to “draw attention to the career opportunities available at the country level, specifically for WHO Representative (WR) positions.”

The message cited opportunities in over two dozen WHO offices in Africa, the Middle East, Europe, Asia and the Caribbean – including Senegal and Nigeria; Bulgaria and Slovenia; Egypt and Palestine.  Although some of the posts on offer, such as in the violence-wracked Democratic Republic of Congo and the Demoratic People’s Republic of Korea (North Korea), could hardly be said to be plum positions.

Transparency, management structures, prioritizing internal staff talent 

Speaking at the Staff Association Town Hall, SA leadership sought to reassure staff that Association representatives were now  being engaged in some aspects of the Administration’s restructure planning – after initially being left largely in the dark. 

“Feedback has come through loud and clear from staff,” said Jerome Zanga Foe, a Staff Association vice president, who called for “involvement for the Staff Association and staff at the division and at the department level and at also the highest level in the organization –  not just updates after decisions are being made.

“The Staff Association was not brought into the initial prioritization meetings,” he acknowledged. “But at the same time, we have now been included in several key committees, and the DG has committed to another town hall, which we’re going to be having next week. We hope engagement will be more of a two-way engagement… early and transparent and structural.”

Cautious optimism on a slimmer management structure  

Foe also expressed cautious optimism over the slimmed-down management structure reflected in the draft organigrams circulating over the past two weeks, saying: 

“The message was clear that any credible…effort needs to look at leadership structures too, and we have seen some movement there. The updated organigrams show a smaller senior structure, and the management confirmed that post abolition and reassignment rules apply equally to ADGs and directors. It’s a positive step.” 

Finally, he said that the Staff Association would press the WHO administration to “prioritize internal talent” in the process of cutbacks and reorganization – before turning to external hires or consultants.

“Management is developing a talent pool to help match affected staff with future roles,” he said. “We see that as an encouraging step, but how this works in practice is what will really matter, and we promise to follow up on that. We are continuing to advocate that wherever possible, roles currently held by consultants or left vacant should be made available to staff at risk.”

Consultants’ shouldn’t replace staff who are cut 

At the same time, other Staff Association leaders stressed that consultants also play a legitimate role in the organization: 

“There’s been a degree of consultant bashing, but consultants do have a proper role in the organization, and if anything, we would like to see some of these consultants be moving to staff positions,” said Anthony Fake, another Staff Association vice president. 

Holding any kind of staff post, per se, should not, de facto, guarantee first priority for a future job selection, said VP Lianne Gonsalves. 

“We want to see function and ideally performance factored in. … For this committee of staff members, current contract type, whether they be continuing fixed or temporary, is not a proxy for their respective performance in, or commitment to, this organization. 

At the same time, she reaffirmed that long-serving WHO staff should have first priority in global re-assignments, if their current functions are terminated. 

“What we will be doing is making sure that for continuing appointments and fixed term appointments [of 1-2 years] who have more than 10 years of continuous service with the organization, those folks are going to be entitled to global reassignment, and we will be part of that, making sure that those staff are looked over, looked after in that process.” 

Gonsalves added:   “I can assure you that we will be keeping a very close eye …that what we don’t see is a reduction in workforce, followed by an immediate outsourcing to have that same work completed by consultants.”

Since 2017 the number of WHO consultants has exploded, from an estimated 3200 full-time equivalent positions to approximately 7600 in July 2024 – approaching the number of regular WHO staff. 

At the Open House, Staff Association leaders also denied reports that they were considering a preemptive legal action against WHO to contest any potential violation of staff contract terms in advance – describing it as not feasible. 

“I don’t think you can file preemptive lawsuits,”  Gonsalves said. “So that’s not something that we are doing.”

Image Credits: WHO / Yoshi Shimizu, WHO, 2025, WHO .