BERLIN — The World Health Organization is kicking off its first European “investment round” Monday at the World Health Summit, seeking to secure backing for its $11.1 billion four-year strategic plan.

The Berlin summit, a marquee event on the global health calendar, draws thousands of health leaders, researchers, and advocacy groups. On the agenda: pandemic preparedness, artificial intelligence in healthcare, climate change’s health impacts and pharmaceutical intellectual property rights.

The fundraising push is the centrepiece of the WHO-led summit. The plan? Putting the world’s leading health agency on a firmer financial footing with long-term, secure, flexible funding commitments from European nations, philanthropies and foundations.

“COVID was really the trigger for this journey towards sustainable financing,” WHO Assistant Director-General Catarina Boehme told Health Policy Watch in an interview Sunday evening. “Member states realised what’s wrong with WHO’s funding – it’s about the resilience of funding, the lack of diversification and the lack of flexibility.”

The publicly broadcast event will feature prominent speakers including German Chancellor Olaf Scholz, philanthropist Bill Gates and Wellcome Trust CEO John-Arne Rottingen, alongside health ministers from France, Germany, Greece, Norway and Switzerland.

Boehme, a German national and former chief of staff to WHO Director-General Tedros Adhanom Ghebreyesus, is spearheading the new funding initiative. The effort aims to find new formulas for voluntary funding critical to filling chronic budget shortfalls left by member states’ regularly assessed contributions.

For decades, member fees have covered only 20%-30% of WHO’s regular budget. A 2022 decision aims to increase that to 50% by 2030, but significant funding gaps remain.

WHO funding drive hits Europe

Europe is neither the first nor the last stop for WHO’s pledging drive. On Oct. 7, South East Asian countries pledged $345 million in voluntary donations to the global health agency’s operations during a closed-door event coinciding with WHO’s South East Asia Regional Committee meeting.

Following the Berlin event, investment rounds are planned in WHO’s remaining four regions: the Americas, Eastern Mediterranean, Africa and Western Pacific.

Loosely inspired by successful fundraising drives of multilateral health organizations like The Global Fund and Gavi, the Vaccine Alliance, WHO’s approach, approved by member states in May, appears more restrained.

While The Global Fund’s “replenishment drives” have featured heads of state sharing stages with rock stars to boost visibility, WHO is working through potential donors region by region.

The focus is on broadening the base of member states who supplement their “assessed” contributions and changing the culture of giving to foster long-term funding commitments with fewer restrictions.

‘COVID was the trigger’

“COVID was really the trigger for this journey towards sustainable financing,” Boehme said. “It was through the pandemic that member states realized what’s wrong with WHO’s funding.”

“It’s about the resilience of funding. It’s about the lack of diversification. It’s about the lack of flexibility,” Boehme said, noting that more than 70% of WHO’s funding comes from just 10 donors.

Boehme hopes that pledges obtained at the event and in its aftermath will include fewer “earmarked” donations, which tie funds to specific programs or projects — a common feature of voluntary contributions to the UN health body to date.

“We are super ineffective because 80% of our funding is earmarked,” Boehme said. “It’s really narrowly defined what we can spend it on, which is terrible, for example, for health emergencies. We basically cannot direct our funding where we need it.”

She added that predictability is also a major issue, with 50% of WHO’s voluntary donations made as one-year grants. This leaves the organization heavily reliant on short-term staff “with no job security.”

“It’s not even about elevating the baseline. It’s actually more about making funding more predictable, more flexible,” Boehme said. “Then we can use the baseline to pay for the core stuff we need to then be able to react to emergencies.”

Trust and health

In his opening remarks Sunday evening, WHO Director-General Dr Tedros Adhanom Ghebreyesus, linked the fund-raising drive to the conference theme of “trust”, saying that building trust between WHO and its member state partners is critical to improving the organization’s credible response to fast-evolving disease outbreaks and conflict-driven emergencies.

“Trust itself does not make people healthy, but no one can be healthy without trust,” said Tedros, pointing to examples of outbreaks, from Ebola to the COVID-19 pandemic, where public confidence in advice on issues ranging from safe burial to vaccination was critical to getting diseases under control.

“Strong partnerships – like strong relationships – are built on trust,” he added, saying “Everything we do depends on the trust of the communities we serve, the partners with whom we work, and the Member States who set the global health agenda, and entrust us with the resources to deliver it.”

“At this year’s World Health Assembly, Member States adopted a new and ambitious strategy to save 40 million lives over the next four years: the 14^th General Programme of Work,” he added, referring to the objectives of the 2024-2028 budget plan.

“Delivering that strategy requires a strong and sustainably financed WHO, which is why we have launched the first WHO Investment Round, to mobilize upfront the predictable funding we need to do our work over the next four years.

“We know that we are making this ask at a time of competing priorities and limited resources. But as the COVID-19 pandemic demonstrated, when health is at risk, everything is at risk.  Investments in WHO are therefore investments not only in healthier populations, but also in more equitable, more stable and more secure societies and economies.

“They’re investments in the vision countries had when they established WHO in 1948: the highest attainable standard of health for all people, as a fundamental right.”

Image Credits: Stefan Anderson/HPW, LinkedIn.