Uneasy Peace: Countries Tussle & Agree Over Way Forward on WHO’s Priorities Constrained By Tightening Purse Strings [#EB156]

Newsletter Edition #253 [The Files In-Depth]

Hi,

Public sector finances draw unforgivable scrutiny especially at the multilateral level, and rightly so.

Following the mini-cataclysm in its finances after the Trumpian withdrawal from WHO, countries are taking a hard look at improving efficiencies and cutting costs at the organization.

But instead of throwing the baby with the bath water, WHO member states will go through a long, much-needed, politically contested process of prioritisation. At stake is policy and practice of the institution with implications for global public health, despite grave financial uncertainties.

We will continue to report on how foreign policy reframes global health, and what this forced transition at WHO means for people globally.

Thank you for reading.

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Priti

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Illustration Credit: Amy Clarke, Chembe Collaborative

I. UPDATE EB156

Uneasy Peace: Countries Tussle & Agree Over Way Forward on WHO’s Priorities Constrained By Tightening Purse Strings

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As the WHO’s 156^th Executive Board meeting draws to a close in rainy Geneva, it marks the end of one of the most unusual set of deliberations in a highly uncertain period for the organization with underlying power plays spurred by a rupturing financial crisis.

The meeting was characterised by continuous disagreement between countries, first on the size of the budget for the next cycle 2026-2027; on agreeing to increase membership fees to the institution; and finally on the decision to proceed with proposed resolutions from member states.

Some of these matters have not been fully resolved at the time of the conclusion of the EB, and will continue to be discussed over the next few weeks. The countries will subsequently adopt related decisions at the World Health Assembly in May 2025.

“We this as a game being played by the big powers. And it is unfolding in global health,” a diplomat from an African country told us last week. This is about leverage and political calculations on influence,” the diplomat added.

This is a much-divided institution, wounding at unfolding geopolitics. The current board meeting witnessed three votes on Palestine, even as member states wrestled over budgetary discussions.

We broke the story last week, that some countries pushed a proposal to slash the upcoming budget for 2026-2027 by US$ 400 million to US$ 4.9 billion. To put the budget into perspective, diplomats said that WHO implements programmes of nearly US$ 50 billion globally. Developing countries have been of the view that the reduction in budget does not make sense, and that the financing gap can be addressed in due course ahead of the Assembly when it will be adopted.

In this story, we examine not only what countries said, but also what these discussions indicate about the shifting power dynamics within the institution, and indeed global health.

We also discuss below the status on China’s decision on agreeing for an increase assessed contributions, an issue that has not yet been resolved. Latest WHO projections show that membership fees due to China factoring in a 20% increase will stand at US $137 million a year in 2026.

Image Credit: Photo by Nick Collins, Pexels