Germany sick of 'déjà vu' in WHO financing battle

BRUSSELS/MANILA — Germany is hoping to draw on momentum around the global COVID-19 response in order to address the World Health Organization’s long standing funding woes, and is pushing for an agenda on sustainable financing at the WHO executive board’s meeting in 2021.

Speaking Monday at the resumed 73rd World Health Assembly on behalf of the European Union, German health minister Jens Spahn said the COVID-19 pandemic had highlighted “a gap between WHO‘s 194 member states’ expectations and requests vis-à-vis the organization and its de facto capacities to fulfill them.”

Around the time Spahn was speaking, a German official was hitting similar notes in a committee discussion on the U.N. health agency’s 2020-2021 program budget.

“Each year, again and again … with a déjà vu we see pockets of poverty — so specific programs that have not received adequate funding,” the official said of the assembly. “Within the last 10 years, many options have been explored in order to change the situation but the financing challenge has not been properly addressed.”

The 2020 WHA has been largely virtual, and split in two due to the COVID-19 pandemic. The first edition was in May, which is when it is ordinarily held, but was followed by further talks this week.

Amid the pandemic, the official said “we all have to explain to our constituencies that we have explored all options to make the world safer. And for Germany, addressing WHO’s financing challenge is part of this.”

Financial challenges have long plagued WHO. It not only has a small budget, but a large proportion of its funding is earmarked for specific programs. That leaves the organization little flexibility in terms of allocating resources where it deems necessary, including for health emergencies.

Much of the organization’s funding also comes from a few donors, leaving it vulnerable to shocks should a donor withdraw funding. In July, the Trump administration notified the United Nations of its intent to withdraw from WHO, which would have gone into effect one year later. There is hope now that decision will be reversed with a Joe Biden presidency. In the last funding cycle, the U.S. provided $893 million — 20% of the agency’s budget.

WHO Director-General Tedros Adhanom Ghebreyesus had thought out the risks of its funding scheme early on in his tenure. Broadening the WHO donor base was on his priority list upon taking the helm of the organization. In 2019, during the 72nd World Health Assembly, Tedros also announced the creation of a WHO Foundation.

More details about the foundation — an independent grant-making organization meant to help increase WHO’s funding base through nontraditional sources, including the general public, individual major donors, and the private sector — came to light last May 2020. Early in the COVID-19 pandemic, WHO also partnered with the U.N. Foundation and the Swiss Philanthropy Foundation to launch the COVID-19 Solidarity Response Fund to facilitate donations and aid in the organization’s COVID-19 response.

But the German official who spoke at the committee discussion said WHO members’ debate on sustainable financing is “often not adequately grounded on a thorough analysis. We are discussing earmarked versus flexible, predictable versus non-predictable funding. But we never discuss what the consequences and implications are for WHO to perform.”

To remedy this, Germany wants an item on sustainable financing on the agenda of the 148th meeting of the WHO board, scheduled for January 2021. Berlin called on WHO to use that occasion to report on its current financing efforts; the connection between support from members and its capacity to do its work; which options have been explored in the past 15 years and whether these were successful; as well as potential future options for sustainable financing.

“Currently, there is a major discrepancy in between how we all praise the importance of a well-functioning and effective WHO, and our common will to finance WHO through our membership fee,” Spahn said on behalf of Germany. “Let us open our eyes: Are $490 million in membership fees per year [by WHO member states] adequate to fulfil WHO’s mandated role? Hardly!”

The minister concluded by saying that Germany, which holds the rotating presidency of the Council of the EU for the rest of the year, is “ready to explore all possible options to make WHO stronger. But in the end, this will only be possible, if the 194 members of this organization take on more financial responsibility.”