WHO grapples with deepening funding shortfall

The World Health Organization is proposing to slash its budget ambitions for the next two years to $4.2 billion. However, it may need to ramp up its fundraising to fully finance its work. In a recent presentation to member states, a copy of which was seen by Devex, preliminary figures for WHO’s financial outlook for 2026-2027 show a funding shortfall of over $1.8 billion, or roughly 43% of its targeted budget. The presentation outlines secured and expected funding for the next two years. Secured funding includes over $1 billion in assessed contributions; $147 million in funding to be carried forward from 2025; and $233 million in signed agreements. Meanwhile, expected funding covers unsigned investment round pledges and projected funds, including those from global health partnerships. However, the assessed contribution figure hinges on an increase in membership dues that still needs to be approved at the 78th World Health Assembly in May. Additionally, the agency’s ability to carry forward funds remains uncertain due to significant funding shortfalls in 2025. Adding to the challenge are projected funds, from entities such as Gavi, the Vaccine Alliance and the Global Fund to Fight AIDS, Tuberculosis and Malaria, both of which are also facing a challenging replenishment period. The Trump administration also terminated support for Gavi, although, as of last week, Gavi CEO Dr. Sania Nishtar said the organization has not received a termination notice and that it is expecting $300 million approved by the U.S. Congress for the organization’s work this year. A WHO official, who spoke on condition of anonymity as they are not authorized to speak on the matter, told Devex it’s unrealistic to project contributions from the likes of Gavi and the Global Fund “when these institutions haven't even finished their own replenishment rounds [and have not] made any pledges for the future.” “To add it all up and say that this is how much we have, well, we don't have that,” the official said. WHO has suffered from perennial funding challenges. Over the years, more and more of its budget has been taken over by earmarked voluntary funding, which means it has become more reliant on unpredictable and unsustainable funding from a limited number of donors, the United States included, for much of its work. It has tried to change that in recent years, but its current financial situation shows those efforts have not been sufficient. Significant cuts across WHO Due to major U.S. funding cuts, WHO is reevaluating its priorities to manage its budget shortfall. The U.S. is WHO’s biggest donor, contributing over $1.2 billion in 2022-2023. But on the first day of his second term in office, U.S. President Donald Trump announced that he is withdrawing the country from the U.N. agency. The U.S. is supposed to pay WHO its full membership dues before exiting, as required by U.S. law. But it’s unclear whether that will happen. It still owes WHO membership dues for both 2024 and 2025, totaling $260 million. The cuts triggered a series of belt-tightening measures at the agency, including hiring freezes, reduced travel, and offers of early retirement to staff approaching 55 years old. But while these efforts have helped save the agency some dollars, it’s not enough to fill the gaping hole in its budget, which amounts to $600 million for 2025 alone, according to an email sent to staff by WHO Director-General Tedros Adhanom Ghebreyesus last Friday. He also noted that “the prevailing economic and geopolitical conditions have made resource mobilization particularly difficult.” In the same email, Tedros announced further reductions in WHO’s planned budget for 2026-2027 — a 21% decrease from the original $5.3 billion to $4.2 billion. This is lower than the $4.9 billion WHO member states discussed at the executive board meeting early this year. The budget still needs to be approved by the World Health Assembly in May. Regarding the prioritization exercise, he said: “Everything is on the table, including merging divisions, departments and units, and relocating functions.” He also confirmed there will be job cuts. “Despite our best efforts, we are now at the point where we have no choice but to reduce the scale of our work and workforce. This reduction will begin at headquarters, starting with senior leadership, but will affect all levels and regions,” Tedros said in the email. The prioritization work is being led by a select group of WHO officials at its headquarters in Geneva and regional and country offices. At headquarters, multiple WHO sources told Devex that each division has been asked to identify its priorities — from essential activities to maintain to those that can be deferred or scaled back and those that can be phased out. They’ve also been asked to list staff members for potential layoffs, as well as potential mergers and relocation options. All levels of the organization are expected to be impacted, although some expect headquarters to bear the brunt of the cuts. But it needs to be fair, they said. “We're being told HQ will take the brunt of the cuts, which is fine, but which parts of WHO? Those who've been bleeding over the past five years or so? Or those who've been ballooning?” the WHO official who spoke on condition of anonymity said. Some teams, which traditionally receive limited funding and operate with fewer staff, could suffer disproportionately if cuts are applied uniformly. There is growing uncertainty and concern among WHO staff. One staff member said initially, some believed that only those on temporary contracts would be affected, but now staff members of all contract types are worried. Employees expect announcements on the cuts this month. “There's huge uncertainty, [and] there's a sense of desperation,” the official said. Some staff feel misled, having been reassured in earlier meetings that the situation was under control. During a town hall in December, a source said there didn’t seem to be an acknowledgment of the grim reality ahead. “This is a crisis, but I don't think the crisis is suddenly going to end.” --— Jeremy Farrar, chief scientist, WHO At headquarters, those eligible for early retirement are also panicking. Some don’t want to take the offer, but fear if they don’t take it now, they may not be given a choice the next time around. “We've been really flabbergasted by the lack of leadership and direction,” another staffer said. A long-term crisis WHO expects to complete the prioritization exercise this month, giving it limited time to execute changes. Jeremy Farrar, WHO’s chief scientist and part of the team leading the prioritization exercise, told Devex they’re using the limited time they have to think strategically on what WHO needs to focus on, and what kind of structures will be needed for WHO to help deliver on those priorities now and in the future. “I would not be in favor — and the WHO is not going to take this approach — of just saying this is a percentage cut across everything … because I think that doesn't make sense,” he said. Prioritization is very much needed to sustain the organization, not just in the next few months but in the coming years. “This is a crisis, but I don't think the crisis is suddenly going to end. We're going to be in a new sort of global context for some time. And therefore what we're also trying to do is lay a foundation for the organization to be sustained, resilient financially and scientifically, expertise wise,” he said. Some staff are anticipating a 21% workforce reduction across WHO. However, Farrar said, “there's nobody who could give you a number at the moment of what that's going to be.” However, he emphasized the importance of early communication. “We mustn't hide away from anybody the fact that with such a dramatic reduction in budget, there will need to be a reduction in the number of staff in WHO. There's no point pretending that's not true. The most important thing is to communicate that honestly and transparently because people have to plan their own lives. And it’s crucial people know that as early as possible,” he said.