The global coronavirus pandemic shines a spotlight on the World Health Organization (WHO). This pivotal organisation with a broad mandate, public health, is under increasing financial pressure and responsibility – highlighted and deepened by the COVID-19 pandemic.
The WHO has an impressive record, in the elimination of smallpox, the near-eradication of polio, and the fight against diseases like HIV, malaria, and tuberculosis. It has long warned of potential disease outbreaks and pandemics that may threaten public health globally, and COVID-19 is proving to be its greatest challenge so far.
This specialized health agency of the United Nations founded in 1948, is currently made of 194 member states, relies on contributions from these member states and private organizations for funding and runs on a two-year budget cycle. The organization’s programme budget 2020–2021, which sets out the financial resource levels required to deliver the organisation’s work over this period, is US $4.84 billion, US $2.42 billion per year. The WHO’s total budget for 2018-2019 was US $4.4 billion (WHO, 2020a).
Its budget relies on its two primary sources of revenue, a funding model shared with other UN agencies. The first is assessed contributions, which are set amounts paid by member governments, depending on a country’s population and wealth. The second is voluntary contributions, which are additional funds provided by member states plus contributions from private organizations and individuals. The organization’s top 20 contributors, whose contributions account for 79% of total revenue, during the 2018 fiscal year, can be seen in the graph, according to a report on its 2018-2019 budget cycle. Member States continue to be the largest source of voluntary contributions, contributing 51% of total voluntary contributions in 2018 (WHO, 2020b).
“The WHO has a budget around the size of a large U.S. hospital. It’s about one quarter of the budget of the U.S. Centers for Disease Control and Prevention (the health protection agency in the United States)”, says Lawrence Gostin, a law professor at Georgetown University and director of the World Health Organization Collaborating Center on National and Global Health Law (2020). However, the additional expenditures incurred during the COVID-19 health emergency means its actual revenue and expenditures over the biennial period will deviate from the budgeted amount. Furthermore, the US, the biggest single donor to the WHO, halted funding since mid-April. How this is being executed has still to be clarified.
“The WHO has a budget around that of a large hospital in the United States or the United Kingdom.”
The WHO has received criticism from some parties due to its bureaucratic governance structure. In addition, its position as a technical agency with health expertise as well a political body has attracted disapproval where divisive health issues, and even political, are concerned.
Nonetheless it is unclear how the WHO, as the essential coordinating body in this pandemic, will abide by its mission as its budget becomes more reliant on voluntary contributions, often earmarked for specific activities.
How it will remain operative and financially viable as its scope of responsibility grows, but its finances do not in the current crisis and as public health gains importance in budgets around the world, has still to be resolved.
A contributor and member of the Cov360 team
25 May 2020