WHO Investigation: Who Funds the World Health Organization?

The World Health Organization’s leitmotif is to "promote and safeguard public health worldwide" by setting health standards. Created in 1948, the Geneva-based institution is now present in more than 196 countries. In the midst of the Covid-19 health crisis, the agency is at the heart of the storm and is being singled out, in particular by the United States, which blames it for its lack of responsiveness and for colluding with Beijing.

During his speech on April 15th, in another spectacular, move Donald Trump decided to turn off the tap by announcing the temporary suspension of America’s contribution to the WHO. And more recently, US Secretary of State Mike Pompeo said during a radio interview that the United States may never reverse its decision to cut off funding to the organization. Going even further, he claims that the US is considering setting up an alternative to the WHO.

It is a decision that is not without consequences which puts the organization on the backfoot. However, regardless of Washington’s announcement, the question of how the WHO should be financed and the composition and breakdown of its budget remains.

Breakdown of the 2020/2021 budget

The WHO’s 72nd World Health Assembly approved the 2020/2021 budget in May 2019. $5.84 billion was allocated to cover all health programmes. According to Anne Sénéquier, co-director of the Global Health Think Tank at IRIS (the French Institute for International and Strategic Affairs), this budget would appear to be derisory, reminding us that the WHO’s purse is far from sufficient to battle a pandemic.

The minutes of the assembly outlined the organization's main priorities. The first item of expenditure is associated with the Universal Health Coverage programme, amounting to $1.35 billion. This is followed by the programme entitled "A more effective and efficient WHO providing better support to countries." This programme was allocated the significant sum of $1.09 billion. Elsewhere, $888.8 million was allocated to responding to health emergencies. Well-being and the preservation of health are also in the spotlight, with the organization devoting $431.1 million to this area. In the other sectors mentioned, the WHO is still very committed to eradicating polio, with a budget of $863 million. It is also devoting $208.7 million to fund its special programmes. Finally, the organization allocates $1 billion for "emergency operations and appeals," which in the words of the allocation decision, "can be increased, if necessary".

Still under its health crises support strategy, on April 3rd, 2020 the WHO, together with Unicef, announced a new programme called the "Covid-19 Solidarity Fund", created with the joint participation of the United Nations Foundation and the Swiss Philanthropy Foundation. In just three weeks, the scheme raised more than $127 million. According to the press release published on the Unicef website, the funding came from 219,000 private contributors and 90 global companies and organizations.

20% fixed contributions, 80% voluntary

An amount that could well change in line with the various health emergencies around the world, as was the case with the fight against the Ebola virus. But in concrete terms how is the funding of this budget distributed? There are two main sources of funding to be considered. The Organization's website reveals that it is made up of contributions described as "fixed" and assessed "according to the wealth and population of the country." The 194 member countries are liable for this payment as of January 1 of the current year. These amounts represent just under 20% of the WHO's overall budget, or $956.9 million. The remainder, 80% of the budget, is made up of so-called "voluntary" contributions. That is to say, all the sums paid voluntarily by a number of entities such as member states, public and private organizations. In recent years, the organization has seen an explosion in the number of contributions from these private stakeholders. A development that should be encouraged, according to Anne Sénéquier, who recalls the urgent "need for more diversified and less targeted funding for greater budgetary flexibility."

The list of the UN-dependent organization’s benefactors in 2018 is a long one. And to name but a few, it included the Bill & Melinda Gates Foundation, the Gavi Alliance, Baxter International Inc. the European Commission, Rotary International and Unicef.

The United States, the largest contributor

It would be an understatement to say that the United States' reconsideration of its participation in funding the WHO has created controversy among all global players in the midst of a global health crisis. Its director-general, Tedros Adhanom Ghebreyesus, said he "regrets" this decision, and is studying the possible impacts while seeking alternative solutions to offset this temporary loss. The United States, it should be remembered, has contributed more than $400 million over the past number of years. This makes it the largest voluntary contributor, according to the latest available figures for 2018, with a donation of more than $281 million. A sum to be contrasted with the second largest private voluntary contribution, that of the Bill & Melinda Gates Foundation, of €229 million, although less generous that year, since in 2017 it contributed $324 million. The United Kingdom rounds out this top trio with funding of around $205 million.

The United States is not to be outdone, however, as it also has the highest fixed contribution, based on population and GDP, with according to the IMF in 2019, a contribution of $14.2 billion. So the American giant has to pay more than $115.8 million a year for its "membership" of the WHO. China, which the US condemns for its actions during the pandemic, comes in second place, far behind, with a fixed contribution of $57.4 million for the year 2020. France, for its part, ranks sixth with $21.2 million in contributions for the current year.

Although for the time being, the announcement of the suspension, even temporarily, of the American contribution makes the WHO legitimately anxious, this conflict underlines the need for the WHO to source a greater part of its funding from private benefactors and thus secure its independence from member states, which is now more than ever necessary in managing the major health challenges facing humanity.