WHO’s Fairy Dust Financing

With the world now facing epidemics of yellow fever and Zika virus, both of this week’s high-powered gatherings of the G-7 leaders in Ise-Shima, Japan, and the annual World Health Assembly in Geneva had outbreak control placed high on their agendas. But it will take a lot more than minor reorganization and promises of cash to bring the World Health Organization (WHO) and its 194 member nations up to readiness status for these and future epidemics. That kind of preparedness begins with leadership and mutual trust between the institutions of public health, political leaders, and the populations they are supposed to serve. This is a feat that WHO has not, by any measure, accomplished.

WHO is governed by its World Health Assembly, which convenes at this time every year in Geneva to debate a laundry list of resolutions aimed at improving the survival and health of billions of people. One key resolution the assembly has refused, for nearly four decades, to bring to the floor for debate or vote is money — how much individual nations must pay in annual assessment to support WHO. The assessments, which are based on national GDP and population, fairly place the greatest burden on the wealthiest countries, with the United States paying the most. But because the assembly has declined to even entertain an increase in annual assessment rates for nearly four decades, when adjusted for inflation, the WHO core budget has steadily declined.