What is the WHO Foundation, Member States ask?

Pressure is building: what was said behind closed doors about the WHO Foundation is now stated publicly. What is the WHO Foundation, Member States ask?

This is an onsite edited excerpt of the G|O Briefing newsletter

Today, we return to the question of the World Health Organization's financing. The pandemic is a massive stress test on the organization. WHO is faced with the daunting task of responding to the pandemic while simultaneously grappling with its long-delayed structural reforms. Tensions flared up again during the current session of its Executive Board Meeting. And the agency is now getting hit with criticism from countries questioning its transparency, its decision-making process, and how it came to launch an ambitious initiative through the WHO Foundation.

Pressure is building: what was said about the WHO Foundation behind closed doors is now publicly stated.

Criticism has mostly been expressed in a quiet diplomatic way: in closed-door meetings, WHO's directors have been put on notice that consultations about the Foundation's progress and actions are not being held in a satisfactory way. But some countries have decided to increase the pressure by going public, using the pulpit of the Executive Board meeting to put pressure on WHO. During last week's meeting, ambassadors from the UK, China, Spain, and others took the floor to request explanations and to express their concerns regarding the WHO Foundation.

The Foundation wants to support global public health needs by providing funds to WHO

Two years in the making, it was launched in May of last year to allow WHO to broaden its funding base, with the aim to raise $1 billion by 2023. But instead of tapping countries or organizations with Global Health as their primary mission, the WHO Foundation seeks funding from high-net-worth individuals and philanthropists, and private sector companies.

When announcing its launch, WHO chief Tedros Adhanom Ghebreyesus said “It is well documented that one of the greatest threats to WHO's success is the fact that less than 20% of our budget comes in the form of flexible assessed contributions from Member States, while more than 80%is voluntary contributions, from Member States and other donors, which are usually tightly earmarked for specific programmes. In effect, that means WHO has little discretion over the way it spends its funds, almost 80% of its funds.”

Headquartered in Geneva, the Foundation wants to support global public health needs by providing funds to WHO to deliver on the Organization's "triple billion" goals: protect 1 billion people from health emergencies; extend universal health coverage to 1 billion people, and insure healthy lives and wellbeing to 1 billion people by 2023.

The Foundation Board Chairman, former Swiss official Thomas Zeltner, is highly regarded in the health community. WHO's D-G closest advisor Professor Senait Fisseha also sits on the Foundation's Board. Anil Soni, a global health expert with a career in both the public and private sector, became CEO of the Foundation on January 1, 2021.

Will pharma be able to influence where the money will be spent?

But many questions remained unanswered. What will happen if pharmaceutical industries decide to contribute? Will they be able to also influence where the money will be spent? Will that buy them a place at the table? How will member states be able to control and decide on the fate of the resources?
One of the most vocal criticisms came from the United Kingdom.

A lack of vision

The government's representatives lamented the lack of a vision on how this initiative would fit in a more general plan for the WHO in the next years. “We would like to underline the need for transparency on all such new initiatives and their inclusion in a clear transformation strategy or plan to pre-empt such surprises in the future,” the British diplomat stated.

China expressed a concern echoed by others: how will the regular budget of the WHO be impacted or influenced by the disbursement of money by the Foundation. “Would the budget increase affect the overall level of assessed contributions? What is the relationship between the WHO Foundation and the regular budget?” Beijing asks.

While Spain applauded the establishment of a working group responsible for making specific proposals on the financial sustainability of the WHO, it argued that the group also be in charge of “defining the role that should be played by the WHO Foundation.” In other words: countries should be consulted on the new mechanism.

WHO insiders tell The G|O that the pressure on the Foundation is also meant to ensure better coordination between WHO and the member states around the initiatives pushed by Dr. Tedros. Last week, he addressed some of the critics by admitting a “communication gap.” “These initiatives were announced in 2018 and officially in 2019, March,” he said. “All regional directors were involved, and then we announced the WHO Foundation and the WHO Academy, among others,” Tedros defended himself.