The disconcerting shock of the Covid-19 pandemic has undoubtedly refined WHO Member States’ awareness of the value of health and the need for investment in it. While the phrase “No one is safe until everyone is safe” has become a motto for global health institutions such as WHO, calls have been growing for a funding formula that will sustain the health agency’s capacities to fight this pandemic and future health disasters.
According to the health agency’s website, “WHO gets its funding from two main sources: Member States paying their assessed contributions (countries’ membership dues), and voluntary contributions from Member States and other partners. Assessed contributions (AC) are a percentage of a country’s Gross Domestic Product (the percentage is agreed by the United Nations General Assembly). Member States approve them every two years at the World Health Assembly. They cover less than 20% of the total budget. The remainder of WHO’s financing is in the form of voluntary contributions (VC), largely from Member States as well as from other United Nations organizations, intergovernmental organizations, philanthropic foundations, the private sector, and other sources.”
Since the start of the pandemic in December 2019, over fifty non-governmental organisations (NGOs) wrote letters to the WHO executive board stating that international evaluation panels that appraised Covid-19 found out that WHO has inadequate and irregular financing which is in need of modification.
One of the letters submitted to the board notes that frequent forewarnings to reinforce barricades against pandemics had been disregarded, “leaving the world dreadfully ill-prepared almost two years ago for the tsunami of suffering to come……The funding problems of the WHO are not new, but rather have been playing out over decades. They are symptomatic of an overall failure to invest sufficiently in global public health. This must stop now.”
In November 2021, WHO member states, including Botswana, came up with a set of recommendations for sustainable financing. Some of the recommendations include the increase in assessed contributions from member states to 50 per cent of the base budget by 2029. Member States also called for the betterment in transparency with regards to budget setting.
At this year’s Seventy-fifth World Health Assembly held in Geneva, Switzerland from 22 to 28 May, 2022, Member States agreed to overhaul how they fund the UN health agency. More importantly, they agreed to give more money the health agency to spend on its own priorities. This budget overhaul will address an age old problem which saw the health agency failing to respond to global health crises like the coronavirus pandemic.
Latest figures show that contributions account for only $957 million, while specified voluntary contributions make up $3.7 billion, highlighting the imbalance which the health agency was keen to correct. The biggest assessed contribution membership fees are from the USA ($219 million), China ($115 million), Japan ($82 million), Germany ($58 million) and Britain ($44 million). This has been a very concerning issue.
Although the COVAX facility has a well-intended objective to ensure fair and equitable access to vaccines for all 190 participating economies using an allocation framework formulated by WHO, the initiative has faced major problems to meet its targets. This has affected smaller nations such as Botswana in many ways. COVID-19 Vaccines Global Access, abbreviated as COVAX, is a worldwide initiative aimed at equitable access to COVID-19 vaccines directed by Gavi, the Vaccine Alliance, the Coalition for Epidemic Preparedness Innovations, and the World Health Organisation. But almost three years into the pandemic, it has not succeeded in achieving its intended target because of fund shortages, among other reasons.
A medical practitioner who spoke to this publication on condition of anonymity indicated that the new funding model is good in the sense that it somewhat weans the WHO from political influence of its donors, especially America which is the biggest funder for the WHO.
“The funding overhaul means that WHO is now able to have a more steady income stream and control over a much bigger portion of the funding flowing into their coffers. This gives the health agency an upper hand if another pandemic is to strike,” he says, adding that this funding face-lift will firm-up the health agency and make it more responsive to global health crises.
Among other things, the new funding model will see countries such as Botswana give half of their WHO contributions as straightforward membership fees, giving the organisation more flexibility. Prior to this, Member States sent their money into health projects of their own choosing. The membership fee portion will rise to 50 percent by the 2030-2031 budget cycle at the latest.
WHO Director General Dr Tedros Adhanom Ghebreyesus, said overhauling the funding model will assist the health agency to address its priorities “more effectively and efficiently,” adding that rather than the health agency spending time looking for money “You’re telling us to focus on the programmes, and the funding will be taken care of.”
For her part, WHO regional director for Africa, Matshidiso Moeti expressed gratitude to member states for reopening the debate and told the working group that the outcomes will be vital in addressing non-communicable diseases (NCDs.)
Increased and sustainable health financing for the WHO is critical in order to meet Sustainable Development Goal 3 (SDG) by 2030. Goal 3 stands for “good health and wellbeing,” and it is one of the key items among the 17 SDGs. The session was held under the theme: “Healthy Return: Investing in a Sustainably Financed WHO.”
