The reform proposal led by Germany and France to strengthen WHO’s emergencies response and bolster global health security, could result in a balance of power tilting in favour of donor countries, diplomatic sources in Geneva say. Questions are being raised on whether the proposal truly seeks to empower WHO, or if it is also an attempt to fill the leadership vacuum caused by the retreat of the U.S. from the multilateral institution.  

The proposal, being perceived in some quarters, as a genuine effort to strengthen multilateralism in global health, may be focusing too much on global health security; and risks exclusion of countries who may not be able to contribute as much as wealthy countries by way of assessed contributions – a key suggestion by Germany and France.

There is no doubt upper middle-income countries and middle-income countries should pay more to make WHO’s financing more flexible, so that all countries become beneficiaries of a strong international organization. However, with the pandemic wreaking havoc in some of these economies, with many projected to have negative GDP growth rates and severely contracted economic conditions, their ability to contribute more to WHO may be affected for years to come, diplomatic sources from developing countries told Geneva Health Files.

Both Germany and France have pledged additional contributions to WHO, in wake of the US decision to leave the UN’s only policy-setting technical agency.  

This reform proposal that is being discussed at WHO, and informally among some member states, suggests three key areas for reform including a wider WHO reform; WHO’s work in emergencies and WHO’s work under the framework of the IHR, according to the document seen by Geneva Health Files. The proposal describes in detail, the vulnerability caused to WHO as a result of uncertainties around financing, and how this impacts its operations from staff recruitment, to fighting emergencies. It also notes weakening of WHO, even as its partner organizations (some of whom are also its donors), continue to be better-funded and often use WHO structures to implement their specific health goals.

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