WHO investment round: a disappointing, but predictable outcome

While world leaders granted the WHO high-level political support but did not match this with dollars. The WHO secured only half of the funding it aimed to raise. Why? We argue in a recent essay in Global Policy that part of the explanation lies in the WHO’s fundraising approach, which mimics that of public-private global health partnerships, but is ill suited to a normative international organization like the WHO.

The WHO has faced an unsustainable funding situation for decades, with detrimental effects on its performance and independence. To address this challenge, member states committed in 2022 to gradually increase their membership dues so that they make up half of the organization’s budget by 2030 (currently 16 per cent). They also supported a new approach to raising voluntary contributions that would ensure more flexible and predictable funding and expand the donor base. As part of an “investment round”, the WHO asked donors for USD 7.1 billion upfront for the period 2025-2028, a funding level equivalent to what it obtained in the past strategic cycle (2021-2024).

Disappointing outcome

Despite considerable diplomatic and communication efforts during the past six months, the investment round culminated in pledges worth USD 1.7 billion, on top of which the WHO expects USD 2.1 billion from pre-existing commitments.

On the bright side, the WHO has increased the amount of voluntary funding available at the start of its strategic period, which contributes to making its budget more predictable. The WHO also succeeded in securing support from 39 new donors, mainly low- and middle-income countries.

This half-full glass is in many ways disappointing. The investment round raised only USD 1.7 billion in new commitments. Despite new countries contributing, 92 per cent of voluntary contributions still come from high-income countries, and it is unsure whether these are more flexible than before. Few emerging powers stepped-up. Brazil and Saudi Arabia who co-hosted the “investment round” did not make any pledges, neither did India. South Africa and China contributed only USD 1 and 20 million, respectively.

Bad timing or an inappropriate fundraising model?

Part of the explanation for this result may be contextual. In 2024, major donors have made massive cuts to their official development assistance budget and announced further cuts in 2025; and the election of Mr. Trump as US president is certainly not good news for the WHO, which the US left under his first mandate.

While all these conjunctural factors certainly did play a role, we argue in Global Policy that the WHO’s new fundraising model may also be at fault. The WHO’s ‘investment round’ largely mimics Gavi’s and the Global Fund’s model of raising voluntary donor contributions in multiyear funding cycles known as replenishments. This sets the WHO up to compete for tight funding with other public-private global health partnerships, who are also currently trying to raise USD 100 billion for their next replenishments. This is an unfair competition for the for at least two reasons.

First, across several replenishment cycles, Gavi and the Global Fund have developed a highly sophisticated “replenishment playbook” with which the WHO cannot compete. They rely on powerful advocacy coalitions consisting of hundreds of nongovernmental organizations, PR companies and celebrities, often with financial backing from the Gates Foundation. Their grandiose pledging ceremonies conclude by bringing together these networks and heads of states and other officials around the announcement of massive pledges. By contrast, the WHO has few well-resourced advocates. Instead of a flamboyant replenishment ceremony, its investment round concluded in a so-called “culminating moment,” which was a 15-minute press conference featuring the President of Brazil and his minister of health.

Second, convincing donors to “invest” in the WHO by using a private-sector logic of quantified returns on investments is extremely challenging, and potentially risky. Gavi and the Global Fund purchase and distribute vaccines and drugs in poor countries, which produces measurable results that can be framed as “cost-effectiveness” interventions. By contrast, the WHO’s work is primarily normative and coordinating and therefore difficult to quantify. WHO’s claim that it will save 40 million lives over the next four years is an estimate of the lives saved by programs relying on its normative guidance,  “regardless of the payer.” In other words, the WHO appropriates a portion of other global health agencies’ impact. Moreover, by trying to demonstrate its impact, the WHO might be drawn to emphasize its operational work, like how many solar panels it set up on health facilities or how many patients it treated.

As we argued in Global Policy, the WHO should be fully funded for the unquantifiable services it delivers to the world as a normative agency and coordinator of global health efforts – rather than for doubtful estimates of its impact in terms of lives saved.

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Katerini T. Storeng is a medical anthropologist and Professor at the University of Oslo’s Centre for Development and the Environment.
Antoine de Bengy Puyvallée is a Researcher at the Centre for Development and the Environment.