Context

• On January 20, 2025, the United States government issued an executive order to withdraw from the World Health Organisation (WHO), raising serious concerns about the financial and operational stability of the global health body.
• While this decision has sparked debate about the potential weakening of WHO due to reduced funding, it also presents an opportunity to reevaluate the role of different nations in shaping the global health agenda.
• Amid these developments, it is important to explore the implications of the U.S.’s withdrawal, the challenges posed by WHO’s funding structure, and the need for the global south to play a more significant role in global health.

WHO’s Funding System and the Consequences of U.S. Withdrawal

• WHO’s Funding System
  • WHO’s funding is divided into two major categories: assessed contributions (AC) and voluntary contributions (VC).
  • AC is a fixed annual membership fee that each member-state is required to pay, which ensures stable funding for WHO’s basic operations, such as salaries and administrative costs.
  • One of the key reasons cited by the U.S. for its withdrawal was that its AC was disproportionately high.
  • On the other hand, VC funds, which come from various donors and are often allocated to specific projects, are inherently unpredictable.
• Consequences of U.S. Withdrawal
  • With the U.S. pulling out, not only will its AC contributions be lost, but its VC funding may also diminish as U.S.-based donors and agencies like USAID could reduce or halt their funding to WHO.
  • Given that many of these funds support critical projects like polio eradication, patient safety, and antimicrobial resistance, WHO’s ability to execute global health initiatives may be severely impacted.
  • However, while the financial setback is significant, it also highlights the vulnerability of WHO’s funding structure and the necessity for reform.

Reason Behind the Failure of Global Institutions

• The Rise of Nationalism and its Impact on Global Collaboration
  • In recent years, a wave of nationalism has swept across many countries, leading to an increasing focus on domestic priorities at the expense of international cooperation.
  • Political leaders in high-income nations have increasingly adopted ‘nation-first’ policies to appeal to their domestic constituencies.
  • This has resulted in reduced funding for international institutions, weakened alliances, and a reluctance to engage in multilateral efforts.
  • The U.S. withdrawal from WHO is a prime example of this trend.
  • Citing concerns over financial contributions and bureaucratic inefficiencies, the U.S. government decided to pull out of an organisation that has historically been instrumental in coordinating global responses to health crises.
  • This decision not only undermines WHO’s ability to function effectively but also sends a troubling signal to other countries that international cooperation can be abandoned when politically convenient.
• The Erosion of Trust in Global Institutions
  • Another major issue facing global institutions is the erosion of trust among member states.
  • Over the years, some countries have criticized organisations like WHO for being slow to act, overly bureaucratic, and influenced by the interests of a few powerful nations.
  • While these criticisms are not entirely unfounded, they have led to a situation where countries hesitate to fully support global initiatives, fearing that their interests will not be adequately represented.
  • The COVID-19 pandemic exposed some of these shortcomings. WHO was criticised for its delayed response in declaring the virus a pandemic and for its perceived over-reliance on information from certain member states.
  • These concerns, while valid, should serve as a catalyst for reform rather than an excuse to abandon global institutions altogether.
  • A stronger WHO, one that is more transparent, efficient, and equitably governed, is essential to ensuring global health security.

The Need for Systemic Reforms in Global Institutions

• Decentralisation of Global Health Governance
  • WHO’s headquarters in Geneva is far removed from the regions that face the most pressing health challenges.
  • Relocating parts of WHO’s operations to regional offices in Africa or Asia could improve response times and ensure that resources are directed where they are needed most.
• Diversification of Funding Sources
  • To reduce dependency on any single country, WHO and similar institutions should diversify their funding mechanisms.
  • Encouraging pooled contributions from multiple countries, as well as innovative financing mechanisms such as global health bonds or public-private partnerships, could enhance financial stability.
• Enhancing Inclusivity in Decision-Making
  • Historically, global health policies have been dominated by high-income countries.
  • Ensuring that low- and middle-income nations have a greater voice in decision-making processes will lead to more equitable and effective policies.
  • This can be achieved by increasing representation from Africa, Asia, and Latin America in WHO’s leadership and governing bodies.
• Strengthening Enforcement Mechanisms
  • Currently, many global health agreements lack enforcement mechanisms, making it difficult to hold countries accountable.
  • Introducing legally binding commitments with penalties for non-compliance could enhance adherence to global health protocols. 

The Role of the Global South in Strengthening Institutions

• In light of the challenges faced by global institutions, countries in the global south must take a proactive role in shaping their future.
• Instead of relying on high-income nations to dictate the global health agenda, emerging economies like India, Brazil, South Africa, and Thailand should step up as leaders in international health governance.
• Organisations like BRICS (Brazil, Russia, India, China, South Africa) could play a pivotal role in funding and supporting WHO’s initiatives.
• Additionally, investing in global health training programs within the global south will help create a more diverse and self-sufficient pool of experts, reducing dependence on Western-trained professionals.
• Furthermore, countries in Africa and Asia must advocate for fairer global health policies.
• By collectively pushing for reforms in WHO and other institutions, they can ensure that global health priorities reflect the needs of all nations, not just those of high-income countries.

Conclusion

• While the U.S.’s withdrawal from WHO presents immediate challenges, it also provides an opportunity for restructuring global health governance.
• The decision underscores the need for a stronger WHO that is less dependent on any single country for funding and expertise.
• Countries in the global south must take the lead in filling this gap by increasing financial contributions, training more experts, and establishing regional institutions dedicated to global health.
• The withdrawal of the U.S. should not be seen as a crisis but rather as a catalyst for a more independent and resilient WHO.