Funding

Financing gap

The WHO has long been struggling with chronically insufficient funding. The progressive expansion of its mandate amid stagnant financing forced the agency to confront difficult prioritisation decisions and trade-offs across programmes. Yet, the financing situation has never been as difficult as following the United States (US) withdrawal from WHO, initiated in January 2025 and concluded one year later, which precipitated a sudden US$1.3 billion shortfall (18 % of prior budget), 25 % staff reductions, and programme suspensions – amplifying historical vulnerabilities to unprecedented levels. Moreover, declining investment in development assistance, not least in its health component, observed worldwide, including in Europe, make the financial pressure even more acute.

US withdrawal

The US has been a member of WHO since 1948. The US financial contribution – the largest globally – has been vital to the WHO. The US supported the agency through assessed (core, or mandatory) contributions, set at 22 % of the WHO core budget (US$134.58 million, or around €114.63 million for 2025), as well as voluntary contributions with an average annual amount of US$237 million (or almost €202 million) between 2012 and 2024. In terms of overall funding – voluntary and mandatory – the US contribution amounted to between 16 % and 18 % of the total WHO budget, depending on the year. On 20 January 2025, on his return to the White House, US President Donald Trump initiated the US withdrawal from WHO through an executive order. ¹ The executive order accused WHO of continuing to demand 'unfairly onerous payments ... far out of proportion' with other countries' assessed contributions – annual amounts that each of WHO member and associate member is required to pay to WHO. In particular, the executive order pointed at China, which, with a population of 1.4 billion – around 4.3 times larger than the US population – allegedly 'contributed nearly 90 % less to WHO' than the US. In reality, whereas the US paid a 22 % share of the WHO core budget, China was asked to pay almost 15.3 %, and the 27 EU Member States together contributed almost 24 % in the fiscal year 2024-2025 (see Figure 1).

Source: Compiled by the author based on WHO data. Graphic by Nadejda Kresnichka-Nikolchova, EPRS.

Regarding the overall contribution to the WHO budget, in the years 2022 to 2023, the US contribution of US$1.28 billion (around €1.09 billion) amounted to 16.2 % of the total WHO budget; China provided the WHO with US$0.16 billion (around €0.14 billion), accounting for 2 % of the total budget. Meanwhile, the contributions from the European Commission, the EU Member States and the European Investment Bank (EIB) amounted to US$2.35 billion (€2 billion), or 29.8 % of the total 2022-2023 WHO budget (see Figure 2).

Source: Compiled by the author, based on WHO data. Graphic by Nadejda Kresnichka-Nikolchova, EPRS.

The impact of the US withdrawal is broader than the stark financial loss. It also resulted in the loss of human resources and technical and scientific expertise, among other things. The withdrawal also reduces the WHO's quasi-global reach and creates new challenges in an even more fragmented global health landscape (see the section 'Governance, authority and political pressure' below).

In this context, the WHO was forced to accept a 9 % decrease in its budget for the years 2026 to 2027 compared with the budget agreed for the previous biennium (see the Table 1). As a result, WHO's 2026-2027 programme budget totals US$6.2 billion – US$0.6 billion less than in the years 2024 to 2025 and US$1.2 billion less than initially proposed by the WHO Executive Board (EB)² for the years 2026 to 2027. This budget covers base programmes, which represent the WHO's core mandate and the largest part of its budget (US$4.27 billion); polio eradication (US$770.9 million);³ special programmes (US$168.7 million);⁴ as well as emergencies and emergency appeals (US$1 billion).⁵

Table 1 – WHO's current programme budget for the years 2020 to 2025 (US$ million)

Budget segment	Programme budget 2020-2021	Programme budget 2022-2023	Programme budget 2024-2025 (1)
Base programmes	3 768.7	4 968.4	4 968.2
Polio eradication	863.0	558.3	694.3
Special programmes	208.7	199.7	171.7
Emergency operations and appeals	1 000.0	1 000.0	1 000.0
Total	5 840.4	6 726.4	6 834.2

Data source: WHO, Proposed programme budget 2026-2027, 2025. Note: RC: regional committees; EC: Executive Committee; WHA: World Health Assembly.

Table 2 – WHO's proposed programme budget for the years 2026 to 2027 (US$ million)

Budget segment	Proposed programme budget 2026‑2027 (RC version)	Proposed programme budget 2026‑2027 (EB version)	Programme budget 2026‑2027 (adopted by WHA) (2)	Difference between (1, previous table) and (2, this table)
Base programmes	5 687.7	5 324.1	4 267.1	-701.1
Polio eradication	976.3	976.3	770.9	+76.6
Special programmes	172.8	172.8	168.7	-3.0
Emergency operations and appeals	1 000.0	1 000.0	1 000.0	0.0
Total	7 836.8	7 473.2	6 206.7	-627.5

Data source: WHO, Proposed programme budget 2026-2027, 2025. Note: RC: regional committees; EC: Executive Committee; WHA: World Health Assembly.

Inflexibility

WHO also struggles with a lack of flexibility in using its funds. The agency is funded through two primary sources: assessed contributions from member states and voluntary contributions from partners (see Figure 3).

Assessed contributions, i.e. mandatory dues based mainly on a country's gross domestic product and adjusted for WHO's membership, are a key source of financing for WHO, providing predictable and flexible financing. They are approved by the member states every two years at the World Health Assembly. Before 2022, they accounted for less than 20 % of the WHO programme budget. However, after increases in May 2023 and May 2025, the assessed contributions now cover around 40 % of the WHO budget, with a target of 50 % by 2030.

Voluntary contributions from governments, UN agencies, foundations and private donors make up the remaining 60 %. These fall into three categories based on flexibility:

• core voluntary contributions (fully flexible);

• thematic and strategic engagement funds (partially flexible);

• specified voluntary contributions (inflexible, tightly earmarked for specific programmes; account for more than 85 % of the total voluntary funds).

As a result, a big part of WHO funds is not flexible. This limits the WHO's discretion in deciding on its action, and is often seen as limiting the agency's agility in carrying out its mandate. In particular, it results in a prioritisation mismatch when the WHO is obliged to adhere to the donor priorities – such as health security – over other needs, such as addressing the determinants of health or ensuring equitable access to medicines. Inflexible funding also slows down adaptation, which is particularly visible during major crises such as COVID‑19, when the agency struggled with the timely repurposing of funds. Finally, some note that a few powerful donors are able of shaping the WHO's action, which again limits the agency's autonomy and discretion.

Source: Compiled by the author, based on WHO data. Graphic by Nadejda Kresnichka-Nikolchova, EPRS.

Unpredictability

In addition to being insufficient and inflexible, the WHO's funding is characterised by unpredictability. Most of the agency's funds are voluntary contributions with no guarantee of timely payment or renewal. This undermines the WHO's ability in the long-term planning of its actions, particularly those that are not on the top of key donors' agenda (e.g. the burden of NCDs; occupational health and safety, UHC). This often results in the agency having a reactive, short-term focus. Moreover, the WHO is susceptible to facing programme disruptions owing to late, reduced or stopped pledges. For instance, because of the US withdrawal from the WHO and an overall decline in global health financing, the agency experienced an immediate financial hit that resulted in serious operational disruptions, including workforce cuts, programme halts and other operational difficulties pertaining, among other factors, to the urgent need for reprioritisation (see text box below).

Reprioritisation efforts

Following the announcement of the US withdrawal from the WHO and rapidly decreasing global health funding worldwide, both of which resulted in a reduced financial envelope for the WHO, the agency launched a reprioritisation and realignment process. This is grounded in the principle that the WHO should focus its efforts where it provides the greatest added value. The preliminary results show that the agency should (i) refocus on its core mandate stipulated in the WHO Constitution – leadership, policy options, norms and standards, research, monitoring and technical support; (ii) better delineate work from partners and WHO member states; (iii) seek better alignment across the WHO's three levels; and (iv) consolidate fragmented efforts and address duplication.

Source: Compiled by the author, based on WHO data. Graphic by Nadejda Kresnichka-Nikolchova, EPRS.

Governance, authority and political pressure

The WHO is challenged, among other things, by its governance, owing to disagreements about the agency's purpose, limited authority due to insufficient independence and legal power; and political and funding pressure from member states.

First, WHO operates in a highly fragmented global health landscape with many different actors at the regional, national and local levels. Over the decades, the field of global health has become increasingly crowded. Global health actors include not only the WHO and its member states (with health actors at different levels) but also international organisations such as the World Bank, which branched out into funding health projects in the 1980s; public-private partnerships such as the GAVI Vaccine Alliance; private foundations such as the Bill Gates Foundation; and non-governmental organisations such as Médecins Sans Frontières. In 2026, following the US and Argentina's withdrawal notifications and their efforts to replace WHO-led global health effort with bilateral partnerships, fragmentation has further increased. This is seen both as challenging the WHO's authority as the main global health actor globally and its visibility. Moreover, with many global health actors having divergent interests and priorities, the WHO has to navigate in a complex, highly nationalised and politicised global health environment.

Second, the agency itself relies on regionalisation of its offices. Currently, WHO member states belong to six regions: the Americas, Europe, the Eastern Mediterranean, South-East Asia, the Western Pacific and Africa. The regions have a high level of autonomy with their own leadership, budget and priorities. Some experts go as far as to argue that the WHO functions not as a single organisation but as seven separate ones – the six regional offices along with the headquarters. While the regional offices are important to adapt global health priorities to suit local context, some experts note that the WHO regional offices structure often hinders global coherence, coordination and the WHO's effectiveness in addressing global health issues. For instance, during health crises, this regionalisation has been shown to obstruct the fair distribution of resources. During COVID‑19, in particular, studies reported inequitable vaccine distribution (via COVAX) and inconsistencies in pandemic responses, partly due to regional offices focusing on local national interests rather than global solidarity.

These structural challenges – fragmentation of the global health landscape and a heavy regionalisation of the agency itself – lower the WHO's ability to effectively carry out its mandate. Most notably, analysts argue that the WHO struggles with ensuring efficient coordination between actors, maintaining its relevance and visibility among proliferating global health actors, including non-governmental ones, and navigating between the diverging interests of its member states and regions. That said, divergent interests and power dynamics among WHO member states mean decisions in the World Health Assembly and Executive Board often reflect politics and bargaining instead of purely technical public health priorities. Moreover, due to its reliance on funding from a few key actors – either member states or non-county contributors – the agency is forced to focus on actions that are aligned with those contributors' interests.

Experts also argue that the agency is not equipped with the necessary authority for its mission, because global health governance requires extensive oversight and enforcement powers (e.g. to verify data, inspect sites or sanction non‑compliance) that the WHO does not have. To give an example, the International Health Regulations, adopted under WHO auspices, are legally binding but heavily depend on national reporting and compliance; without sanctioning and overall enforcement power, the WHO often struggles to compel governments to share timely, accurate information or to implement its measures and recommendations. This results in the WHO relying on technical cooperation instead of stronger measures and their enforcement, which in turn is seen as a limitation to the agency's authority and efficiency, particularly during emergencies. Most notably, during the COVID‑19 pandemic, the WHO was criticised for being too deferential to China and slow to challenge its early handling of the outbreak, reflecting a non‑confrontational strategy that collided with a highly politicised environment.

Vulnerability to misinformation and disinformation

The WHO is facing additional challenges – misinformation and disinformation – that constitute obstacles to effectively carrying out the agency's mandate. This is because misinformation and disinformation negatively affect people's health behaviours and erode trust in the WHO. A paper published in the Bulletin of the World Health Organisation in 2022 found that poor-quality health-related information, misinformation and disinformation is present, in particular, during pandemics, humanitarian crises and health emergencies at an increasing rate. This is problematic in that such spreading of misinformation or disinformation in crisis situations often amplifies vaccine hesitancy and promotes unproven – and sometimes harmful – treatments, as well as non-compliance with official guidance and measures. Moreover, more recently, the negotiations on the WHO Pandemic Agreement were challenged with misinformation and disinformation, fuelling opposition to the initiative. WHO officials claimed that conspiracy theories and false claims, including those arguing that the agreement would take away sovereignty from countries by imposing lockdowns or vaccine mandates, were responsible for an increase in public opposition to the agreement and for hindering negotiations.

Recognising this increasing challenge, WHO has taken several steps to counter misinformation and disinformation and increase resilience to them. The WHO now runs infodemic management activities, including monitoring of social and news media, network analysis of misinformation ecosystems, and coordination with a large network of fact‑checking groups. For example, WHO worked with YouTube to enhance its COVID-19 misinformation policy and provide guidelines for content providers to ensure no medical misinformation relating to the virus proliferates on their platform.

Selected examples of EU–WHO cooperation

The EU, through the Commission, also supports a wide range of WHO programmes, focusing on areas such as UHC, health systems strengthening worldwide, health security, antimicrobial resistance, enhancing laboratory capacities in Africa, advancing wastewater surveillance for public health and the intersection of health and environmental issues, as well as on strengthening health information systems in Europe and globally.

European Parliament position

The European Parliament is a vocal supporter of more proactive action on global health. In various resolutions (see text box with examples below), Parliament expressed its support to the agency and called on the Commission and the EU Member States to comply with various WHO measures, initiatives and guidelines.