The World Health Organization’s future is more uncertain than ever. The United States’s formal request to withdraw from the body on January 20th, 2025, and halt all future funding deprived the WHO of $1.28 billion, equivalent to 16% of its total revenue in 2022-2023. Consequently, the WHO is projecting a reduced budget of $4.2 billion for 2026-2027, down from an initial estimate of $5.3 billion.
The body cannot make ends meet with these tighter finances, finding itself $600 million behind for the current year. WHO’s top brass is considering several ways to close the financial gap. A 25% cut in salary costs, hiring in cheaper cities, and scaling back the WHO’s mission to “only the most urgent health needs” are on the table.
Nobody, though, is prepared to point out the obvious: the best place to start saving money is on the privileges of the top brass themselves.
Lavish travel and endless meetings are the easiest hanging fruit. For instance, the World Health Assembly, the supreme decision-making structure of the WHO, usually involves the complicated and tedious task of coordinating and flying out decision-makers from all 194 United Nations member states to luxurious five-star hotels in Geneva, Switzerland, in May, all just to meet and discuss internal WHO affairs. Ironically, the same expensive extravaganza was organized this year to talk about reducing spending, of all things!
Of course, the World Health Assembly is not the only event of its kind. Many of the same top brass who are now bemoaning difficult budget decisions for their employees and world health enjoy attending large, medium, or small gatherings in over 150 countries annually. In 2025 so far, we have had the “Fourth Global Ministerial Conference on Road Safety in Morocco”, the “Second Global Conference on Air Pollution and Health” in Cartagena, Colombia, and the upcoming “Global Conference on Climate and Health” in Brasilia, and “Mental Health in All Policies” in Paris. Let us not forget the six annual regional meetings in Zambia, USA, Egypt, Sri Lanka, Fiji, and Denmark, either.
It should come as no surprise that the WHO spends over $200 million on travel expenses. That is money being wasted on forums that could have easily been organized online at a fraction of the cost. To put the sum into perspective, the same amount would be enough to finance AIDS, tuberculosis, and malaria efforts combined.
The other elephant in the room is executive bloat. One 2025 investigation by Health Policy Watch found that “The number of WHO’s top-ranked directors (D2), the highest level of staff before the Director General’s senior leadership team, has nearly doubled since Director General Dr Tedros Adhanom Ghebreyesus took office, with 75 people holding D2 positions in July 2024 in comparison to only 39 in July 2017”. The bill for this excessive top-down bureaucracy is an eye-watering $92 million spent on just 215 Directors, the Director General, and 11 senior staff.
Both forms of excess point to structural problems that require structural solutions. As Erica Harper, Head of Research and Policy Studies at the Geneva Academy of International Humanitarian Law and Human Rights, has repeatedly emphasized, what the WHO needs is better budgeting via smart implementation, finding easier ways to achieve the same objectives, or new ways to fulfill the same goals.
There are encouraging signs that leadership understands the need for smart implementation and is willing to change. WHO Director-General Tedros Adhanom Ghebreyesus publicly emphasized the need for the WHO to adapt by limiting travel to essential missions, conducting virtual meetings, and cutting costs in areas such as IT equipment and office refurbishments.
Yet words need to be matched by action. Most new executive hires are found in the Geneva Headquarters, the WHO’s single most expensive location, with new D2 positions increasing from 29 in 2017 to 46 in July 2024. Thinning their numbers would keep costs down without damaging regional engagement. Similarly, focusing on virtual meetings would reduce bloat and signal a commitment to more efficient and vital functions while freeing up resources for the type of health campaigns the WHO is meant to conduct. One example of another area that needs improvement is the Framework Convention on Tobacco Control (FCTC), which coordinates its pre-COP regional meetings across WHO regions before even beginning the main COP session in Geneva in November. These preparatory meetings could be conducted virtually at a fraction of the current cost, drawing on the example of European pre-FCTC meetings that were organized virtually. It is easy to demand sacrifices of others when demanding far less of oneself.
The current fiscal crisis is not just a challenge, but an opportunity to leave the world better off by being better. If the WHO wants to have a future, it must take the chance to change.
Dr. Emil Panzaru is Research Director at the Consumer Choice Center. His background is in the political economy and governance of complex institutions and socio-economic systems. He has written extensively on healthcare policy issues that affect ordinary consumers' lives, from chemical regulations and food labeling to GLP1 agonists.
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