We propose three interconnected areas of reform to reposition WHO as a legitimate, effective, and independent multilateral health institution. The candidates for Director General must take clear positions on the critical issues outlined below. (Will the donors lose their influence?—Nass)
WHO cannot be everything to everyone. Its future lies in concentrating on its constitutional mission. We identify the following as core functions for the Organization:
WHO must provide timely, evidence-based normative and technical guidance to ensure global health progress and safety of citizens. (I think this means qualifying/licensing vaccines and pushing out pandemic orders, globally—despite lacking any mandate from its members to do so in the 2 pandemic treaties—Nass)
WHO must serve as the authoritative source of global health data and assessments . It is the global coordinator of surveillance and reporting on health progress linked to the Sustainable Development Goals and warn of new emerging health challenges. (WHO will surveill and own all the data; analyze it; announce pandemics, and shove the SDGs down everyone’s throats—Nass)
Data are an essential part of norms and standard setting role of WHO and for implementation by countries. WHO must be the trusted place for reliable health data, not influenced by national and commercial interests. It must set standards for data use in a world of data extraction for private profit.
Technological transformation will be necessary. WHO’s ability to serve as a global health data hub will depend on upgrading its systems to harness modern data science, AI, and real-time analytics.
Pandemic preparedness and emergency coordination:
WHO must retain its leadership role and authority in global responses and must have the resources to fulfill the roles assigned in the revised IHR and the Pandemic Agreement, especially compliance oversight . (WHO will force nations to comply with its edicts—Nass). This further includes the declaration of a Public Health Emergency of International Concern (independent verification and early alert function) and providing guidance to states. It further includes coordinating the emergency response to a pandemic without taking on operational country-level implementation or logistics and fundraising responsibilities. It acts as a capacity builder for member states preparedness.
Convening power:
The Organization must remain the forum for global health diplomacy and international dialogue on global health priorities. It must be forward looking and set new health agendas.
The WHO Secretariat should present a comprehensive refocusing proposal by the January 2026 Executive Board, to be debated and ratified at the 2026 World Health Assembly (WHA). This might imply readjustments of the 14th GPW.
WHO’s legitimacy in the knowledge ecosystem must be restored. The emergence of new, fragmented, decentralized, and competitive dynamics in knowledge production calls for reaffirming of the WHO’s legitimacy in providing scientific guidance in global health . The spread of fake news and alternative truths makes this legitimacy only more essential. Safeguarding the independence of its normative work from political and commercial interference is essential.
The WHO’s role is also to support national authorities in countries to translate normative guidance into national policies.
(In case you were not sure whether the WHO wanted to govern member states, you just got your answer—Nass).
The role of regional and country offices should be revisited in line with the core functions, and a proposal should be presented to the Executive Board in January 2027. This will be a key agenda for implementation by the next Director General. (I think they are asking for more, not less centralization of WHO, which is not what nations wanted—Nass)
A focus on the four core missions mentioned above also implies that WHO member states should revisit and possibly cease or adapt certain WHO functions. We propose that WHO has a key role to identify and set research priorities and to develop research frameworks and guidelines. It must address the implications of new knowledge and translate science into global norms and recommendations. WHO’s direct role in conducting and supporting research and coordinating global research networks (“We will own the science”—Nass) should however be assessed. We support an approach which fully separates institutional research from setting norms and standards.
We propose that the future of the important normative role of prequalification of medical products (international licensing of vaccines and drugs—Nass) should also be reviewed as it can be considered as a conflict of interest with the core, independent, normative function of WHO. New regulatory bodies such as the African Medicines Agency and upgraded regional and national regulatory authorities should emerge as part of an alternative system to be developed. Ultimately the core focus of WHO should be a norm setter for regulatory quality, and the maintenance of a reference database of approved products. (Is this an attempt to move licensing to regional offices to dispel the appearance of a conflict of interest?—Nass)
WHO’s precarious financing structure jeopardizes its independence. Today, assessed contributions account for just 20% of WHO’s budget. The remaining 80%—provided via voluntary, often earmarked contributions—may drive programming in ways that undermine collective priority-setting.
This model is no longer sustainable.
A shift to a funding model anchored in fully unearmarked assessed contributions is overdue. We propose that by 2030, 80% of WHO’s budget should come from assessed contributions, reflecting each country’s economic capacity. The 80% target will become realistic and acceptable through a focus on the four core functions proposed above. The overall budget will be decreased significantly through stopping other activities, reducing country offices and cutting back in regional offices. (Keep us in Geneva where life is good; don’t shift responsibilities to much cheaper cities like Nigeria or Kenya—Nass)
This financial reform must be co-led by countries of the Global South, not only by traditional donor states. It is a political opportunity to reshape WHO’s governance and agenda in a more equitable and representative manner.
Key decisions on this issue must be taken at the WHA in 2026 and 2027. Without financial independence, any call for a “strong WHO” lacks credibility.
For WHO to fulfill its mandate, its governance must evolve. Governance of the WHO must align with the expectations that Member States and the international community have of the Organization. In this regard, the commitment from Member States to the WHO goes beyond their role of financial contributor. In an era of waning trust in multilateralism, WHO governance and accountability must adhere to the highest standards of transparency, ethics, and performance management.
The World Health Assembly must retain its authority as the primary global forum on health, as the world needs a platform for health policies across geopolitical divisions. But the Executive Board (EB) must also be revitalized. The EB has, in practice, become a mini-WHA, failing to operate as a strategic decision-making body. Its role should be redefined to enable rigorous debate and oversight. A reform committee should be reinstated and present proposals on improving governance and accountability beginning in January 2027.
The WHA must initiate discussions on post-2030 global health priorities in the next two years. As the Sustainable Development Goals (SDGs) are unlikely to be met, there is a pressing need to define the next agenda—one that can be carried to the UN General Assembly and Heads of State.
Leadership reform is also essential. The WHO Director-General must act as a neutral, trusted representative of all Member States—engaging with global health initiatives, UN agencies, civil society, and the private sector.
As the ACT group – a coalition of Member States focused on improving the UN processes of selection and reform – has proposed for the Secretary General of the UN and the Independent Panel on Pandemic Preparedness and Response have proposed for the WHO Director General, we recommend a single, non-renewable seven-year term for the Director-General and Regional Directors. This should depoliticize leadership and prevent campaign-related distortions of the WHO’s operations. The same rule should be adopted for Regional Directors. Debate on this reform should begin at the EB in January 2026 and be implemented no later than 2030.
Financial and programmatic reporting to the EB and WHA must become more substantive and more thoroughly scrutinized by Member States. Independent evaluations should become routine and lead to actionable reforms. (This means WHO needs to control its corruption and secretiveness as to where the money goes—Nass)
Accountability is not merely a bureaucratic necessity—it is foundational to restoring Member State confidence and ensuring WHO can deliver on its mandate.
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