75 YEARS OF WHO: The World Health Assembly Considers WHO's Future

 

The World Health Assembly, the decision-making body of the WHO, will host thousands of government officials, global health experts, and advocates. As the world's leading health agency celebrates its 75th anniversary, the Assembly will focus on how to strengthen it to meet evolving health needs today and in the future. When the WHO was founded 75 years ago, global health was very different.

Global smallpox spread. The disease killed 300–500 million people worldwide in the 20th century. No global system tracked disease spread, making outbreaks difficult to control, especially those that

crossed borders.

Countries knew little about antibiotics, a promising new drug class

The newly founded WHO worked with partners and countries to eradicate smallpox, established the first disease-tracking service, and advised governments on antibiotic and health product use. WHO defends health rights today. However, geopolitical tensions, economic fragility, climate change, and mis- and disinformation trends complicate its work. The 194 WHO Member States and other stakeholders will use lessons from the COVID-19 pandemic to strengthen WHO and build modern health systems at the 76th World Health

Assembly in Geneva from May 21 to 30.

Restructuring health emergency preparedness and response

Global pandemic readiness is a top priority after the pandemic's massive toll and trauma. Two international legal agreements to improve health emergency preparedness and response are under negotiation. Member States are negotiating a new pandemic accord through the Intergovernmental Negotiating Body (INB). Another Member State-led negotiation will update the International Health Regulations (IHR), which were first agreed to in 1969 and last revised in 2005.

 

These two negotiations are underway and could strengthen the rules-based international system for health emergency responsee and collaboration. Member States expect these processes to help the world respond more quickly, effectively, and equitably to the next health

crisis. This year, Member States will negotiate difficult issues like equitable access to vaccines and treatments to balance ambition with political feasibility. Intellectual property and technology transfer policies vary widely among Member States. This Assembly will present INB and IHR progress reports, and unofficial discussions will continue until 2024.

 

Since WHO is responding to 56 graded health emergencies, the World Health Assembly will review its work on other emergencies. Nine acute emergencies include the cholera outbreak in Africa and the Middle East, the aftermath of the February 6 Türkiye-Syria earthquake, and the Ukraine war. Because 70% of WHO disease outbreaks occur in fragile, conflict-affected, and vulnerable settings, WHO leadership will update Member States about its Global Health for Peace Initiative. The Assembly will consider a draught strategy for the initiative, which addresses drivers of critical health needs in crisis settings and reinforces health as a key

component of peace and sustainable development. Increasing momentum for universal and primary health care Now that COVID-19 is here to stay, universal health coverage is more urgent than ever.

SDG3: Good Health and Well-Being explicitly state that UHC's core principle—that all people have access to the health services they need, when and where they need them, without financial hardship—is essential to achieving the SDGs.In 2022, WHO Director-General Tedros Adhanom Ghebreyesus made reorienting health systems from vertical programs and specialized care to primary care one of his five priorities.WHO estimates that primary care can provide up to 90% of essential health services and could increase global life expectancy by 6.7 years by 2030. Member States agreed to hold a high-level meeting for universal health coverage during the UN General Assembly in New York in September because political momentum for strengthening primary health care is growing. Member States are expected to pass a resolution at WHA in May to keep primary health care at the center of the high-level meeting and political declaration. This broad commitment to UHC in Geneva and New York

shows that countries are serious about resuming progress toward universal health care.

 SUSTAINABLE FINANCING FOR WHO 

 The WHA gives Member States an official way to create new mandates for the WHO secretariat to carry out, such as providing technical support to countries or organizing consultations.This process assigns WHO new workstreams that require funding.

For most of its 75-year history, WHO has had insufficient and unpredictable funding. Predictive, fully flexible financing covers less than 20% of its budget. In 2021, a Member State working group recommended a series of measures to improve WHO funding, recognizing it is declining quality. At the WHA in May 2022, Member States agreed to raise WHO membership dues, called "assessed

contributions," for six years. 

This year, Member States must approve the biennial program budget for 2024–2025, which reflects the new dues scale. Approval would help WHO fulfill its mandate and send a political

message about WHO's role as the world's health coordinator. While the

discussion of increasing assessed contributions is well advanced, Member States

will actively consider other recommendations from the Member State working group to improve WHO's voluntary financing predictability and flexibility. Voluntary funds make up most of WHO's budget, often designated for specific priorities and subject to withdrawal. This rigidity has prevented the organization from addressing chronically underfunded areas.

 NEW HEALTH PROBLEMS 

 Even as Member States and WHO struggle to make the most of finite resources through the budgeting process, new and complex health challenges will require WHO to evolve, adapt,

and possibly expand its scope of work. Mental health disorders and environmental and social factors are increasingly seen as major threats to health and well-being that require multisectoral solutions.WHO Member States welcomed a new draught global framework to address some of these worsening trends earlier this year, and WHA76 will review the strategy. These issues are likely to drive disease and hinder global wellness and prosperity in the

organization's next 75 years.WHA gives member states a place to show that they

are committed to working with WHO in new ways, with new resources, and with new

partners to build a world where everyone can live healthy, productive lives, no

matter where they are or where they live.