Deep funding cuts disrupting global health services, warns WHO

Dollar currency notes. Photo collected._11zon

Penang, 3 Feb (Kanaga Raja) — Deep funding cuts forced significant workforce reductions and abrupt declines in bilateral aid triggered major disruptions to health systems and essential services across many countries in 2025, according to Dr. Tedros Adhanom Ghebreyesus, the Director-General of the World Health Organization (WHO).

Describing 2025 as being a “year of stark contrasts”, he said landmark milestones were achieved including the adoption of the WHO Pandemic Agreement, the entry into force of amended International Health Regulations, approval of the next increase in assessed contributions, and a strong UN General Assembly political declaration on non-communicable diseases and mental health.

However, these advances unfolded against one of the most challenging periods in WHO’s history, he added.

In his address to the 158th session of the WHO Executive Board on 2 February, the WHO chief said that 2025 “was undeniably one of the most difficult years in our Organization’s history.”

“Significant cuts to our funding left us with no choice but to reduce the size of our workforce. And sudden and severe cuts to bilateral aid have also caused huge disruptions to health systems and services in many countries,” said the Director-General.

However, he pointed out that despite the challenges that were faced, there are many achievements to celebrate.

In this context, he highlighted several achievements, the first being WHO’s work to promote health and prevent disease by addressing its root causes.

He said in response to funding cuts, WHO is supporting many countries to sustain essential health services, and to transition away from aid dependency towards self-reliance, based on domestic resources.

He highlighted domestic resource mobilisation as central to this transition, noting that higher health taxes on tobacco, alcohol and sugary drinks can provide governments with sustainable revenue to strengthen their health systems.

For instance, he said that WHO launched the 3-by-35 Initiative last year, calling on all countries to raise the real prices of tobacco, alcohol and sugary drinks by at least 50% by 2035.

Last year alone, Malaysia, Mauritius, Slovakia, Sri Lanka and Viet Nam were among countries that introduced or increased taxes on one or more of these products, the WHO chief noted.

Already this year, India introduced a new excise duty on tobacco and Saudi Arabia introduced a tiered excise tax on sugary drinks.

On tobacco, Dr. Tedros noted that the WHO Framework Convention on Tobacco Control (FCTC) celebrated its 20th anniversary last year.

Since the FCTC entered into force, tobacco use has dropped by one-third globally, and continues to decline in 140 countries, he pointed out.

Last year, Maldives became the first country to adopt a generational tobacco ban for people born from 2007.

In other areas, WHO also recognized Austria, Norway, Oman and Singapore for their efforts to eliminate trans fats from their food supplies, said the Director-General.

“The Commission on Social Connection delivered the first global evidence-based framework on loneliness and social isolation.”

Member States also endorsed an updated Global Road Map on Air Pollution and Health, including a commitment to halve health impacts by 2040.

Dr. Tedros said new data from the WHO/UNICEF Joint Monitoring Programme showed that one billion more people now have access to safely managed drinking water than a decade ago, saving an estimated 5 million lives.

He also highlighted WHO’s work in supporting countries to provide health, by strengthening health systems on the road to universal health coverage (UHC).

In this regard, he said that following cuts to bilateral aid, WHO developed guidance on responding to the health financing emergency, supporting countries including Cambodia, Ethiopia, Mozambique and Uganda.

However, he said that the latest UHC Global Monitoring Report shows that 4.6 billion people still lack access to essential health services, and 2.1 billion people face financial hardship because of health costs.

One of the main reasons people miss out on health services is because they don’t have access to a health worker, he said, adding that the world is facing a shortage of 11 million health workers by 2030, more than half of which is a shortage of nurses.

In response, last year WHO supported 11 countries facing the most acute shortages to strengthen their national workforce strategies, contributing to commitments for nearly 100,000 new health worker jobs.

For instance, the WHO chief said with WHO’s support, South Africa has expanded its health workforce by 28% over the past five years.

The WHO also continues to support countries to strengthen their health data systems, including through the use of digital technologies and artificial intelligence.

Furthermore, Dr. Tedros said the WHO continues supporting countries to expand access to essential medicines.

Last year, the WHO pre-qualified 44 medicines, nine vaccines, 10 in-vitro diagnostics, 21 medical devices, eight vector control products, and performed 185 inspections of manufacturing sites, he noted.

It also updated the Essential Medicines List to include new medicines for cancer and GLP-1s for diabetes in people with obesity, as well as reviewed 5,000 pediatric formulations to prioritize those that are optimised and age-appropriate for children.

On antimicrobial resistance, the Director-General said the Global Antimicrobial Resistance and Use Surveillance System – GLASS – showed that 1 in 6 bacterial infections globally are now resistant to antibiotics, and the trend is increasing.

Expressing concern, he said GLASS also shows that many countries are potentially accelerating resistance by using antibiotics that are in the “watch” category, when they could be using antibiotics in the “access” category.

In addition to WHO’s work to strengthen the foundations of health systems, it also saw progress on its disease- specific programmes, said the WHO chief.

On immunization, he said that despite the funding cuts, the WHO introduced malaria vaccines in seven new countries, supported 15 more countries to introduce HPV vaccination to prevent cervical cancer, as well as the use of vaccines towards the eradication of polio.

WHO also pre-qualified lenacapavir for HIV prevention and published guidelines on its use, supporting the first eight countries to accelerate the rollout of this new tool that could change the trajectory of the HIV epidemic, the Director-General said.

On non-communicable diseases, he noted that the UN General Assembly adopted the most ambitious political declaration yet, with concrete targets on tobacco, hypertension and mental health.

He said the WHO also issued new guidelines on the use of GLP-1s for the treatment of obesity in adults; and WHO initiatives on cervical, breast and childhood cancer are now benefiting over one million people in more than 100 countries.

On the WHO’s work to support Member States to prevent, prepare for and respond to health emergencies, Dr. Tedros pointed out that last year, Member States adopted the WHO Pandemic Agreement and that the amended International Health Regulations entered into force.

WHO also took many other steps last year to strengthen health emergency preparedness and response, he added.

Dr. Tedros stressed that despite the many challenges it has faced, the WHO has continued to deliver.

“Most significantly, we proposed – and in 2022, the World Health Assembly approved – a plan to progressively increase assessed contributions to 50% of the base budget, from just 14% at the time.”

Member States approved the first increase in May 2023, the second increase in May 2025, and the next three increases are scheduled for approval in May 2027, May 2029 and May 2031, said Dr. Tedros.

Pointing to several other steps taken to broaden the donor base, he said that the WHO has now mobilized 85% of the resources it needs for the base budget this biennium – 2026-27, adding that at one level, “we are in a better position than ever before at this stage of a biennium.”

However, the WHO chief said that because the majority of voluntary contributions remain earmarked, the WHO continues to see pockets of poverty, including for its work on emergency preparedness, anti-microbial resistance, health financing, climate resilience, determinants of health and more.

“And although 85% sounds good – and it is – the environment is very difficult and the remaining 15% will be hard to mobilise,” Dr. Tedros warned.

“If you had not approved the increase in assessed contributions, we would have been in a far worse situation than we are,” he told the Executive Board meeting.

This demonstrates why Member States must continue on the same path and approve the remaining increases, to secure the long-term stability, sustainability and independence of WHO – not only until 2031 but even beyond, he suggested.

“The story of 2025 is not one of austerity but resolve. It is the story of the people of this Organization serving the people of this world. They are the reason WHO is here, and the reason we will continue to be here. This is your WHO. Its strength is your unity. Its future is your choice,” he concluded. - TWN