World Health Assembly opens amid high-stakes pandemic treaty vote, global funding crisis

The 78th World Health Assembly opened on Monday with a broad appeal to global solidarity, as delegates from around the world gather in Geneva to confront mounting health, climate, and financial challenges – and finalise a global treaty to head off the next pandemic, according to the official UN website.

Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, urged Member States to remain focused on shared goals even amid global instability.

“We are here to serve not our own interests, but the eight billion people of our world,” he said in his keynote address at the Palais des Nations. “To leave a heritage for those who come after us; for our children and our grandchildren; and to work together for a healthier, more peaceful and more equitable world. It’s possible.”

The Assembly, WHO’s highest decision-making body, runs through 27 May and brings together delegations from 194 Member States under the theme One World for Health.

This year’s agenda includes a vote on the intensely negotiated Pandemic Agreement, a reduced budget proposal, and discussions on climate, conflict, antimicrobial resistance, and digital health.

A central item on the Assembly’s agenda is the proposed WHO pandemic accord, a global compact aimed at preventing the kind of fragmented response that marked the early stages of COVID-19.

The treaty is the result of three years of negotiations between all WHO Member States.

“This is truly a historic moment,” Dr Tedros said. “Even in the middle of crisis, and in the face of significant opposition, you worked tirelessly, you never gave up, and you reached your goal.”

A final vote on the agreement is expected on Tuesday.

If adopted, it would mark only the second time countries have come together to approve a legally binding global health treaty under WHO’s founding rules. The first was the Framework Convention on Tobacco Control, adopted in 2003 to curb the global tobacco epidemic.

In his address, Tedros presented highlights from WHO’s 2024 Results Report, noting both progress and persistent global health gaps.

On tobacco control, he cited a global one-third reduction in smoking prevalence since the WHO Framework Convention entered into force two decades ago.

He praised countries including Côte d’Ivoire, Oman, and Viet Nam for introducing stronger regulations last year, including plain packaging and restrictions on e-cigarettes.

On nutrition, he pointed to new WHO guidelines on wasting and the expansion of the Tobacco-Free Farms Initiative in Africa, which has supported thousands of farmers in transitioning to food crops.

He also emphasised WHO’s growing work on air pollution and climate-resilient health systems, including partnerships with Gavi and UNICEF to install solar energy in health facilities across multiple countries.

On maternal and child health, Tedros noted stalled progress and outlined new national acceleration plans to reduce newborn mortality. Immunisation coverage now reaches 83 per cent of children globally, compared to less than 5 per cent when the Expanded Programme on Immunisation was launched in 1974.

“We are living in a golden age of disease elimination,” he said, citing the certification of Cabo Verde, Egypt, and Georgia as malaria-free; progress in neglected tropical diseases; and Botswana’s recognition as the first country to reach gold-tier status in eliminating mother-to-child transmission of HIV.

Turning to WHO’s internal operations, Tedros offered a stark assessment of the organisation’s finances.

“We are facing a salary gap for the next biennium of more than US$ 500 million,” he said. “A reduced workforce means a reduced scope of work.”

This week, Member States will vote on a proposed 20 per cent increase in assessed contributions, as well as a reduced Programme Budget of $ 4.2 billion for 2026–2027, down from an earlier proposal of $ 5.3 billion. The cuts reflect an effort to align WHO’s work with current funding levels while preserving core functions.

Tedros acknowledged that WHO’s long-standing reliance on voluntary earmarked funding from a small group of donors had left it vulnerable. He urged Member States to see the budget shortfall not only as a crisis but also as a potential turning point.

“Either we must lower our ambitions for what WHO is and does, or we must raise the money,” he said. “I know which I will choose.”

He drew a sharp contrast between WHO’s budget and global spending priorities: “US$ 2.1 billion is the equivalent of global military expenditure every eight hours; US$ 2.1 billion is the price of one stealth bomber – to kill people; US$ 2.1 billion is one-quarter of what the tobacco industry spends on advertising and promotion every single year. And again, a product that kills people.”

“It seems somebody switched the price tags on what is truly valuable in our world,” he said.

The Director-General also detailed WHO’s emergency operations in 2024, which spanned 89 countries. These included responses to outbreaks of cholera, Ebola, mpox, and polio, as well as humanitarian interventions in conflict zones such as Sudan, Ukraine, and Gaza.

In Gaza, he said, WHO had supported more than 7,300 medical evacuations since late 2023, but over 10,000 patients remained in urgent need of care.

The WHO chief closed with a look at the agency’s future direction, shaped by lessons from the COVID-19 pandemic. He highlighted new initiatives in pandemic intelligence, vaccine development, and digital health, including expanded work on artificial intelligence and support for mRNA technology transfer to 15 countries.

WHO has also restructured its headquarters, reducing management layers and streamlining departments.

“Our current crisis is an opportunity,” Dr Tedros concluded. “Together, we will do it.”