Hundreds of World Health Organization (WHO) officials will join donors and diplomats in Geneva from Monday with one question dominating their minds - how to deal with crises from monkeypox to cholera without its main funder, the United States (US), Reuters reports today.
The annual assembly, which includes week-long sessions, votes and policy decisions, typically showcases the scale of this United Nations (UN) agency that was established to combat disease outbreaks, approve vaccines and support health systems around the world.
US President Donald Trump began the year-long process of leaving the WHO with an executive order on his first day in office in January.
"Our goal is to focus on high-value things," Daniel Thornton, WHO's director for coordinated resource mobilization, told Reuters.
What those "high value items" will be is up for discussion.
Health officials said WHO's work to provide guidance to countries on new vaccines and treatments for conditions from obesity to HIV would remain a priority.
A WHO slide show for the event, distributed to donors and seen by Reuters, suggests that work on approving new drugs and responding to outbreaks would be protected, while training programs and offices in wealthier countries could be closed.
The US provides about 18 percent of WHO's funding.
"We have to make do with what we have," said one Western diplomat who asked to remain anonymous.
Staffing has been on the rise - management and budget cuts - since Trump's January announcement in a flurry of directives and aid cuts that have disrupted a range of multilateral pacts and initiatives.
The US remains a member of the WHO - its flag still flies outside its headquarters in Geneva - until its official departure date of January 21, 2026.
Trump, who accused the WHO of mishandling Covid, which the organization denies, muddied the waters a few days after his statement by saying he might consider rejoining the agency if its staff "cleaned up."
But global health envoys say there has been little sign of a change of heart since then. So the WHO is planning to live with a $600 million budget gap this year and a 21 percent cut over the next two years.
As the US prepares to exit, China will become the largest provider of government fees - one of the main streams of funding for the WHO besides donations.
China's contribution will rise from just over 15 to 20 percent of the total state tax in line with an overhaul of the financing system agreed in 2022.
"We have to adapt to multilateral organizations without Americans. Life goes on," Chen Xu, China's ambassador to Geneva, told reporters last month.
Others suggested that this might be the time for an even broader overhaul, rather than continuity under a reconstructed hierarchy of supporters.
“Does WHO need all its committees? Does it need to publish thousands of publications every year?” said Anil Soni, executive director of the WHO Foundation, an independent fundraising body for the agency.
He said the changes have led to a reexamination of the agency's operations, including whether it should focus on details like purchasing gasoline during emergencies.
There was also an urgent need to ensure that key projects did not fall through during the current crisis. That meant going to donors with vested interests in those areas, including pharmaceutical companies and philanthropic groups, Soni said.
The ELMA Foundation, which focuses on children's health in Africa with offices in the US, South Africa and Uganda, has already recently stepped in with $700 million for the Global Measles and Rubella Laboratory Network known as Gremlin - more than XNUMX laboratories that monitor infectious disease threats, he added.
Other business at the assembly includes approving a historic agreement on how to deal with future pandemics and raising more money from donors.
But the focus will remain on funding within the new world order. Ahead of the event, the WHO manager sent an email to staff asking them to volunteer, without additional pay, as ushers.
Bonus video:
