Some good news! A summary of the last week's WHA meeting reveals an energetic push by small nations for national health sovereignty, and less WHO governance
Worldwide, public health governance has lost its head of steam, thanks to many of us revealing its real intentions
This article was hosted by Tom Frieden’s Think Global Health and written by Priti Patnaik, founder of Geneva Health Files. Both are big supporters of global health and the WHO. Which makes what they have to say even more delicious.
The piece starts like this:
A year after official development assistance for health began sliding into a historic cascade [PDF], coupled with political strife surrounding vaccination and sexual and reproductive rights, global health institutions such as the World Health Organization (WHO) have been forced to calibrate their mandates.
Forced vaccinations were not popular, and the WHO’s bizarre emphasis on universal access to to birth control and abortion as a necessary part of primary healthcare was similarly unpopular, especially in Africa, where having lots of children is expected. And Africa has not forgotten allegations that a WHO clinical trial of a tetanus vaccine in Kenya is alleged to have contained HCG (human chorionic gonadotrophin) which sterilized the women who received the vaccine. Oddly, the trial was only conducted in young women.
Even though the WHO budget was slashed to $2.1 billion/year for 2026 and 2027, it remains $1 billion short. Compare this to WHO’s revenue of $3.1 Billion in 2025, and it is obvious that nearly half its funds have dried up.
The article concludes hopefully, from my perspective:
Last week, the World Health Assembly adopted a decision that will empower WHO to host a joint process [PDF], led by member states and in concert with global health partners, to support reforms of the global health architecture.
The objective is to develop options and recommendations for reforms, while drawing on existing endeavors and relevant elements of the UN80 Initiative. The DG is expected to release a summary report by next year.
Based on statements made at the assembly, countries are eager for a new architecture to reference the expansion of national health sovereignty and regional capacities; reflect on changing disease burdens and health risks; consider the rapid evolution of science, AI, and digital technologies; and address contractions in health financing.
The effort will be to restore power imbalances,
[I think she means fix power imbalances, a recurring theme in these venues]
fragmentation, and duplication. Member states are urging the elevation of country ownership and leadership in reaction to the expansion in the number of large-scale health actors over the last several decades, creating too much complexity in the global health landscape. Initiatives such as the Accra Reset seek to put developing countries in the driver’s seat. It is not clear yet how reform efforts outside WHO will tie to the member-state-led process.
Critics are less hopeful that WHO’s initiative for reform will be a meaningful one. The WHO process shies away from touching the mandates of existing institutions.
Haiti, a new member of the WHO Executive Board, said that countries facing vulnerabilities must still be able to fully participate in global health governance and decision-making.
Starve the beast, and it has no choice but to cooperate.
Best comment of the day . “ Starve the beast, and it has no choice but to cooperate.”
I like the fact that they are now openly referring to their layers of policy tyranny as “ Architecture “ Brick by Brick they have been building their digital prison and now that it has walls and a roof that shows its form, we can and will take a wrecking ball to it.