The financial sustainability of the World Health Organization and the political economy of global health governance: a review of funding proposals
Open Access
- 29 November 2018
- journal article
- review article
- Published by Springer Science and Business Media LLC in Globalization and Health
- Vol. 14 (1), 1-11
- https://doi.org/10.1186/s12992-018-0436-8
Abstract
The World Health Organization (WHO) continues to experience immense financial stress. The precarious financial situation of the WHO has given rise to extensive dialogue and debate. This dialogue has generated diverse technical proposals to remedy the financial woes of the WHO and is intimately tied to existential questions about the future of the WHO in global health governance. In this paper, we review, categorize, and synthesize the proposals for financial reform of the WHO. It appears that less contentious issues, such as convening financing dialogue and establishing a health emergency programme, received consensus from member states. However, member states are reluctant to increase the assessed annual contributions to the WHO, which weakens the prospect for greater autonomy for the organisation. The WHO remains largely supported by earmarked voluntary contributions from states and non-state actors. We argue that while financial reform requires institutional changes to enhance transparency, accountability and efficiency, it is also deeply tied to the political economy of state sovereignty and ideas about the leadership role of the WHO in a crowded global health governance context.Keywords
Funding Information
- Faculty of Medicine, McGill University
This publication has 62 references indexed in Scilit:
- International organizations as collective agents: Fragmentation and the limits of principal control at the World Health OrganizationEuropean Journal of International Relations, 2013
- Governance Challenges in Global HealthThe New England Journal of Medicine, 2013
- WHO signals intent to trim sailsCMAJ : Canadian Medical Association Journal, 2011
- Political Context of the World Health Organization: Sugar Industry Threatens to Scupper the WHOInternational Journal of Health Services, 2003
- WHO in 2002: Have the latest reforms reversed WHO's decline?BMJ, 2002
- “The Worst of Both Worlds”: The Management Reform of the World Health OrganizationInternational Journal of Health Services, 2001
- WHO's Slow Road to Funding ReformScience, 1998
- WHO at country levelThe Lancet, 1998
- WHO and the effects of extrabudgetary funds: is the Organization donor driven?Health Policy and Planning, 1996
- What future WHO?Health Policy, 1994