The little known human cost of WHO-led global health policy
The march of democracy-sapping multilateral global bodies that undermine state sovereignty continues unabated. Decisions made by the World Health Organisation in Geneva ripple across the world’s most vulnerable health systems. Here are six examples where WHO-led or WHO-endorsed policy is causing measurable harm — particularly to low- and middle-income countries (LMICs).
1. Debt is gutting health budgets in the world’s poorest countries
The IHME’s Financing Global Health report has found that health budgets in low- and middle-income countries have been cut by 8.9 per cent — this is the direct result of debt repayments on loans taken by countries to fund WHO-endorsed Covid-19 responses. Such nations already have fragile systems that carry heavy disease burdens. The cuts are causing direct, measurable harm. Even before Covid academic research had shown that by 2019, 54 LMICs were already spending more on servicing debt to foreign creditors than on their own health services — a figure that has worsened since the pandemic. The worsening debt results in cut to health services.
2. Aid budgets have been diverted away from basic health and nutrition
During Covid, Official Development Assistance (ODA) was heavily redirected toward pandemic preparedness — a shift WHO championed and continues to push. Analysis by Brookings found that ODA for basic health care fell by 34.5 per cent in 2020, while funding for nutrition declined by over 10 per cent. Those pre-Covid allocations have never recovered. The OECD has since confirmed that while ODA for pandemic preparedness grew 30 per cent annually between 2019 and 2022, basic health care and nutrition programmes fell across the same period.
The consequences are threefold:
- Known disease burdens are being neglected in favour of pandemic preparedness — an approach that is increasingly biomedical and security-focused rather than preventative or addressing the health pressures now.
- Global health aid has shifted away from holistic health promotion toward narrow, externally directed programmes that often ignore local needs. Decisions on healthcare priorities are being moved further away from where the need is greatest.
- Weaker health systems mean weaker resilience — to everyday illness and to future crises. We are treating symptoms, not causes and preparing for healthcare demands that may never transpire or may well be different from what does transpire.
3. Developing countries say WHO is steamrolling them on the Pandemic Agreement
The Africa Group, Friends of Equity, and a number of Latin American and East Asian countries have accused WHO of prioritising its own reputation over genuine member state consensus. The result is a stark divide: these countries on one side, against the EU, G7 and large pharma nations on the other — with WHO seen as siding with the latter, naturally.
Opposition delegations are under resourced and report that WHO is deliberately managing the pace of negotiations to prevent them from organising effectively — including introducing new texts for approval only hours before WHA votes, in violation of WHO’s own rules.
The International Health Reform Project’s report names the contradiction squarely. The WHO has spent years publicly committing to decolonising global health, acknowledging that the field has long concentrated money and decision-making in wealthy-country institutions. Research published in The Lancet Global Health argued that the exclusion of subsidiarity from the agreement’s governance architecture was a direct missed opportunity to act on that commitment. What the Global South received instead were aspirational provisions, carve-outs protecting pharmaceutical industry interests in high-income countries, and a series of deferrals.
And yet the IHRP is clear that its purpose is not to dismantle international health cooperation — but to make it function as advertised.
4. The WHO’s influence creates dependency, not self-reliance
The WHO sets global health policy that is then adopted — with conditions — by the IMF, World Bank, and major global health funds. This chain of influence has created dependency cycles in which recipient countries have diminishing say over their own health programmes while becoming increasingly reliant on externally imposed solutions.
This is widely understood to produce poor health outcomes. WHO’s funding model is central to the problem: roughly 80 per cent of its budget comes from voluntary, earmarked contributions — meaning donor priorities, not member state needs, drive policy.
5. Decades of progress on malaria, TB and polio have been reversed
Progress on malaria and TB has been significantly set back by resource shifts during Covid. Modelling published in The Lancet Global Health found that deaths from malaria, TB and HIV could increase by up to 36 per cent, 20 per cent and 10 per cent respectively due to pandemic-related service disruptions.
Subsequent analysis confirmed that malaria incidence reversed its downward trend that it had enjoyed from 2019 to 2021. Despite acknowledging this, the WHO is accused of paying lip service to the problem while continuing to prioritise pandemic preparedness as a more high-profile agenda.
In some countries, polio programmes have not resumed since 2020. Staff redeployed to administer Covid vaccines have not returned. The long-term health and economic costs are significant.
6. Africa says WHO is blocking its path to self-determination
When the African CDC applied to become an implementing agent for the World Bank’s Pandemic Fund — a move designed to build African capacity and reduce dependency on external actors — the WHO blocked the application. Devex.com reported that the Africa CDC said this had considerably constrained its ability to work toward greater health security on the continent.
The African Centre for Disease Control and the African Union responded formally, with Africa CDC issuing a public statement calling for decisive action to admit it as an implementing entity and urging equity-based, transparent decision-making. The perception among African member states is that WHO’s institutional interests depend on keeping Africa dependent. This episode directly fed the current impasse in Pandemic Agreement negotiations. Returning responsibility to sovereign states is the best answer.
The simple truth is that If global health institutions genuinely aim to help countries help themselves, current practice is not just falling short — it is actively working against that goal. The centralising grip of the WHO needs to be loosened, not tightened like a garrotte.
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Pictured, the WHO headquarters in Geneva.
