By Dr Tedros Adhanom Ghebreyesus*
WHO Advances Global Health Despite US Aid Reductions
Geneva: 2025 was a year of stark contrasts for our organisation, as we all know. On one hand, it was a landmark year: the WHO Pandemic Agreement was adopted; the amended International Health Regulations entered into force; the next increase in assessed contributions was approved; and the United Nations General Assembly adopted an ambitious political declaration on noncommunicable diseases and mental health. On the other hand, it was undeniably one of the most difficult years in our Organization’s history. Significant cuts to our funding left us with no choice but to reduce the size of our workforce.
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Of course, WHO is just one part of a much bigger picture. Many other international organisations have been affected. And sudden and severe cuts to bilateral aid have also caused huge disruptions to health systems and services in many countries. I am proud that despite the challenges we faced, there are many achievements to celebrate.
In response to funding cuts, WHO is supporting many countries to sustain essential health services and to transition away from aid dependency towards self-reliance, based on domestic resources. One key tool for mobilising domestic resources is health taxes. That’s why WHO launched the 3 by 35 Initiative last year, calling on all countries to raise the real prices of tobacco, alcohol and sugary drinks by at least 50% by 2035. Last year alone, Malaysia, Mauritius, Slovakia, Sri Lanka and Viet Nam were among the countries that introduced or increased taxes on one or more of these products. Already this year, India introduced a new excise duty on tobacco, and Saudi Arabia introduced a tiered excise tax on sugary drinks. Last year, the Maldives became the first country to adopt a generational tobacco ban for people born in and after 2007. WHO also recognised Austria, Norway, Oman and Singapore for their efforts to eliminate trans fats from their food supplies. The Commission on Social Connection delivered the first global evidence-based framework on loneliness and social isolation. The WHO Alliance for Transformative Action on Climate and Health grew to more than 100 countries, helping them to build climate-resilient, low-carbon health systems. Member States also endorsed an updated Global Road Map on Air Pollution and Health, including a commitment to halve health impacts by 2040. And new data from the WHO/UNICEF Joint Monitoring Programme showed that one billion more people now have access to safely managed drinking water than a decade ago, saving an estimated 5 million lives.
Following cuts to bilateral aid, WHO developed guidance on responding to the health financing emergency, supporting countries including Cambodia, Ethiopia, Mozambique and Uganda. In December, we established the UHC [Universal Health Care] Knowledge Hub in Tokyo with the World Bank and the Government of Japan, which is now supporting the first cohort of eight countries through capacity-building, knowledge sharing, and by bringing ministries of health and finance together. The latest UHC Global Monitoring Report shows that 4.6 billion people still lack access to essential health services, and 2.1 billion people face financial hardship because of health costs.
Last year WHO supported 11 countries facing the most acute shortages to strengthen their national workforce strategies, contributing to commitments for nearly 100 000 new health worker jobs. Building the capacity of the global health workforce was one of the main reasons for establishing the WHO Academy in Lyon, with the support of the Government of France, which now brings together in one place our work on health workforce policy, strategy, data and advocacy, alongside learning. The Academy now offers more than 250 courses free of charge, in up to 20 languages, with more than 100 000 enrolments last year. A study of over 35 000 patients in 17 hospitals in Nepal, Uganda and Zambia showed a reduction in mortality of between 34% and 50% following the implementation of the WHO Academy Basic Emergency Care training.
We continue to support countries to strengthen their health data systems, including through the use of digital technologies and artificial intelligence. We expanded the Global Digital Health Certification Network to 82 countries, enabling 2 billion people to access their health records on national digital health wallets. And we have now rolled out ICD-11 to 132 Member States. Every day, our ICD systems receive around 3 million requests for information, improving data quality and generating insight into population health trends.
We also continue supporting countries to expand access to essential medicines. Last year, we prequalified 44 medicines, nine vaccines, 10 in vitro diagnostics, 21 medical devices, eight vector control products, and we performed 185 inspections of manufacturing sites. We updated the Essential Medicines List to include new medicines for cancer and GLP-1s for diabetes in people with obesity. We reviewed 5000 pediatric formulations to prioritise those that are optimised and age-appropriate for children. And we designated five more agencies as WHO Listed Authorities: Australia, Canada, Indonesia, Japan and the United Kingdom. This will help expedite regulatory processes and have medicines available in time. In addition, we recognised Ethiopia for reaching maturity level 3 for regulatory oversight of medicines and vaccines.
On immunisation, despite funding cuts, we protected the Global Measles and Rubella Lab Network, enabling our network of more than 740 labs to process more than 700 000 tests to detect and respond to measles outbreaks globally. We supported seven new countries to introduce malaria vaccines, bringing the total to 24, and we supported 15 more countries to introduce HPV vaccination to prevent cervical cancer. Since we launched the global call to action to eliminate cervical cancer in 2018, almost 75 countries have introduced HPV vaccination, meaning 65% of girls globally now live in a country with routine HPV vaccination.
In response to concerns about vaccine safety, WHO conducted an analysis of 31 studies in multiple countries over 15 years that showed once again that vaccines, including those containing thiomersal and aluminium adjuvants, do not cause autism.
Vaccines are also bringing us closer to the eradication of polio, with 41 cases of wild polio reported last year from just 24 districts in Pakistan and Afghanistan, down from 99 cases in 49 districts in 2024. And with partners WHO vaccinated over 600 000 children in Gaza, controlling the Strip’s first recorded polio outbreak in 25 years.
2025 was another year in which more countries eliminated neglected tropical diseases. Burundi, Egypt, Fiji, Mauritania, Papua New Guinea and Senegal eliminated trachoma, Guinea and Kenya eliminated sleeping sickness, and Niger became the first African country to eliminate river blindness. In addition, WHO certified Georgia, Suriname and Timor Leste as malaria-free; the Maldives became the first country to achieve triple elimination of mother-to-child-transmission of HIV, syphilis and hepatitis B; Brazil was validated for eliminating vertical transmission of HIV; and Botswana reached gold tier status on the path to elimination.
WHO also prequalified lenacapavir for HIV prevention and published guidelines on its use, supporting the first 14 countries to accelerate the rollout of this new tool that could change the trajectory of the HIV epidemic. Lenacapavir is the nearest thing we have to an HIV vaccine: a long-acting injectable antiretroviral taken every six months that has been shown to prevent almost all HIV infections in those at risk. It’s the first example of a new approach to develop prequalification and guidelines in parallel, not in sequence, to speed up equitable access to innovative new tools.
On TB, WHO supported countries to scale up rapid TB diagnostics and promoted shorter and more effective treatment regimens. And the TB Vaccine Accelerator is working with countries to prepare for the rapid integration of new TB vaccines into health systems, should they succeed in phase three trials.
Just as we supported countries to prevent and prepare for health emergencies, we also supported them to respond.
In 2025, WHO detected 1.2 million signals, assessed and verified about 500 threats, and supported countries to respond to 450 of those events, preventing disease spread and saving lives. You do not see this in the news because they were controlled, managed and contained. In total, we responded to 50 emergencies in 82 countries and territories last year.
We released US$ 29 million from the WHO Contingency Fund for Emergencies to support the rapid response to emergencies in 30 countries. And through the Global Outbreak Alert and Response Network – GOARN – we coordinated 59 deployments to support emergency response in 16 countries.
In addition to outbreak response, we also responded to the health needs of more than 25 million people affected by humanitarian emergencies in 33 countries.
In 2025, WHO verified 1350 attacks on health care in 19 countries and territories, causing 1981 deaths and 1168 injuries among health workers and patients. We launched a new global action plan and a new global network to strengthen clinical trials, with 34 major research institutions, advancing equitable research capacities around the world. We also launched a three-year project to modernise the way WHO prioritises, develops and disseminates our highest-priority guidelines.
This year, we are introducing a new case management system with AI capability and a new integrity hotline. Both will help to strengthen timely, high-quality investigations and provide safer channels for reporting, strengthening our internal justice.
I hope you will agree that despite the many challenges we have faced, your Organization has continued to deliver. We have designed, communicated and implemented the changes we have made based on the principles of transparency, fairness and humanity. By and large, the outcome was good. Although there are still a few issues to finalise, we have now largely completed the prioritisation and realignment. We have reached a position of stability, and we are moving forward.
It’s important to remember that although the cuts we faced last year were a shock, they were a shock we saw coming, and for which we have been preparing. When we began the WHO Transformation more than eight years ago, we identified our over-reliance on a handful of donors as a major risk, and we took several measures to address it. Most significantly, we proposed – and in 2022 the World Health Assembly approved – a plan to progressively increase assessed contributions to 50% of the base budget, from just 14% at the time. Member States approved the first increase in May 2023, the second increase last year, May 2025, and the next three increases are scheduled for approval in May 2027, May 2029 and May 2031. We also took a series of other steps to broaden our donor base, including establishing the WHO Foundation and conducting our first Investment Round, with your support.
Thanks to all these measures, we have now mobilised 85% of the resources we need for the base budget this biennium, 2026–27. At one level, we are in a better position than ever before at this stage of a biennium. However, because the majority of voluntary contributions remain earmarked, we continue to see pockets of poverty, including for our work on emergency preparedness, AMR, health financing, climate resilience, determinants of health and more. And although 85% sounds good – and it is – the environment is very difficult, and the remaining 15% will be hard to mobilise.
Although we have faced a significant crisis in the past year, we have also viewed it as an opportunity. It’s an opportunity for a leaner WHO to become more focused on its core mission and mandate, including in the context of the UN80 reform initiative. This means sharpening our focus on our core mandate and comparative advantage, doing what we do best – supporting countries through our normative and technical work – and leaving to others what they do best. WHO’s superpower is its convening power – the ability to bring together governments, experts, institutions, partners, civil society and the private sector under one umbrella.
We can see the difficulties of the past year as a setback, or we can choose to see them as the catalyst for the future of WHO. The story of 2025 is not one of austerity but resolve. It is the story of the people of this Organization serving the people of this world. They are the reason WHO is here, and the reason we will continue to be here.
*Excerpts from WHO Director-General’s opening remarks at the 158th session of the Executive Board – 2 February 2026.
