The World Health Organization (WHO) is one of the most important agencies in global health. It helps fight diseases, supports countries during health emergencies like pandemics, and works to improve healthcare worldwide. But behind the scenes, there’s a funding problem—and one name keeps coming up: the Bill & Melinda Gates Foundation.
Who Pays for the WHO?
The WHO gets its money from two main sources:
- Assessed Contributions – These are membership fees paid by countries. They’re based on a country’s wealth and are agreed on every two years.
- Voluntary Contributions – These come from countries, charities, NGOs, and private donors, and can be used for specific programs or emergencies.
Here’s the catch: assessed contributions make up less than 20% of WHO’s budget. The rest—over 80%—is voluntary. This means WHO has very little control over how most of its money is spent because donors usually specify what the funds should be used for.
Enter the Gates Foundation
The Bill & Melinda Gates Foundation is WHO’s second-largest donor (after the United States). It provides more than 88% of all philanthropic donations to the organization. Other big names like the Bloomberg Family Foundation and the Wellcome Trust give too, but their contributions are much smaller.
This has raised concerns. Critics say that when one private foundation gives such a huge share of the funding, it gains too much influence. It’s like the saying goes: "He who pays the piper calls the tune."
Why Is This a Problem?
According to global health experts, the Gates Foundation’s generosity—while well-intended—gives it a louder voice in setting priorities. WHO has ended up focusing on projects that align with donor preferences, like polio eradication, which has been a top priority for the Foundation.
Meanwhile, broader issues like universal health coverage or pandemic preparedness often struggle to get funding, even though they’re essential. As one health law expert put it, WHO can't truly lead global health if it doesn’t control how its money is used.
How Did We Get Here?
The issue started decades ago. In the 1980s and 1990s, countries froze their assessed contributions. As WHO’s responsibilities grew—with outbreaks like Ebola, COVID-19, and monkeypox—it didn’t get a matching boost in its core funding. To keep up, it turned to voluntary donors, which now dominate its budget.
This leaves WHO stretched thin and under pressure to follow the money, not necessarily the science.
What’s the Solution?
The Gates Foundation itself has admitted it’s not ideal for a private charity to be one of WHO’s largest funders. Its CEO, Mark Suzman, said last year, “It’s not right for a private philanthropy to be one of the largest funders of multinational global health efforts.”
So, what’s the alternative?
Raise membership dues: Countries could agree to increase their assessed contributions, giving WHO more freedom to spend where it sees the most urgent need.
Create new funding sources: Some experts suggest a global health tax. Industries that benefit from a healthy, stable world—like airlines, sports, or finance—could contribute a small share to fund pandemic preparedness and health systems.
Design a WHO for the 21st century: Public health professor Kelley Lee argues that WHO was built for a post-WWII world. Today’s challenges call for new laws, stronger decision-making powers, and more stable funding.
Final Thoughts
WHO plays a critical role in keeping the world safe and healthy. But to do that effectively, it needs independent, reliable funding—not just well-meaning donations from a few wealthy donors.
Until governments step up and take more responsibility, the WHO will continue to rely on groups like the Gates Foundation. While that support has done a lot of good, it also highlights how global health is being shaped behind closed doors by those with the deepest pockets.
Source:
https://www.who.int/about/funding/contributors/usa
https://www.gatesfoundation.org/ideas/articles/2023-gates-foundation-an…
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