This article was first published on the website of the Global Health Hub Germany on Nov. 20, 2024. This is a revised version after new data was published. Written by Christoph Benn and Rafael García.
On November 19 at the conclusion of the G20 Summit in Rio de Janeiro, the World Health Organization announced the preliminary outcome of its first-ever Investment Round (IR) — a new approach to mobilise “predictable and flexible resources” for its core work over the next four years (2025-2028). Brazilian President Lula da Silva and WHO Director-General Dr. Tedros reported a total of US$3.8 billion in pledges, funding agreements and partnerships, covering 53% of the IR’s US$7.1 billion funding target. This is a significant achievement in contrast to 2020 when initially WHO had only 17% of funding secured at the beginning of its previous strategy. A broad group of countries supported the process by co-chairing the IR together with Brazil: France, Germany, African Union, Kingdom of Saudi -Arabia, Norway, Indonesia and South Africa.
Although leaders still have time in the coming months and years to make pledges and further strengthen WHO’s finances, the significance of the current commitments goes beyond the headline figures. A deeper analysis reveals notable results and offers key insights into the success of future resource mobilisation efforts in 2025 and the advancement of new, sustainable funding models for WHO and other global health initiatives.
WHO’s IR high-level figures
The following analysis is based on WHO’s commitments data as shown on Nov. 26, 2024 (14h00 CET).
The IR attracted new commitments from 70 donors in total (one is not included in the available data) amounting to US$1.65 billion. Out of the 69 disclosed pledges, 54 were sovereign donors (78% of disclosed contributors), 11 were philanthropy and private sector entities (16%), and 4 were multilateral organisations (6%).
In terms of the disclosed pledged amounts — almost US$1.65 billion —, sovereign donors committed US$1.41 billion equaling 86% of the total. Philanthropies and the private sector contributed US$200.5 million (12%), and multilateral entities pledged US$38 million (2%).
The top ten contributors to the IR provided 83% of the total pledges.
Sovereign donors’ pledges under the microscope
A closer look at sovereign donors shows remarkable results. To start, from WHO’s 194 Member States, 53 countries made pledges, representing 27% of its membership. By WHO region, Africa had the highest number of contributing countries (18), while Europe pledged the largest amount. The highest participation per region was observed in the Western Pacific Region (WPRO), with 14 of its 27 countries (52% of the region’s members).
When it comes to leading economies, 8 members of the G20 matched their stated commitments to global health and WHO with a pledge: Australia, China, Germany, Indonesia, South Africa, Türkiye, United Kingdom, and the European Union. Out of the 38 members of the OECD — which represent about 60% of the world’s GDP — 15 (39% of its members) pledged: Australia, Denmark, Estonia, Finland, Germany, Greece, Ireland, Latvia, Luxembourg, Netherlands, Norway, Slovenia, Spain, Türkiye, and the United Kingdom.
WHO also reported that 39 countries pledged additional financial support beyond their assessed contributions for the first time, which is a remarkable achievement. Moreover, it is crucial to evaluate all pledges not only in absolute terms but also in relation to WHO’s assessed contributions, which are calculated through a fair-share formula. This formula considers factors such as national wealth and debt, reflecting each country’s overall capacity to contribute and global health efforts.
From this perspective, while low-income countries’ pledges accounted for 0.4% of the total, they were also equivalent to 10.1 times their combined assessed contributions. In contrast, high-income sovereign donors contributed 94% of the total, but representing 2.9 times their aggregated assessed contributions.
Notably, 27 countries committed amounts exceeding at least double their assessed contributions for the 2024–2027 period, demonstrating their prioritisation of health investments. Particularly remarkable were the commitments from Timor Leste, Luxembourg, and Niger, which pledged 43.6, 33.5, and 29 times their assessed contributions, respectively.
Finally, compared with the Global Fund’s last replenishment—another crucial global health initiative—WHO’s IR had a similar number of sovereign donors. In 2022, 51 countries and the European Union committed to contributing to the Global Fund, while 53 countries and the European Union pledged financial support for WHO’s IR for now.
Given that this pledging moment was the first after the US election and in a context of significant cuts in several major donor countries to their international cooperation budgets, it is worth to analyse the outcome of the WHO in more detail and look for lessons learned for other upcoming resource mobilization campaigns in health and other sectors.
Our five takeaways for WHO and global health financing
- Bringing on board non-traditional donor countries is crucial. WHO’s Investment Round (IR) has been a successful resource mobilisation effort, engaging a broad donor base beyond the traditional high-income countries that typically provide official development assistance. In this round, 53 countries, representing 27% of WHO’s membership and spanning five of its six regions, pledged financial contributions. There are specific reasons why the commitments from the PAHO regions are considered differently.
- Size matters, but not only in absolute terms. While most pledged funds (80%) come from high-income countries, it’s commendable that many low- and middle-income countries (LMICs) have more than doubled their assessed contributions. Their pledges highlight the value these countries place on supporting WHO and practising global solidarity, indicating a growing willingness to explore more ambitious international cooperation and financing models.
- Reinforcing health as a global public good. There is widespread agreement among WHO members that healthy societies are essential for global security and stability. However, there remains a need to strengthen the case for equitable contributions to health as a global public good and to bolster global solidarity—especially from the major economies.
- Sustainability remains an open challenge. While the IR marks a pioneering step towards the sustainable and predictable funding of WHO, efforts must continue to fill the remaining gap and appeal to member states who have yet to announce their commitments beyond the Assessed Contributions.
- A commitment to explore a Global Public Investment model. WHO is already a step ahead in moving towards a model in which all member states contribute based on their capacities. WHO’s assessed contributions formula aligns with GPI principles (all countries contribute, all countries benefit, all countries decide) by defining each country’s fair share. With the IR results, WHO now has a solid foundation for further exploration of models and complementary formulas that could enhance governance, improve financial predictability, and support a sustainable, fair and equitable financing structure that addresses remaining gaps and benefits all countries and people — All for Health, Health for All.
Acknowledgements:
The authors thank Nana Nyama Danso for her support in elaborating on this analysis.
Header image: President of Brazil H.E. Luiz Inácio Lula da Silva, Minister of Health Nísia Trindade and WHO Director-General Dr Tedros Adhanom Ghebreyesus at the G20 Leaders’ Summit during an event of support to WHO’s Investment Round, Rio de Janeiro, 19 November 2024. Credit : PAHO / WHO / Karina Zambrana