The Brazilian government is opposing the idea presented in Geneva to increase the budget of the WHO, the World Health Organization, by 50%. The project, defended by the summit of the main health agency in the world, is supported by European and African governments. But it faces strong resistance in regions such as the Americas.
Under the proposal, the 50% budget increase would allow the WHO to have an extra $1.2 billion to fight outbreaks, epidemics and address public health challenges.
Government contributions are mandatory. Each country pays based on a calculation that includes the size of its GDP, development conditions and other factors. In the Brazilian case, the contribution to the WHO reaches US$ 15 million per year, which places the country in seventh place among the largest contributors.
In recent years, however, Brazil has struggled to pay its contributions.
At the height of the first year of the health crisis, in 2020, governments demanded that the work of the WHO undergo a kind of audit and that reforms be proposed. The work concluded that, indeed, changes need to occur. But the agency would need to be beefed up in its budget to be able to fulfill its mandate. Today the budget is equivalent to that of a medium-sized hospital in the USA.
Over the past few months, several developing countries that could benefit from more WHO resources have shown interest in supporting the project.
To try to convince the main donors, the idea is that the increase will take place over six years, starting in 2024. At the end of the transition period, the agency would have a base budget of US$ 2.1 billion, in addition to of specific donations and program supplements.
Internally, the WHO fears that, without this increase in resources, the coming years will witness a gradual marginalization of the institution. Another scenario is that private donors end up dominating the agency’s agenda. Today, the Gates Foundation is the organization’s biggest donor, with $775 million in the 2022 and 2023 budget. The problem is that only $200 million goes to the regular budget. The rest is used based on guidance from the Gates Foundation.
But, despite the pressure to increase resources, governments claim that the institution is not transparent enough or efficient in its management to justify an increase in public money.
At a meeting this Tuesday (25th), in Geneva, Itamaraty took the floor to justify its position. For the government, the debate on strengthening the WHO needs to be based on “new premises”. That is, in a new budget proposal.
Itamaraty considers that any decision on the budget increase will only occur after decisions are made on efficiency gains, cost reductions, governance and transparency.
According to the government, many countries are still dealing with waves of Covid-19 contamination and the economic and social impact of the pandemic is profound.
Brazil is not alone in its refusal to talk about the increase, with no guarantees of reforms. Japan and other governments also considered the proposal a sustainable step, demanding greater transparency from the multilateral bureaucracy.
At the end of the meeting, the chairman of the working group that had been established to debate the budget increase admitted that there was no consensus. Bjorn Kummel, from Germany, mediated the negotiating process and indicated that a significant number of countries supported the proposal, while others wanted the increase to be even greater.
But he regretted that one group remained reluctant. Kummel warned that the world may not have a gap anytime soon to promote resource change at the WHO. According to him, if not even a pandemic has opened that window, potentially there won’t be a second chance.
For him, keeping the budget as it is is “leaving the WHO vulnerable and fragile to prevent a new (health) crisis” in the future. According to the German, without new resources, the role of the WHO will shrink.
“What we are debating is not a budget. But the future of the WHO and whether it can fulfill its mandate”, he added, insisting that the current level of funding is “unacceptable”.