Podcast Summary:

The CGD Podcast – Pandemic Proof: Funding the WHO for Pandemic Preparedness
Date: December 12, 2024
Host: Center for Global Development (Guest Host: Pete Baker)
Guest: Katerina Boehmer, Assistant Director General for External Relations, Partnerships and Governance, WHO

Overview

This episode of "Pandemic Proof" delves into the critical issue of financing the World Health Organization (WHO) for pandemic preparedness. Pete Baker hosts Katerina Boehmer from WHO to discuss how recent reforms—like the historic increase in assessed contributions and the first-ever investment round—aim to make WHO’s funding more predictable, flexible, and diversified. The conversation highlights both progress and persistent obstacles in securing sustainable financing for WHO, explores the allocation of new funds, and offers candid assessments of risks ahead in a political and economic environment growing more challenging for global health.

Key Discussion Points and Insights

1. Historical Context & Current Funding Challenges

• WHO’s Dependence on Unpredictable, Volatile Funding:
  • WHO’s annual budget has historically been about $2.1 billion, "equivalent to that of Mount Sinai in New York" (03:23), spread thinly across 194 countries and 154 country offices.
  • Only "16% of the WHO funding came from so called assessed contributions," i.e., country membership fees; the vast majority (84%) was from voluntary contributions, mostly designated and from "just 10 donors" (03:23).
  • Voluntary contributions are typically short-term, with "over half" being one-year commitments, resulting in inefficiencies and instability for staffing and program planning.
  • Underfunding of pandemic preparedness has been a chronic problem, briefly remedied during COVID before returning to a “period of neglect” (03:23).

“Our goal in a summary is very simple. It's funding that's predictable, flexible and diversified. Because we cannot keep firefighting with funds that arrive only when the fire has already started.”
— Katerina Boehmer, [00:03], [06:54]

2. Recent Reforms and the Investment Round

• Historic Change:
  • In 2022, the World Health Assembly resolved to cover at least "50% of WHO's core budget by 2030" through assessed contributions—a significant shift away from reliance on voluntary funding (07:52).
• The Investment Round:
  • Launched in 2024, it aims to raise $7.1 billion for WHO’s 2025–2028 work program.
  • As of the G20 summit in Rio, $1.7 billion has been pledged (totaling $3.8 billion, including pre-existing commitments) (13:48).
  • Notably, "28 of these first-time pledges are from low or middle income countries," demonstrating a more diversified donor base (07:52).
• Progress & Caveats:
  • Increased political commitment and flexibility of funding.
  • Yet, “the risk of over reliance on a few large donors persists”—diversification and further development of innovative financing are needed (07:52).

“Flexibility and predictability... we estimate to have doubled our predictability. However, ...it’s still far from perfect.”
— Katerina Boehmer, [07:52]

3. Realities of Amount Raised vs. Ambitions

• Despite progress, there’s a major gap between funds raised and the $7.1 billion goal. Some funding remains in the pipeline, and South Africa will champion continued fundraising during their G20 presidency in 2025 (13:48).

“For us, this investment round, in a way, is not yet over. We still will add all the money that comes in between now and the World Health Assembly next year.”
— Katerina Boehmer, [13:48]

4. How New Funds Will Support Pandemic Preparedness

• Allocation:
  • Funds are matched to a pre-approved, bottom-up budget created jointly with member states (15:41, 21:22).
  • Key priorities include: strengthening surveillance, workforce capacity (with a 10 million health worker gap), and equitable access to countermeasures (15:41).
  • Investment round funds “plug gaps identified in the WHO health emergency appeal” and complement, but do not duplicate, other mechanisms such as the Contingency Fund for Emergencies, the Pandemic Fund, and the IMF’s Resilience and Sustainability Trust (15:41).
• Increasing Threats:
  • WHO responded to 39 graded emergencies as of October, and expects incidents to rise given ongoing global and climate challenges (15:41).

5. Distinct Funding Mechanisms Explained

• Contingency Fund for Emergencies:
  • Designed for immediate, flexible response—can deploy funds within 24 hours to a country hit by crisis (19:05).
• Investment Round/Core/Base Budget:
  • Pays for WHO’s core workforce and ongoing capabilities, allowing sustained preparedness and “readiness muscle” rather than emergency firefighting (19:05).
• Other Mechanisms:
  • Coordination is prioritized to avoid overlaps with efforts like the Pandemic Fund, which is particularly focused on surveillance and lab capability (21:22).

“The contingency fund…is a very flexible funding mechanism that…can use within 24 hours to basically give to a country that has a very acute crisis... this is really the early funding that enables us to be agile, fast...That’s not the purpose of the investment round at all.”
— Katerina Boehmer, [19:05]

6. Budget Development and Prioritization

• Inclusive, Bottom-up Process:
  • National priorities are identified by countries in collaboration with WHO country offices, aggregated regionally and globally (21:22).
  • Health systems strengthening is a current top priority, with pandemic preparedness gaining more traction post-COVID and MPOX (21:22).

“This bottom up approach of developing a budget has become now the norm and is very transparent…Pandemic preparedness…can easily get forgotten by countries because it’s not always front of mind.”
— Katerina Boehmer, [21:22]

7. Risks and Persistent Gaps

• Funding Shortfalls:
  • No major increase in overall funding for pandemic preparedness post-COVID, and shrinking ODA and national health budgets threaten progress (21:22).
• Call for Cohesion:
  • “In those times, it’s going to be even more important that we work closely with all partners and …stand together and get the job done.” (21:22)

Notable Quotes & Memorable Moments

• On Mission-Critical Funding:
  “Because we cannot keep firefighting with funds that arrive only when the fire has already started. This can make a huge difference for global health security going forward.”
  — Katerina Boehmer, [00:03], [06:54]

• On Assessed vs. Voluntary Contributions:
  “Only 16% of the WHO funding came from so-called assessed contributions… 84% of the funding came from voluntary contributions from various donors. The vast majority… over 70% actually came from just 10 donors.”
  — Katerina Boehmer, [03:23]

• On New Donors:
  “28 of these first time pledges are from low or middle income countries, representing a real shift in how WHO is funded…shows also the significant political commitment from these member states countries to WHO.”
  — Katerina Boehmer, [07:52]

• On Investment Round Funding Gap:
  “At this point, as of the Rio highlight G20 summit, we received US$1.7 billion… that brings our funding to a current total of 3.8 billion of the 7.1 billion we need.”
  — Katerina Boehmer, [13:48]

• On Emergency Funding Mechanisms:
  “The contingency fund for emergency is really distinctly different… can use within 24 hours to basically give to a country that has a very acute crisis… allows the very early response that is very often needed.”
  — Katerina Boehmer, [19:05]

• On Persistent Global Inequity & Needed Change:
  “If I could prioritize one change, I think it would be to institutionalize equitable global financing for pandemic preparedness. This means establishing a binding commitment for all countries to contribute to a global health security fund based on the country's capacities and similar to what we see in climate financing… Every day the world spends $7 billion fighting wars and preparing for them, and we need just a tiny portion and fraction of that to make our world safe from pandemics and outbreaks.”
  — Katerina Boehmer, [24:46]

Important Timestamps

• 00:03 — Funding should be predictable, flexible, diversified (Katerina Boehmer)
• 03:23 — Historical context: WHO's budget constraints and funding flaws
• 07:52 — Sustainable financing reforms and impact so far
• 13:48 — Reflections on the investment round fundraising gap
• 15:41 — Allocation of new funds to pandemic preparedness and complementarity with other mechanisms
• 19:05 — Distinction between emergency fund and investment round/core funding
• 21:22 — How WHO’s budget process works: bottom-up and country-driven
• 24:46 — “One change” for global pandemic financing: binding, equitable global fund

Tone & Atmosphere

The conversation is frank, ambitious, and collaborative, balancing cautious optimism about recent funding reforms with realism about persistent and future challenges. Boehmer is open about both improvements and remaining shortcomings, and unafraid to call for bolder institutional changes comparable to those in climate finance.

Recap

The episode spotlights critical advances in WHO financing—for the first time, assessed contributions are set to make up half the core budget, new donors are entering the fold, and investment mechanisms are increasingly focused on flexibility and readiness. Yet, significant risks and funding gaps remain. The key takeaway: institutionalizing equitable, binding global financing for pandemic preparedness is urgently needed to break the current cycle of panic and neglect, and to future-proof global health security for all.