The 78th World Health Assembly and the future of global health: can global health cooperation outpace converging crises?

The 78th World Health Assembly (WHA78) takes place amid deep and intersecting global crises: from climate collapse and deepening inequality to austerity and resurgent authoritarianism. Environmental destruction threatens lives, social protections are eroded, and far-right leaders attack rights in favor of profit. Armed and genocidal violence rages in Africa and West Asia, while militarization spreads across Europe under the guise of “security.”

These conditions are not inevitable: they are the result of decades of political decisions and economic policies that prioritize capital accumulation over care and equality. Austerity, privatization, and deregulation have eroded the foundations of health and justice. They’ve also hollowed out the institutions meant to safeguard public global health, including the World Health Organization (WHO).

This year’s Assembly meets at a pivotal crossroads: will global health continue to serve the interests of the powerful, or can the WHO be reclaimed as a truly democratic institution that centers justice, rights, and solidarity? The choice is still open, but not for long. The WHA78 must rise to this historic challenge. Civil society, member states, and communities must demand a bolder path forward.

WHO financing: who pays, who decides?

At the heart of the crisis facing the WHO is the issue of financing. Created to uphold the fundamental right to health, the WHO was envisioned as a global public good, an institution governed by its member states and accountable to the people. Health, as defined in the WHO Constitution, is “a state of complete physical, mental and social well-being,” not merely the absence of disease. Yet in a world of climate crises, pandemics, and globalized risks, the WHO is being asked to do more with less.

The organization’s financial instability has been years in the making. Since the 1990s, the proportion of voluntary, earmarked contributions from private actors and specific countries has steadily increased. This undermined the WHO’s independence and turned it into a fragmented, donor-driven body. The exit of the United States under President Donald Trump left a gaping hole in the WHO’s budget. Yet the total cost to fill this gap is shockingly low: just  USD 3 million per country. The fact that this has not yet happened reflects a political crisis.

Read more: Trump bids WHO goodbye: what comes next?

For years, the WHO Director-General’s plea to member states over restrictive earmarked funding has followed a familiar script. This year, Dr. Tedros Adhanom Ghebreyesus took a harder line, contrasting the organization’s modest budget with the staggering sums spent on war and death as he asked for  USD 2.1 billion per year to fund its life saving core programs.  “USD 2.1 billion is what the world spends on militaries every eight hours,” he told the Assembly. “Somehow, humanity has lost sight of what truly matters.”

If countries stepped up to fully fund the WHO through unearmarked assessed contributions, they could reclaim control from corporate and philanthropic interests and restore the organization’s capacity to address structural determinants of health. As WHA president Dr. Teodoro Javier Herbosa warned: “The cost of inaction is counted in lives.” WHA78 must not shy away from this truth. Without bold steps on financing, meaningful reforms of WHO are impossible.

Emergencies and the technocratic trap

One of WHO’s core and historic roles is to function as an executive and governing body during health emergencies. Following the devastation of the COVID-19 crisis, the WHA78 is discussing the Health Emergency Prevention, Preparedness, Response and Resilience (HEPR) framework. This framework guides Member States to build capacity and the infrastructure to stay true to the agreements of the Pandemic Accord and act effectively in the case of other health emergencies. It emphasizes advances in surveillance systems, countermeasures, and coordination. The framework also focuses on technocratic and biomedical solutions: it fails to name and address the root causes of health emergencies.

COVID-19 was a social and political catastrophe. The failures of vaccine inequity, the hoarding of resources by wealthy nations, and the sidelining of low-income countries from decision-making laid bare the deep injustice at the heart of global health governance. Real preparedness means more than having laboratories and stockpiles. It requires addressing the root causes: poverty, exclusion, environmental destruction, and colonial legacies.

Global health must stop treating symptoms and start curing systems. WHA78 must take a stand against the commodification of emergency response.

The genocide in Gaza and the politicization of health

A rhetorical trap lies ahead when it comes to the narrative on health in Palestine, one where member states imply the politicization of the WHA. Yet, health is and always has been inherently political. In Gaza, the health system is being deliberately destroyed. More than 1,400 health workers have been murdered, hospitals have been bombed, ambulances attacked, and humanitarian access systematically denied. The result is not just a public health disaster, it is a humanitarian catastrophe and a moral failure on a global scale.

Read more: Israeli destruction of Gaza’s healthcare is a blueprint for future imperialist wars

The rhetorical tactic applied by some WHO members, insisting health must be “neutral” or “technical,” functions to silence critique and protect power. The WHO’s own Commission on Social Determinants of Health makes this clear: displacement, apartheid, and military occupation are not abstract issues, they are material determinants of whether people have access to shelter, nutrition, and life itself. To speak of health in Gaza without naming the forces destroying it is to distort the concept of health beyond recognition.

The Assembly and the whole global health community must call for an immediate and permanent ceasefire, the end of occupation, and the recognition of the Palestinian people’s right to self-determination.

AI and austerity: false solutions

The role of artificial intelligence (AI) in health systems is also gaining traction at WHA78. AI is being promoted as a way to streamline diagnostics, surveillance, and emergency response. In an era of austerity, AI is being sold not only as an addition to human care but as a substitute for public investment and workforce development.

Read more: Digital Health in Brazil: imperial threat or promise of sovereignty?

AI software does not protect personal data and is often extractivist in nature. It will deepen existing inequalities, entrench racism and bias, and divert attention from the political determinants of health. Moreover, AI is increasingly developed and controlled by private tech firms whose profit motives do not align with public health goals.

The WHO must not allow the promise of innovation to become a smokescreen for privatization and automation. Instead, WHA78 should commit to transparent, accountable, and rights-based governance of digital health tools, centered on public ownership and community control.

The WHA we want and need

At this historic juncture, we must move beyond the language of austerity. Now is the time to be bold, to speak truth to power, and to shape the WHO people want and need.

The WHO must confront the political roots of health inequality. People need a health organization that works to redistribute power and economic resources to achieve health for all, and that places community-led solutions at the heart of its work. An organization that acknowledges the enduring impacts of colonialism, militarism, and occupation, and speaks out when entire peoples are being erased, as is happening now in Palestine, the Democratic Republic of Congo, and Sudan.

Member states must act with courage and commit to fully and sustainably funding the WHO through public contributions, bringing an end to the era of donor-driven policy. We must also resist the outsourcing of public health to private tech giants.

Realizing this vision will require bold leadership from member states, steadfast advocacy from civil society, and a collective commitment to reimagining global health. Let WHA78 be the turning point. Let it be the moment we reclaim global health governance for the many, not the few.

The WHO Watch team members are Pedro Villadri, Jan Wintgens, Mariana Lopes Simoes, Marta Caminiti, Michael Ssemakula, Juliette Mattijsen, Indrachapa Ruberu, Heba Wanis, Dua Ijaz, David Franco, Ben Verboom, and Rahaf Bashir.

People’s Health Dispatch is a fortnightly bulletin published by the People’s Health Movement and Peoples Dispatch. For more articles and to subscribe to People’s Health Dispatch, click here.