BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e6877 (Published 25 October 2012)

WHO is in crisis. Unless member states can be persuaded to “untie” their donations and give the organisation leeway to control its budget and set priorities WHO will slide further into irrelevance with disastrous consequences for global health, warns David Legge

A substantial shortfall in the funds available for basic administrative functions led WHO’s director general, Margaret Chan, to initiate another reform of the WHO in 2010. Although the reform programme has expanded to include priority setting, governance, and management, financing is the fundamental problem. The process of reform is also bedevilled by the same problem that led to the funding crisis in the first place—a switch in power from the assembly of member states to donors (including some member states as well as other donors) with specific interests. This article outlines the problems and what the reforms are trying to achieve.

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