BharatNotes What is World Health Organization Reform?
WHO reform is the post-COVID effort to strengthen the world's apex health body across three fronts — its legal instruments, its finances, and its governance — so that it can prevent, detect and respond to future pandemics more equitably and effectively. The reform package crystallised at successive World Health Assemblies (WHA) between 2022 and 2025.
Key Reform Pillars
1. Amended International Health Regulations (IHR). Member States adopted amendments to the IHR (originally adopted 2005) by consensus at the 77th WHA via Resolution WHA77.17 (June 2024). The amendments created a new highest-level alert — a "pandemic emergency" — above the existing Public Health Emergency of International Concern, and require each country to designate a National IHR Authority. They entered into force on 19 September 2025; 11 of the 196 States Parties formally rejected them.
2. The WHO Pandemic Agreement. After three years of negotiation, the WHA adopted the world's first Pandemic Agreement by consensus on 20 May 2025 (the committee approved it 124-0 with 11 abstentions). Its centrepiece is a Pathogen Access and Benefit-Sharing (PABS) system, to be finalised as an annex by an Intergovernmental Working Group. The Agreement opens for signature only after the PABS annex is adopted, and enters into force after 60 ratifications.
3. Sustainable financing. To reduce reliance on earmarked voluntary donations, WHA75 (2022) agreed to raise assessed contributions (membership dues) to cover 50% of the base budget by 2030-31, with phased 20% increases.
Current Status and the Financial Squeeze
| Reform element | Status (as of June 2026) |
|---|---|
| IHR amendments (WHA77.17) | In force since 19 Sep 2025 |
| Pandemic Agreement | Adopted 20 May 2025; PABS annex under negotiation |
| Assessed-contribution increases | 20% rise approved for both 2024-25 and 2026-27 biennia |
| 2026-27 programme budget | US$4.2 billion, cut ~22% from the proposed US$5.3 billion |
The United States — historically WHO's largest funder — notified its withdrawal under Executive Order 14155 (signed 20 January 2025; effective 22 January 2026) and ceased Pandemic Agreement negotiations. This forced the 2026-27 budget down to US$4.2 billion, with assessed contributions set to fund about 40% of the base budget.
India and the UPSC Angle
India backed the Pandemic Agreement while pressing for robust equity provisions, a workable PABS mechanism, and technology transfer for platforms such as mRNA — reflecting both its public-health interests and its standing as the "pharmacy of the world." For aspirants, the topic links global health governance, multilateral reform, sovereignty debates, and India's Global South leadership. The defining tension to capture: reform must balance national sovereignty against the collective need for fast, equitable pandemic response.
