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Table 1 Thematic overview of funding proposals and stated rationale

From: The financial sustainability of the World Health Organization and the political economy of global health governance: a review of funding proposals

Reform proposal (s) and/or recommendations Key arguments for reform proposal (s)/ challenges/ risks
Theme 1: Predictability and Sustainability of Organizational Funding
Set higher member state ACs [29, 34,35,36]; Double the WHO’s overall budget, with ACs comprising at least 50% of budget within 5 years [53]
**Since the Biennium 2014–2015, WHO gained the power to approve the full budget, enabling strategic allocation of flexible resources [52]
Sustainable financing needed to address WHO’s capacity to respond and nation’s preparedness [54]
Member states reluctant to increase respective ACs and support increased VCs over ACs [36, 39, 50, 51]
Replace zero-nominal growth of ACs with zero-real growth policy [36, 39] Zero-nominal growth policy restricted WHO’s budget growth [13, 38, 39], increased WHO’s reliance on EBFs [40]
Attract new donors (foundations, emerging economies, private and commercial sector) to broaden funding source for WHO’s flexible and unearmarked funds [26, 28, 29] Tensions between financing from non-state actors/ private sector and WHO’s autonomy [34]; ‘trading off the soul of WHO’ [28]
Establish Ethics Committee to oversee WHO engagement with non-state actors [36] BRICS countries asked WHO to ensure supremacy of member states and manage conflict of interests [36]
Charge overhead to VCs [47] Might risk losing donors to other organizations [34]
Practice ‘currency hedging’ to manage currency risks [27]
Establish endowment fund, a multiyear financing framework, or use Robin Hood tax [27]
Theme 2: Improve Transparency and Accountability in (Financial) Governance
Increase transparency in disbursements of funds to WHO regional offices & disclose its utilization [26, 30, 34]
Build strategies for WHO’s rigorous external evaluations [27]
Establish independent governance committees on the lines of Independent Monitoring Board [56, 57] Towards transparency enhancement mechanisms [56]
Establish ‘WHO financing dialogue’ making the opaque process of multilateral negotiations more open and transparent, involving an inclusive discussion [43, 44] **In 2013, the World Health Assembly resolution 66(8) established the Financing dialogue [43] Member states skeptical over the procedures of establishing WHO financing dialogue [62]; BRICS countries support to financing dialogue [36]; financing dialogue is ‘smoke screen exercise’ without resolving Zero-nominal growth policy [44]
Theme 3: Organizational Function and Financial Autonomy
Narrow focus and concentrate resources on lesser health issues [61, 63, 66, 70]
Decentralized governance through smaller independent organizations to bring efficiency and optimal use of funds [46, 68]
Create discretionary fund’ for global health emergencies [26]
Convene regularly a new multi-stakeholder forum to address critical global health issues [28] This reform was argued as a way to better align WHO’s income and work [29, 43]
Greater autonomy for technical function of WHO through protected and adequate budget, with flexibility over its allocation [72]
Acquire greater independence from its largest donors in order to coordinate with Research and Development (R&D) actors [77]
Outsourcing of key activities, thus leveraging the expertise of global health organizations beyond WHO [67, 71,72,73]
Taxation of global resources and global activities to supplement WHO funding [68]