TWN Info Service on Health Issues (Jun26/01)
4 June 2026
Third World Network

WHO: WHA79 Documents reveal fragmented nature of the WHO’s Work in Health Emergencies

Kochi, 4 June (Nithin Ramakrishnan) – The fragmented nature of the World Health Organization’s work in health emergencies was revealed in discussions that took place at its annual gathering of Member States.

The 79^th Session of the World Health Assembly (WHA79) discussed the Report of the Independent Oversight and Advisory Committee for the WHO Health Emergencies Programme (IOAC), the Implementation of the International Health Regulations 2005 (IHR) (Agenda Item 13.2), and WHO’s work in health emergencies (Agenda Item 14.1). 

WHA79 concluded on 23 May 2026 after 6 days of discussions and negotiations.

The following background documents were discussed:

While there are outbreaks of hantavirus and ebola virus infections, the priority agenda was the health emergencies caused by armed conflicts, military attacks, as well as the occupation of Palestine by Israel.

Most of the countries who spoke on these issues focussed on the reporting of their national level work, highlighting the need for more international financial assistance such as through replenishment of the IHR Emergency Contingency Fund.

Several gaps in the WHO reporting and concerns relating to the work of WHO in Health Emergencies did not receive much attention, in particular issues relating to delivery of equity and strengthening of solidarity in health emergency prevention, preparedness and response. 

Moreover, the fragmented reporting makes it difficult for Member States and observers to assess WHO’s performance in health emergencies. For example, while WHO is expected to promote equitable access to health products during the mpox emergency, information on these efforts is scattered across multiple reports. There is no consolidated assessment of what worked, what did not, or the challenges faced by WHO in promoting equitable access. Nor do the reports provide a clear picture of demand and supply of vaccines, therapeutics and diagnostics. As a result, it is difficult to answer even the most basic question: whether WHO’s response met the expectations of Member States.

Insufficient information on Access to Health Products

Although the amended IHR entered into force on 19 September 2025, with significant emphasis on promoting equitable access to health care products, the reporting on the implementation of IHR 2005 does not contain detailed information on equitable access to health care products during disease outbreaks and what assistance WHO has offered. Similarly, the report of the oversight of the IOAC also does not contain detailed information, while the report on WHO’s work in Health Emergencies gives some bits and pieces of information, insufficient for WHA79 to make an analysis of success and challenges in this area.

[The amendments to IHR 2005 adopted by WHA77 in May 2024, entered into force on 19 September 2025, with 11 rejections, and 2 reservations. In addition, 8 declarations and 7 statements were also made by States Parties regarding the implementation and applicability of the IHR 2005 as amended in 2024. Interestingly the reports do not shed light into reasons for the rejections or reservations and what follow-up action or engagement is taken up by the WHO secretariat.]

According to the IOAC report, WHO responded to 50 emergencies in 82 countries in 2025, and as of 3 March 2026 it was responding to 13 Grade-3 emergencies, including “global outbreak of diseases such as Cholera, mpox, dengue, Covid-19, outbreaks of diphtheria, marburg virus disease, rift valley fever, yellow fever and Sudan virus”. However, the report of IOAC also does not address the success or shortcomings of the WHO’s services with respect to enabling or ensuring access to relevant health products in these disease outbreaks.

In paragraph 38, however, IOAC records thus: “The Committee commends major advances in procurement, stock, transport and warehouse management systems. For the first time, the Organization has full end-to-end visibility of its supply chain, enabling real-time tracking of products and expiry dates to maximize efficiency and ensure timely use.”

It is not explicit whether this remark covers relevant health products, while the impact of these advances in managing supply chains for the above disease outbreaks is not presented in the report.  

The report on the Implementation of IHR also talks little about this aspect. In the case of international spread of polio virus, the report notes that the IHR Emergency Committee on Polio met twice since the entry into force of the amended IHR 2005. Nevertheless, the report fails to explain how WHO fared with respect to assessing the availability and accessibility of relevant health products, and what measures it undertook to promote equitable access.

As per amended Articles 15 and 17, WHO should have conducted such assessments and provided recommendations in case of shortages of supplies, as well as information of mechanisms and networks through which access concerns could be addressed.

Similarly, the IHR implementation report talks about extension of standing recommendations for mpox and COVID-19. While mpox recommendations were extended before the amendments entered into force, COVID-19 recommendations were extended in April 2026.

However, the IHR implementation report does not point out whether these recommendations were accompanied with information on WHO coordinated mechanism(s) for access to, and allocation of, relevant health products as well as on any other allocation and distribution mechanisms and networks. Also, there is no clarity on whether the emergency committees that recommended these extensions undertook any assessment of the status of accessibility and availability of the relevant health products. According to amended Articles 16 and 17, the same should have been carried out.

The report of the WHO’s work in Health Emergencies provides some quantitative information on WHO’s work in promoting access to relevant health products. Paragraphs 10 to 23 of the report deals with supplies, distribution, or release of various health products such as vaccines, diagnostic kits, medical kits etc. However, these paragraphs simply states what WHO arranged for, rather than provide a comprehensive assessment of what was needed, and what part of the need was satisfactorily met by the WHO.

For instance, it is said that through the WHO-led Multipartner Mpox Access and Allocation Mechanism over 5 million mpox vaccine doses were delivered to 16 countries (paragraph 10). In another instance it is stated that WHO hosted the International Coordinating Group on Vaccine Provision that received 69 requests for emergencies vaccines from 19 countries, and approved releases of over 58 million doses for the control of cholera, meningococcal meningitis, yellow fever, and ebola virus disease (paragraph 14). However, there is no assessment regarding whether these supplies were sufficient or whether the emergencies were effectively and equitably responded to.

In paragraph 24, the report further makes these two remarks, but again with no description or explanation. First, “Limited surveillance capacities and insufficient production of critical vaccines have affected the ability of WHO and its partners to rapidly detect, respond to and control disease outbreaks and health emergencies.”  Secondly, “Access constraints continue to affect the delivery of essential health services in multiple humanitarian settings”.

The additional report on the updates of strengthening of health emergency prevention, preparedness, response and resilience also takes the same approach but refers to 1.9 million mpox vaccine doses secured through the access and allocation mechanism. It is not clear how this number of 1.9 million relates to the 5 million mentioned in the report regarding the work of WHO in health emergencies.

Further this additional report under the section “access to medical countermeasures” talks about supporting surveillance capacities, genomic sequencing as well as systems like the WHO BioHub for sharing of biological materials and information for research and development. However, no effort by the WHO is recorded in this report that links these initiatives with fair and equitable sharing of outcomes of such research and development, in particular vaccines, therapeutics, and diagnostics developed using these materials and information.

All these points towards a concerning observation that WHO’s work in emergencies continues to be quite separate from the IHR framework, and the WHO is yet to embrace the spirit of the amended IHR in its approach towards health emergencies.  

Incomplete Information on other aspects of IHR Implementation

The above-mentioned documents, i.e. report on the implementation of IHR 2005, report of the IOAC, and the report of the WHO’s work in Health Emergencies also lack several key and pertinent information which are important to understand the effectiveness of the WHO’s work in international health emergencies.

According to the report on IHR Implementation, 472 events with potential international public health implications were assessed by WHO in 2025, of which 396 were substantiated. It also states that updates were posted on the Secure Event Information Site for NFPs, for 88 new and ongoing events involving 33 States Parties as well as 6 announcements for multi-country events. Event updates mostly concerned influenza due to identified avian or animal influenza virus, mpox, poliovirus, cholera and then situations caused due to armed conflicts.

The report on the IHR implementation talks about the 255 verification requests regarding public health events and risks sent by WHO to the States Parties. Only 61% of these requests were responded to within 24 hours. There is no information regarding what happened to the rest of the 100 requests, whether they were responded to, and if yes, when. There is also no information on the reasons relating to these deviations.

Further, regarding IHR Core Capacities development, the report says in 2025, 97% of States Parties (191 out of 197) submitted information using the States Parties Self-Assessment Annual Reporting tool. However, there is no additional information regarding the trends in capacity development with respect to various surveillance and response capacities. The report falls short of explaining which capacities have improved, and what are the general trends in priorities relating to international assistance in this regard.

The major contentious issue over the course of the IHR 2005 amendments was that the IHR capacity building, especially with international assistance, focuses on surveillance capacities (which are usually the donor priorities) and not on the response capacities.

Other Operational Concerns

Financing

The reports further reveal certain concerns, of which only the shortcomings in the WHO Contingency Fund for Emergencies got the immediate attention of many Member States.

The report on the WHO’s work in emergencies states that “US$29.4 million was released during 2025, enabling WHO to deliver life-saving assistance as part of the health response to 24 emergencies. The available balance at the end of 2025 was US$19.5 million”. However, the additional report on the update of strengthening health emergencies prevention, preparedness, response and resilience notes that only US$ 10.6 million was replenished. IOAC report notes that as of 7 April 2026, the fund has got only US$ 17.6 million.

In addition, the IOAC report also notes the “the severe and persistent shortfall in flexible and sustainable financing, which continues to affect not only the WHE (WHO Health Emergencies) Programme but the Organization as a whole” (Paragraph 24). It also takes note of the WHO Health Emergencies Funding Appeal Platform, which mobilized US$3.63 billion since its introduction in 2022. However, the IOAC report also indicates that in 2025 only 58% of the appeal was met, which is a 37% decline from 2024.

Management of WHO Health Emergencies Programme

The IOAC report highlighted some concerns regarding the management of the WHE programme, however, did not receive much Member State attention.

It expressed concerns regarding the deviation and changes in the practices and management of the WHE programme. It states: “… the WHE Programme was established with one clear line of authority, one workforce, one budget, one set of rules and processes, and one set of standard performance metrics… the de facto practice has diverged from this model and is particularly concerned by the growing number of delegations of authority to the regional directors regarding decisions, human resources and budgets in emergency operations” (Paragraph 18).

Noting variations from the practices stemming from the document A69/30, the IOAC reports the following: “Member States originally established the EXD/WHE as a Deputy Director-General level role, recruited through a competitive selection process, to ensure that the WHO’s emergency function would not be marginalized within the Organization’s hierarchy. However, the role has since been downgraded to the Assistant Director-General level, with the EXD/WHE being appointed directly by the Director-General and no longer serving as a permanent member of the Global Policy Group, led by the Director-General and the Regional Directors. The IOAC views this shift as a substantial erosion of the position's institutional authority” (paragraph 19).

[Dr. Chikwe Ihekweazu currently serves as the Executive Director (EXD) of the WHE. He took over leadership of the programme from Dr. Michael Ryan. He was recruited by WHO in November 2021 as an Assistant Director-General to lead the newly created WHO Hub for Pandemic and Epidemic Intelligence based in Berlin, Germany. Prior to joining WHO, he held various senior epidemiological and leadership positions at major institutions, including Germany's Robert Koch Institute, the UK Health Protection Agency, and the South African National Institute for Communicable Diseases.]

In paragraph 30, IOAC raises the concern over 23% loss of staff in the WHO workforce for emergencies. It further states funding constraints have affected the WHO’s partners. Paragraph 39 states that “As at December 2025, of the 24 settings with an activated health cluster, 75% had dedicated, properly trained health cluster coordinators. Of these, 50% were fixed-term staff, 22% were temporary staff and 22% were consultants, whereas in December 2024, of the 28 settings, 86% had dedicated, properly trained health cluster coordinators. By December 2025, 50% of coordinators had been identified as at risk in 2026.”

Further IOAC took note of 181 cases of abusive conduct, 25 cases of sexual exploitation and abuse, and 25 cases of sexual harassment in 2025, with the highest number of reported cases in the African and Eastern Mediterranean Regions (paragraph 35), although the report does not clarify the relationship of these cases with the WHO’s work in health emergencies.

Surveillance and Benefit sharing

As noted in the report on the updates on strengthening health emergency prevention, preparedness, response and resilience, the WHO continues to undertake work on expanding surveillance. This and also other reports do not explain anything about the sharing of benefits arising out of such surveillance, sharing of biosamples and sequence information.

According to the report on the updates, in 2025 WHO mobilized a grant of US$18 million to advance collaborative surveillance implementation and established a regional coordination mechanism across all regions (paragraph 4). Further, the International Pathogen Surveillance Network engaged 366 active partner organizations across 111 countries to strengthen genomic surveillance capacity, co-developed a genomic data use toolkit, and provided US$1.92 million in catalytic funding to low- and middle-income countries (paragraph 5).

Further paragraph 6 notes that “WHO supported 179 laboratories in 136 countries, improving mpox testing, genomic sequencing and outbreak response capabilities, and engaged over 3600 experts from 170 countries to build national workforce capacity. WHO advanced global laboratory initiatives to enhance health security, including the Global Laboratory Leadership Programme, the Laboratory Recognition Programme for national reference laboratories, and a global public health laboratory webinar series. A WHO-coordinated laboratory network of networks for surveillance, preparedness and response to (re-)emerging viruses was conceptualized, with training provided to 170 laboratorians from eight countries”.

As noted earlier, the WHO BioHub System also facilitated the sharing of biological materials with epidemic and pandemic potential for about 30 samples through 17 shipments, involving 17 laboratories across 10 countries.

Despite these extensive reporting on the laboratory networks and sharing of biosamples and information, there is very limited information about the benefit sharing arrangements or facilitation undertaken by these networks, in particular to ensure equitable access to relevant health products developed using such biological resources.+