The World Health Organisation (WHO) has proposed slashing a fifth of its budget following the United States’ decision to withdraw, and must now reduce its reach and workforce, its chief said in an internal email seen by AFP on Saturday.

The WHO is facing an income gap of nearly $600 million in 2025 and has “no choice” but to start making cutbacks, WHO Director-General Tedros Adhanom Ghebreyesus said in the message sent on Friday to the UN health agency’s staff.

Besides triggering the US pullout from the WHO after returning to the White House in January, President Donald Trump decided to freeze virtually all foreign aid, including vast assistance towards boosting health worldwide. The US was by far the WHO’s biggest donor.

“Dramatic cuts to official development assistance by the United States of America and others are causing massive disruption to countries, NGOs and United Nations agencies, including WHO,” Tedros said in his email.

He said that even before Trump triggered the one-year process of withdrawing from the WHO, the organisation was already facing financial constraints, and had begun working on efficiency measures more than nine months ago.

“The United States’ announcement, combined with recent reductions in official development assistance by some countries to fund increased defence spending, has made our situation much more acute,” said Tedros.

“While we have achieved substantial cost savings, the prevailing economic and geopolitical conditions have made resource mobilisation particularly difficult. As a result, we are facing an income gap of almost $600m this year alone.”

WHO budget cut

Last month, the WHO’s executive board reduced the proposed budget for 2026-2027 from $5.3 billion to $4.9bn.

“Since then, the outlook for development assistance has deteriorated, not only for WHO but for the whole international health ecosystem,” said Tedros. “We have, therefore, proposed to member states a further reduced budget of $4.2bn — a 21 per cent reduction from the original proposed budget.”

In the body’s last two-year budget cycle, for 2022-23, the US pitched in $1.3bn, representing 16.3pc of the WHO’s then $7.89bn budget. Most of the US funding was through voluntary contributions for specific earmarked projects, rather than fixed membership fees.

“Despite our best efforts, we are now at the point where we have no choice but to reduce the scale of our work and workforce,” said Tedros. “This reduction will begin at headquarters, starting with senior leadership, but will affect all levels and regions.”