Mwijuka Jesca
President of the Workers in Informal Economy Network Uganda -WIENU

To my opinion, this is a strong topic because it touches money, power, health policy, and who gets to decide.

Here’s how i have  framed it for debate/discussion:

1.THE CORE QUESTION

Did private financial support to WHO during COVID-19 help save lives, or did it shift who controls global health decisions?

2. KEY FACTS TO GROUND

THE DEBATE

A. Who are the „philanthropists“ in WHO funding?

During COVID-19, WHO funding came from these  sources below:

1. Assessed contributions: Membership fees from countries. Only about 16% of WHO budget
2. Voluntary contributions from governments: about 50% of budget
3. Voluntary contributions from non-state actors: Foundations, companies, NGOs. About 34% of budget

„These voluntary contributions also happened here in uganda, if you can remember how companies, individuals, churches,etc… contributed „

The biggest private contributor by far: The Bill & Melinda Gates Foundation. Others: GAVI, CEPI, Wellcome Trust, corporate donors.

B. What did they fund during COVID?

– Vaccines + R&D through COVAX, CEPI

– Testing, PPE, health systems in low-income countries

– WHO emergency response, data, guidance

3. ARGUMENTS PEOPLE MAKE

Argument 1:

„It helped – money saved lives“

– Governments were slow. Private money filled gaps fast for vaccines, tests, oxygen

– Without Gates/CEPI funding, vaccine R&D would have been slower

– WHO needed money to operate during the emergency

Argument 2:

„It concentrated power – democratisation problem“

– Issue of priorities: Donors can earmark money. „We give money for vaccines“ not „for primary care“. So WHO follows donor money, not what member states vote for.

– Issue of influence: If 1 foundation gives greater than 100 countries combined, does it have more voice in WHO meetings?

– Issue of accountability: Elected governments are accountable to voters. Private foundations are not.

– This feeds the „democratisation of the UN“ debate: Should UN agencies be funded and controlled more by member states, not private actors?

4. EXAMPLES YOU CAN USE

1. COVAX: Public-private partnership. Funded heavily by philanthropists. Goal was equity. Result was mixed – rich countries bought vaccines directly first.
2. Earmarked funding: About 80% of WHO voluntary funds are „earmarked“ for specific diseases/programs chosen by donor. COVID money was the same.
3. Policy debates: WHO mask guidance, vaccine recommendations. Critics asked: were these influenced by funders with vaccine interests?

5. LINKS TO „DEMOCRATISATION OF THE UN“

The bigger debate is:

Who should set global health rules?

– Option A: 194 member states, 1 country 1 vote

– Option B: Whoever pays the most, whether state or foundation

UN reform advocates argue: If we want the UN to be democratic, we need to reform funding so agencies don’t depend on a few big donors.

6. QUESTIONS TO DRIVE THE DEBATE

1. Was private money necessary because member states underfunded WHO for years?
2. Did philanthropy improve speed but reduce equity and transparency?
3. What safeguards are needed so money doesn’t equal decision power?
4. What’s the alternative?

Should countries increase assessed contributions so WHO is less donor-dependent?