The Seventy-eighth World Health Assembly concluded on 27 May with landmark achievements that fundamentally reshape global health governance, as WHO Member States demonstrated unprecedented solidarity in adopting the world’s first pandemic agreement and securing transformative financing reforms. The nine-day assembly, convened under the theme “One World for Health”, marked a pivotal moment in international health cooperation following years of intensive negotiations and planning.
Dr Tedros Adhanom Ghebreyesus, WHO Director-General, characterised the outcomes as historic, stating: “The adoption of the Pandemic Agreement and the approval of the next increase in assessed contributions, along with the numerous other resolutions that Member States adopted are a sign to the world that we can achieve cooperation in the face of conflict, and unity amid division.”
Pandemic preparedness framework establishes new global architecture
The assembly’s most significant achievement was the adoption of the WHO Pandemic Agreement on 20 May, representing the culmination of three and a half years of negotiations by the Intergovernmental Negotiating Body.
This legally binding instrument establishes comprehensive measures to prevent future pandemics and strengthen health system resilience globally.
The agreement prioritises equity and access through enhanced global coordination, whilst explicitly respecting national sovereignty. Key provisions include mechanisms for rapid pathogen sharing, ensuring fair and timely access to vaccines, diagnostics and therapeutics, and strengthening technology transfer capabilities alongside financing and supply chain resilience.
Dr Tedros addressed persistent misconceptions surrounding the agreement’s scope and authority. “The Pandemic Agreement will not infringe on national sovereignty, period. And the Pandemic Agreement does not give WHO any powers, period,” he emphasised. “WHO’s job is to make recommendations to governments, but what governments do with those recommendations is entirely up to them.”
The agreement’s implementation timeline requires negotiation of the Pathogen Access and Benefit Sharing system (PABS) annex over the next year, followed by ratification by 60 countries before entering into force as international law. Member States committed to completing this process by May 2026.
Sustainable financing transformation secures organisational stability
In parallel developments, Member States approved the second 20% increase in assessed contributions, representing a fundamental shift in WHO’s financial architecture. This increase adds US$ 90 million annually in predictable, flexible funding, advancing the organisation’s goal of achieving 50% core budget funding through assessed contributions by 20302031, compared to just 16% in 2022.
The sustainable financing commitment extended beyond assessed contributions during WHA78’s high-level pledging event, where health leaders committed at least US$ 210 million to WHO’s Investment Round. This fundraising campaign supports the organisation’s global health strategy outlined in the Fourteenth General Programme of Work over the next four years. Combined with the US$ 1.7 billion already secured, these pledges significantly advance WHO’s financial sustainability objectives.
Since launching in May 2024, the Investment Round has attracted 35 new contributors, diversifying WHO’s donor base and reducing dependence on traditional funding sources. Dr Tedros noted: “This is another major step towards making WHO less dependent on earmarked voluntary funds from a handful of traditional donors.”
Comprehensive health resolutions address global challenges
The assembly’s scope extended far beyond pandemic preparedness and financing, with Member States adopting approximately 75 items across diverse health domains. Notable achievements included establishing new global health targets, with Member States committing to halve the health impacts of air pollution by 2040, reflecting growing recognition of environmental health challenges.
Noncommunicable disease priorities gained prominence through first-ever resolutions on lung and kidney health, strategically timed to complement upcoming UN General Assembly discussions on noncommunicable diseases. The assembly also addressed rare diseases affecting over 300 million people globally across more than 7,000 conditions, demonstrating commitment to health equity for underserved populations.
Social determinants of health received attention through an innovative resolution promoting social connection, supported by emerging evidence linking social connectivity to improved health outcomes and reduced mortality risk. Additional resolutions targeted lead exposure elimination, digital marketing regulation of breast-milk substitutes and baby foods, and Guinea worm disease eradication acceleration.
The assembly established two new official WHO health campaigns: World Cervical Cancer Elimination Day and World Prematurity Day, expanding the organisation’s advocacy framework for priority health issues.
Emergency response capabilities demonstrate global reach
WHO’s emergency response capacity received scrutiny during the assembly, with reports detailing responses to 51 graded emergencies across 89 countries and territories over the past year. These included global cholera and mpox outbreaks – the latter constituting a public health emergency of international concern – alongside multiple humanitarian crises.
Working through partnerships with over 900 organisations across 28 health clusters, WHO provided health assistance to 72 million people in humanitarian settings. Significantly, nearly 60% of new emergencies were climate-related, highlighting the growing intersection between climate change and health security.
Member States endorsed WHO’s leadership in health emergencies whilst supporting strengthened global architecture through the health emergency prevention, preparedness, response and resilience (HEPR) framework. The assembly also addressed specific regional health needs, including situations in Ukraine and the occupied Palestinian territory.
Scientific standards and innovation drive policy development
The assembly reinforced science-driven approaches through resolutions establishing new norms and standards for health policy implementation. Member States approved measures to strengthen the research base on public health and social measures for outbreak control, recognising evidence-based interventions as fundamental to effective health responses.
Progress on International Health Regulations (2005) implementation received attention, with the Director-General’s report noting advancement in global health security architecture. The assembly’s commitment to scientific rigour extended to traditional medicine through adoption of a new global strategy balancing cultural practices with evidence-based standards.
Implications for global health governance
The Seventy-eighth World Health Assembly’s outcomes represent a defining moment in global health governance, establishing frameworks that will influence international health cooperation for decades. The pandemic agreement’s adoption demonstrates that multilateral consensus remains achievable despite global political tensions, whilst the financing reforms provide organisational stability essential for WHO’s expanding mandate.
Dr Tedros reflected on Member States’ commitment: “Countries want a strong WHO and are committed to working together with WHO to build a healthier, safer and fairer world. These were strong votes of confidence in WHO at this critical time.”
The assembly’s comprehensive approach – spanning pandemic preparedness, sustainable financing, emergency response, and diverse health challenges – positions WHO to address contemporary health threats whilst building resilience for future challenges. Implementation success will depend on sustained political commitment and effective translation of resolutions into national health policies and programmes.
- For comprehensive documentation of the assembly’s proceedings and adopted resolutions, visit: https://apps.who.int/gb/ e/e_wha78.html.
- Additional information on WHO’s Investment Round is available at ?
https:// www.who.int/about/funding/invest-in-who/investment-round.
