The new WHO head will face budget pressures and must redefine the UN agency’s role.
Martial Trezzini / Keystone
The race to lead the World Health Organization (WHO) is unfolding at a time when the UN agency is grappling with budget cuts, internal tensions and fundamental questions about its role.
According to the official timeline, nominations for the next director-general will open in April–May 2026, with a final appointment expected in May 2027.
While the process is still in its early stages, the challenges facing the organisation are already shaping what is likely to be a highly political contest.
Tedros Adhanom Ghebreyesus has led the WHO since 2017 and was re-elected in 2022. His tenure has been shaped by the Covid-19 pandemic, during which he raised the organisation’s visibility but also faced criticism over the WHO’s early handling of the outbreak and its relationship with China.
The agency’s funding model relies heavily on voluntary contributions, making it vulnerable to political shifts. The United States, historically its largest donor, began a formal withdrawal process in 2025, triggering a financial crisis that pushed the agency to cut budgets and staff.
In 2026 the WHO will face a 21% budget cut and reduction of up to 25% of its workforce.
A workforce stretched thin
Inside the WHO, the consequences of recent funding cuts are being felt across all departments.
A technical expert who has worked at the organisation for six years, speaking anonymously as they were scared to lose their job if they spoke to the media, described a “very tense” atmosphere following the significant staff reductions.
“We lost 40% of our team, but the workload hasn’t changed,” the expert said. “Some programmes were simply stopped overnight. The organisation acknowledged the cuts, but never the loss of capacity.” According to the same source, cuts were implemented nearly overnight, often targeting consultants and short-term contracts first rather than being based on a strategic reassessment of priorities.
The result, they said, is a system under strain, where teams are forced to constantly shift between urgent crises and longer-term work. “Today, we have to choose: do we respond to an emergency on the ground, or do we work on guidelines? We can’t do both properly anymore.”
More broadly, the current situation has revived a long-standing debate about what the WHO should focus on.
A strategic dilemma: norms or operations?
Suerie Moon, co-director of the Global Health Centre at the Graduate Institute in Geneva, says the funding crisis will ultimately force the organisation to redefine its role.
“One of the big questions raised by the budget cuts is what the WHO’s core functions are,” she said.
Member states are divided. Some prioritise the WHO’s role in setting global health standards and guidelines, while others expect it to play a more operational role, providing direct support during crises. The debate over the WHO’s priorities has been ongoing for years, with high-income countries generally supporting a more normative role and developing countries valuing operational support, says Moon.
Cuts so far have been applied “across the board”, Moon said, leaving all parts of the organisation “stretched very thin”.
But with resources unlikely to recover quickly, the next director-general may have to make clearer choices.
A political role in a fragmented world
Beyond internal challenges, the WHO is operating in a more complex geopolitical environment.
“The director-general role is really hard,” Moon said. “You have to be a politician, a leader and a diplomat.”
The position requires balancing the interests of nearly 200 member states, while maintaining scientific credibility and securing funding in an increasingly competitive landscape.
Tedros’ tenure has highlighted the political nature of the role, particularly during the Covid-19 pandemic, when the WHO had to navigate tensions between major powers while trying to maintain scientific authority.
WHO Director-General Tedros Adhanom Ghebreyesus briefs the media on the disembarkation process of passengers from the MV Hondius cruise ship in Tenerife, Spain, May 10, 2026.
Alberto Valdes / Keystone
In a recent article published in The Lancet, Ellen ‘t Hoen, Director of Medicines Law and Policy, noted that the next WHO chief will have to “strengthen the multilateral role of the agency in a world where multilateralism is under pressure”, with global health responsibilities increasingly dispersed across competing actors.
Lancet journalist John Zarocostas also reports that several names are already circulating among health diplomats, including Jarbas Barbosa da Silva Jr, Director of the Pan American Health Organization; Hanah Balky, WHO Regional Director for the Eastern Mediterranean; and Indonesia Health Minister Budi Gunadi Sadikin.
A need for strong leadership
Despite the challenges facing the WHO, Moon does not believe the agency’s relevance is at stake.
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“It remains the central organisation for global health,” she said, highlighting its unique authority to declare global health emergencies.
During the Covid-19 pandemic, the WHO declared a global health emergency in January 2020 and later characterised Covid-19 as a pandemic. The agency coordinated global guidance, research efforts and vaccine access initiatives such as COVAX.
In the future, its ability to fulfil that role may depend heavily on who takes over in 2027.
For the anonymous WHO expert Swissinfo spoke to, the priority is clear: stronger leadership and clearer direction.
“What we need is someone who can make decisions,” they said. “Someone who can decide what the WHO should focus on, and have the courage to follow through.”
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Edited by Virginie Mangin/ds
