The World Health Organization (WHO) has embarked on one of its most significant internal overhauls in recent history, prompted by a steep reduction in its projected budget for the 2026–2027 biennium. In response to dwindling global donor support and worsening financial constraints, the agency has slashed its proposed spending by over 21%—from US$5.3 billion to US$4.2 billion—triggering sweeping structural reforms that will deeply impact its global operations.

Director-General Dr. Tedros Adhanom Ghebreyesus announced the changes on Wednesday, outlining a comprehensive realignment of the organization’s internal structure. The new reforms include reducing the number of departments, eliminating leadership positions, and cutting overall salary expenditures by a staggering 25%.

Salary Cuts and Job Losses Across WHO

The most painful aspect of the restructuring, Dr. Tedros admitted, involves significant workforce reductions. The decision to cut salary expenditures by a quarter does not automatically equate to a 25% layoff in staff numbers, but the impact will still be substantial.

“We are saying goodbye to a significant number of highly experienced, capable, and dedicated members of our workforce,” Dr. Tedros said. “That means careers interrupted and lives disrupted.”

Although he did not provide an exact figure for the total staff layoffs, Dr. Tedros indicated that the bulk of the reductions would occur at WHO’s headquarters, with regional offices also facing varying degrees of staff and operational downsizing.

Halving of Senior Leadership and Department Count

To streamline operations and increase cost-efficiency, WHO is making deep cuts at the management level. The number of senior leadership positions has been reduced from 14 to 7, while the number of departments at headquarters has been slashed from 76 to just 34.

“This new structure reflects the prioritization of core functions and was developed after a comprehensive internal assessment,” Dr. Tedros noted. “The regional offices are currently finalizing structures that are aligned with the new headquarters model.”

This reduction in leadership and departments signals a dramatic shift in how WHO intends to operate under constrained financial conditions. The agency appears focused on consolidating functions, eliminating duplication, and shrinking its operational footprint globally.

Financial Realignment and Cost-Saving Measures

WHO’s downsizing follows a harsh reality: donor funding, which comprises the bulk of the organization’s budget, has fallen short amid global economic strain. The 21% cut to its projected budget leaves a financial gap that cannot be bridged without fundamental changes.

To mitigate the effects, WHO is adopting several cost-saving initiatives. These include relocating certain functions to less expensive regions, offering early retirement options to eligible staff, and reducing its physical office space globally.

“These measures are expected to generate over US$165 million in savings by the end of the year,” Dr. Tedros revealed.

Despite the financial pressures, he emphasized that WHO remains committed to supporting its employees during this difficult time. The organization has implemented various support programs focused on mental health, professional counseling, and career transition services.

New Executive Management Team Announced

As part of the structural overhaul, WHO has unveiled a revamped executive management team that will assume office on June 16. According to Dr. Tedros, the team was selected with a deliberate focus on gender balance and geographical diversity.

The newly appointed leaders are:

• Dr. Jeremy Farrar – Assistant Director-General for Health Promotion and Disease Prevention and Control

• Dr. Yukiko Nakatani – Assistant Director-General for Health Systems

• Dr. Chikwe Ihekweazu – Executive Director of the Health Emergencies Programme

• Dr. Sylvie Briand – Chief Scientist

• Dr. Razia Pendse – Chef de Cabinet

• Mr. Raul Thomas – Assistant Director-General for Business Operations and Compliance

“This was an extremely difficult and painful decision for me, as it is for every manager who had to decide who stays and who goes,” Dr. Tedros remarked. He also thanked outgoing executives for their service and contributions to global health, expressing optimism about the new leadership’s ability to steer WHO through its most critical transition yet.

Redefining WHO’s Role and Scope

The downsizing signals a philosophical shift in WHO’s future direction. With fewer resources at its disposal, the organization must now sharpen its focus on core functions. This likely means fewer expansive health programs and more targeted interventions, particularly in emergencies and global disease surveillance.

“We are undergoing a major structural realignment to prioritize essential functions,” Dr. Tedros explained. “We cannot do everything, especially not with a reduced budget. We must do what matters most, and we must do it well.”

WHO is also encouraging Member States to show flexibility and understanding during this difficult transition. Dr. Tedros urged nations to avoid overwhelming the agency with additional mandates or responsibilities, given the financial and structural constraints now in place.

A Wake-Up Call for Global Health Financing

This historic restructuring exposes deeper vulnerabilities in the global public health funding system. WHO has long relied on voluntary contributions from Member States and donors, which are often earmarked for specific programs and come with political strings attached. As those funds shrink or disappear, the agency’s ability to function independently and efficiently has been dramatically weakened.

While WHO has faced criticism in the past for bureaucratic inefficiencies, this latest round of cuts threatens to hollow out essential parts of its infrastructure—at a time when global health threats, from pandemics to climate-related diseases, are on the rise.

In response, global health experts have called for a more stable funding model that guarantees predictable, sustainable financing for WHO. Some have proposed increasing the proportion of assessed contributions—mandatory payments from Member States—so the agency can plan long-term and respond to emergencies without scrambling for funds.

Looking Ahead: Transition with Caution

The WHO’s decision to reduce its budget and scale down operations sends a sobering message about the current state of global health diplomacy. As the world’s leading public health authority, WHO’s shrinking capacity could have far-reaching consequences for disease surveillance, pandemic response, and international health policy.

For now, WHO will continue its realignment in the hope that these tough reforms will lay the groundwork for a more resilient, focused, and efficient organization. But the road ahead remains uncertain.

“I ask for your understanding and restraint,” Dr. Tedros pleaded in his closing remarks. “Please support us to focus on our core functions and avoid overburdening us during this time of transition.”

As the restructuring unfolds, much will depend on how WHO manages its reduced workforce, reconfigures its priorities, and maintains its relevance in a world still grappling with unpredictable health threats.