Draft proposed programme budget 2026-2027

Draft proposed programme budget 2026-2027

1. Draft proposed programme budget 2026  2027 Imre Hollo, Director, Planning, Resource Coordination and Performance Monitoring

2. Draft programme budget 2026–2027: What is new? In line with commitments to continuously improve transparency and accountability in line with the Secretariat’s implementation plan for reform

3. Establishing country priorities for the duration of GPW 14 Start at the country level to ensure maximum alignment with country situations, national priorities, evidence Informed by country and regional processes Key to developing, implementing and monitoring of the programme budget 2026–2027, informing budget costing, implementation, allocation of resources and resource mobilization efforts Preliminary priority results are similar to prioritization of the programme budget 2024–2025 Prioritization results may be further refined with greater understanding of the outputs during the operational planning phase Process to be established for changes originated by Member States in updating prioritization if required Priority-setting process is ongoing Initial global ranking of outcomes Initial p rioritization results of joint outcomes from five major offices 24 September 2024 N = 151 Number of countries per regional office that have finalized their priority-setting Main outcomes prioritized globally: Joint outcome 2.2. Priority risk factors for non communicable diseases and communicable diseases , violence and injury, and poor nutrition Joint outcome 3.1. The primary health care approach renewed and strengthened to accelerate universal health coverage Joint outcome 4.1. Equity in access to quality services improved for non communicable diseases, mental health conditions and communicable diseases, and AMR Joint outcome 5.2 . Preparedness, readiness and resilience for health emergencies enhanced Joint outcome 3.2. Health and care workforce, health financing and access to quality-assured health products substantially improved

4. Budget increase for base programmes: in line with what was presented in GPW 14 4 GPW 14 document Draft proposed programme budget 2026–2027 The proposed programme budget 2026–2027 departs from the budget estimate for GPW 14 Based on the latest information from the GPEI, polio transition for Pakistan and Afghanistan not included in 2026–2027 The proposed base budget of US$ 5 530.2 million is allocated by major office, based on Global Policy Group (GPG) decision Possible further adjustments

5. Budget summary: segments 5 Base programmes Core mandate of WHO Largest part of the budget Reflects global health priorities Based on GPW 14 overall budget estimate Emergency operations and appeals Operations in emergency and humanitarian settings Two budget scenarios: US$ 1 billion (same as GPW 13) and US$ 2.8 billion (paired with Global Health Emergency Appeal) Polio eradication WHO’s share for the Global Polio Eradication Initiative Special programmes Additional governance mechanisms and budget considerations Budget segment Approved programme budget 2024–2025 Proposed programme budget 2026–2027 Scenario 1 Proposed programme budget 2026–2027 Scenario 2 Base programmes 4 968.2 5 530.2 5 530.2 Polio eradication 694.3 976.3 976.3 Special programmes 171.7 162.4 162.4 Emergency operations and appeals (two scenarios) 1 000.0 1 000.0 2 846.7 Grand total 6 834.21 7 668.9 9 515.7

6. Budget summary: Base programmes Core mandate of WHO Largest part of proposed programme budget 2026–2027 Includes country, regional and global strategic priority-setting Proposed budget increase: 11% (US$ 562m) explained by main areas of investment (see previous slides), particularly country strengthening Major offices will start budget costing based on priority setting and other considerations within their base budget allocations 6 Major office Approved programme budget 2024–2025 (US$ million) Proposed programme budget 2026–2027 (US$ million) Difference between approved and proposed programme budget 2024–2025 (%) Africa 1 326.6 1 509.5 +14% The Americas 295.6 349.0 +18% South-East Asia 487.3 537.2 +10% Europe 363.5 419.7 +15% Eastern Mediterranean 618.4 743.3 +20% Western Pacific 408.1 463.0 +13% Headquarters 1 468.6 1 508.6 +3% Grand total 4 968.2 5 530.2 +11% Proposed programme budget 2026–2027: Base segment by major office

7. Budget segment of emergency operations and appeals Why two scenarios? Event driven In last two biennia, a proxy amount was used, and subsequently increased in line with the level of operations Proxy amount of US$ 1 billion ( Scenario 1 ) was significantly below actual expenditure This segment now performs an annual planning process, involving all six regions, which is the basis for the Global Health Emergency Appeal (GHEA) Scenario 2 is in line with the GHEA 7 Comparison of the approved budget levels and expenditures for the emergency operations and appeals segment of the programme budget (US$ million)

8. Work on output/leading indicators Refined selection criteria to arrive at reduced number of candidates Does the output indicator reflect performance and accountability of the WHO Secretariat in countries? Is there a direct and clear linkage of output indicator as a measure of the plausible contribution of the output to the health outcome? Is the output indicator measurable? Is the metadata of the output indicator clearly defined? Will the indicator value change each year (exceptionally once every two years)?

9. Working Group on Sustainable Financing Landmark decision WHA75(8) to put WHO on a sustainable financing path and increase Assessed Contributions by the end of the decade to reach 50% of the 2022/23 b ase budget. WHA75(8) specified the end goal and the first increase for 2024/25 (20%) But it did not specify the road to get there, i.e. the pace of the next increases Therefore, it was left for subsequent programme budget resolutions to define it – hence the task at hand

10. Proposed increase in assessed contributions 10 Initial assumptions: use of decision WHA75(8) (2022) approved scale of assessment for 2024–2025; target for assessed contribution increase is set at 50% of the 2022–2023 approved budget for the base segment, at US$ 2182 million, to be reached by 2030–2031; Amount of US$ 2182 million should not change, even if future programme budgets increase more than the approved Programme budget 2022–2023; and the increase in assessed contributions is phased, starting from 2024–2025 The first increase in assessed contributions took place for 2024–2025 (US$191.4 million) Assessed c ontributions increase between 2024 and 2031 As introduced in the report on sustainable financing (A75/9) submitted to the Seventy-fifth World Health Assembly

11. Draft proposed programme budget 2026–2027 (regional perspective) Amr El-Tarek, Regional Advisor, Planning, Budget, Monitoring and Evaluation

12. GPW 14 strategic planning approach in the Region 12 Analysing background information from different sources (e.g. Country Cooperation Strategies, national health plans and data, WHO’s comparative advantage) to inform prioritization Using the situation analysis to identify priority levels of GPW 14 outcomes and indicative outputs for the entire GPW 14 period Identifying the expected contributions/interventions from WHO to support the country in achieving the priority outcomes using a theory of change Discussing the above with the Member State (Ministry of Health and others) and other partners and obtaining the formal consent/endorsement of the Member State Publishing the endorsed priorities transparently for Member States and partners/donors

13. Region: initial outcome prioritization results 22 Countries with outcome prioritization results 63%+ Prioritized outcomes 6.1, 4.1, as high priority 41% Of all outcomes prioritized as “High” Joint outcome 6.1 . Detection of and response to acute public health threats is rapid and effective Joint outcome 4.1. Equity in access to quality services improved for noncommunicable diseases, mental health conditions and communicable diseases, and AMR Joint outcome 2.2. Priority risk factors for noncommunicable and communicable diseases, violence and injury, and poor nutrition reduced through multisectoral approaches Joint outcome 5.2 . Preparedness, readiness and resilience for health emergencies enhanced Joint outcome 3.1. The primary health care approach renewed and strengthened to accelerate universal health coverage Eastern Mediterranean Region ranking of outcomes ( N = 22)

14. Region: initial outcome prioritization results ( N = 22) Prioritization results: all major offices N = 151 Prioritization results: Regional Office for the Eastern Mediterranean N = 22 14 Outcome prioritization has a good alignment with global prioritization (4 of the top 5 prioritized outcomes coincide, in a different order), and with regional specificities, particularly related to health emergencies (6.1 ranked highest) Update of country priorities is available at WHO’s Programme Budget digital platform https://www.who.int/about/accountability/budget/programme-budget-digital-platform-2026-2027

15. Region: initial output prioritization results ( N = 22) 15 6.1.1 : WHO strengthens surveillance and alert systems, including diagnostics and laboratory capacities, for effective monitoring of public health threats and the rapid detection, verification, risk assessment, and grading of public health events 5.2.1 : WHO conducts risk and capacity assessments and supports the development and implementation of national preparedness and readiness plans, including tailored prevention and mitigation strategies for specific hazards 3.2.1 : WHO provides technical guidance and operational support to optimize and expand the health and care workforce for integrated service delivery, essential public health functions and improved health and well-being 2.2.1 : WHO develops norms, standards and technical packages that address risk factors for communicable and noncommunicable diseases, violence and injuries, and supports countries in their implementation, monitoring and development of legislation and regulation. 4.1.4 : WHO develops and disseminates evidence-based guidance and standards, builds capacity and supports implementation of a people- centred public health approach and core interventions package to prevent, monitor and respond to antimicrobial resistance

16. Eastern Mediterranean Region-focused areas based on country consultations Multisectoral dialogue and policy advocacy WHO “best buys” and other effective strategies 16 Promote: Noncommunicable diseases risk factors Management of noncommunicable and communicable diseases in facility and community Surveillance, monitoring, and reporting Addressing AMR through multisectoral One Health coordination UHC Priority Benefits Package based on primary health care and essential public health functions Coordination mechanisms for infection prevention and control Provide: Noncommunicable diseases, communicable diseases and AMR, primary health care for universal health coverage Emergency care system National action plan for health security All hazards health risk assessment using STAR, IHR M&E framework ( eSPAR , JEE, IAR, AAR, SimEx ) Public health emergency operations centres National public health laboratories Early warning alert and response Protect: Preparedness, response

17. Utility of GPW 14 strategic planning and prioritization Development of the regional strategic operational plan to operationalize GPW 14 in the Region, including the Regional Director’s flagship initiatives Programme budget 2026–2027 and programme budget 2028–2029 development and operational planning Deliver impact at country level where the results of the strategic planning are basis for: Resource mobilization Financial and human resource allocations Identifying targeted support from Regional Office and WHO headquarters to countries B asis for joint assessment by Member States and Secretariat Baseline for country reporting and independent evaluations

18. Evolution of Eastern Mediterranean Region’s budget share of the Organization-wide base programmes 18 Major office 2018–2019 2020–2021 2022–2023 Revised 2022–2023 2024–2025 Proposed 2026–2027 Eastern Mediterranean 336.0 391.2 469.6 609.8 618.4 743.3 Total WHO 3 400.3 3 768.7 4364.0 4 968.4 4 968.4 5 530.2

19. Evolution of Eastern Mediterranean Region country offices/Regional Office budget allocation for the base programmes 19 The Eastern Mediterranean Region is among the three WHO regions that have the highest regional budget share allocated to the country offices

20. For consideration and discussion by Member States Are Member States in agreement with the proposed programme budget 2026–2027? Which of the scenarios of the e mergency operations and appeals (2 scenarios) shall be considered to go forward? How would Member States like to move forward the discussion of the increase in assessed contributions for 2026–2027 in preparation for WHA78? How would Member States like to scale up the joint assessment of WHO contributions in countries after it was piloted in Egypt and Jordan from the Region last year? 20

21. Thank you!

22. GPW 14 outcomes and number of draft outputs within it 22 Outcome text # Out puts Joint outcome 1.1. More climate-resilient health systems are addressing    health risks and impacts 1 Joint outcome 1.2 . Lower-carbon health systems and societies are contributing to health and well-being 1   Joint outcome 2.1. Health inequities reduced by acting on social, economic, environmental and other determinants of health 2 Joint outcome 2.2. Priority risk factors for noncommunicable and communicable diseases, violence and injury, and poor nutrition reduced through multisectoral approaches 2 Joint outcome 2.3 . Populations empowered to control their health through health promotion programmes and community involvement in decision-making 1   Joint outcome 3.1. The primary health care approach renewed and strengthened to accelerate universal health coverage 3 Joint outcome 3.2. Health and care workforce, health financing and access to quality-assured health products substantially improved 3 Joint outcome 3.3. Health information systems strengthened, and digital transformation implemented 1   Joint outcome 4.1. Equity in access to quality services improved for noncommunicable diseases, mental health conditions and communicable diseases, while addressing antimicrobial resistance 4 Joint outcome 4.2. Equity in access to sexual, reproductive, maternal, newborn, child, adolescent and older person health and nutrition services and immunization coverage improved 2 Joint outcome 4.3. Financial protection improved by reducing financial barriers and out-of-pocket health expenditures, especially for the most vulnerable 1   Joint outcome 5.1. Risks of health emergencies from all hazards reduced and impact mitigated 2 Joint outcome 5.2 . Preparedness, readiness and resilience for health emergencies enhanced 3   Joint outcome 6.1 . Detection of and response to acute public health threats is rapid and effective 2 Joint outcome 6.2. Access to essential health services during emergencies is sustained and equitable 2   Corporate outcome 1 : Effective WHO health leadership through convening, agenda-setting, partnerships and communications advances the draft GPW 14 outcomes and the goal of leaving no one behind 2 Corporate outcome 2: Timely delivery, expanded access and uptake of high-quality WHO normative, technical and data products enable health impact at country level 3 Corporate outcome 3       : A sustainably financed and efficiently managed WHO with strong oversight and accountability and strengthened country capacities better enables its workforce, partners and Member States to deliver the draft GPW 14 outcomes 7

23. Establishing country priorities for the duration of GPW 14 151 countries have so far completed prioritization of joint outcomes Main prioritized outcomes globally: Joint outcome 2.2. Priority risk factors for NCDs and CDs, violence and injury, and poor nutrition Joint outcome 3.1. The primary health care approach renewed and strengthened to accelerate universal health coverage Joint outcome 4.1. Equity in access to quality services improved for NCDs, mental health conditions and CDs, and AMR Joint outcome 5.2 . Preparedness, readiness and resilience for health emergencies enhanced Joint outcome 3.2. Health and care workforce, health financing and access to quality-assured health products substantially improved Prioritization results of joint outcomes (initial results from 5 major offices) N = 151, 24 September 2024 Update of country priorities will be available at WHO’s Programme Budget digital platform