Parliamentarians support call for fundamental rethinking of the World Health Organization

The All-Party Parliamentary Group on Pandemic Response and Recovery welcomed two members of the International Health Reform Project (IHRP) to their latest meeting. IHRP panel Co-Chair Dr David Bell and panel member Professor Garrett Wallace Brown spoke to the Group about the project, which has released two major reports proposing a bold new framework for multilateral health cooperation.

The IHRP reports, The Right to Health Sovereignty Policy Report and its accompanying Technical Report, challenge the current trajectory of the World Health Organization (WHO) and advocate for a return to a model grounded in health sovereignty, medical ethics, evidence-based public health, subsidiarity and genuine respect for individual and national autonomy.

The IHRP panel comprises a number of international academics, specialists and experts representing multiple continents from fields including global health, human rights, law, philosophy and finance. The project was established over a year ago and is co-chaired by Professor Ramesh Thakur (former UN Assistant Secretary-General).

In his remarks at the meeting, Dr David Bell (clinical and public health physician and former Scientific Officer at WHO) outlined the panel’s concerns and vision:

“The World Health Organization has a legitimacy problem. Early on, the programmes WHO ran were focused on improving global health and life expectancy, particularly in low to middle income countries. However global health governance has drifted too far from its founding principles and we now have mission creep, centralisation justified by emergency framing, rigidity and high levels of earmarked and non-state funding. We formed the International Health Reform Project panel as a group concerned about the deep structural and ethical problems within the WHO. While there are other efforts to talk about reform, they are all about centralisation, expansion, more power. We take a different approach.

“The aim of the panel is to stimulate a rethink of multilateral health cooperation at an institutional level: what would an organisation look like if you designed it now based on the original post-World War II tenets of human rights, medical ethics, evidence-based public health? We are very strongly in favour of having a WHO-like organisation, just one that is much more effective and functions through decentralisation and subsidiarity.”

Professor Garrett Wallace Brown (Chair of Global Health Policy at the University of Leeds) added his perspective on governance and funding issues:

“There are very good people trying to do good work but they are hamstrung by the direction in which the WHO has drifted. Previously, 80% of the funding was assessed contributions from member states. That has flipped entirely, so now 80% of the funding is voluntary, earmarked and dominated by private and other non-State funders like the Gates Foundation who dictate what it should be spent on. It has changed how the WHO functions. I have been working with a lot of countries in Geneva on the Pandemic Agreement, particularly ones that are critical. There is a lot of disquiet among member states. Many have seen how the WHO works, bolstered by reputation and survival instincts. Their concerns can and are being sidestepped or ignored and those member states feel marginalised and exuded.

“Admittedly, member states have let that drift happen so they need to reclaim the WHO’s original mandate, but in the modern context. Return it to being highly focused on global public health proportional to disease burdens and to need.”

Rt Hon Esther McVey MP, who chaired the discussion, said:

“I think it is time serious questions were asked about the World Health Organization’s purpose. We saw how damaging its ‘one size fits all’ approach and conflicting health advice was during Covid. It seems the WHO is now obsessed with pandemics and producing 100 day vaccines, when actually this accounts for a relatively small share of global mortality. It is clear the WHO has adopted this stance largely thanks to the shift in funding, from assessed to earmarked.

“In reality the health issues we should be very concerned about such as heart disease, diabetes, obesity or endemic infectious diseases like TB or HIV in lower income countries, are simply being neglected. The WHO has become detrimental to improving global health outcomes, not really a health organisation at all. Our Group fully supports either reform of the WHO or a brand new international health organisation.”

Speaker biographies:

Dr David Bell is a clinical and public health physician with a PhD in population health and a background in internal medicine, modelling and epidemiology of infectious disease. He has worked in global health and biotech for the last 20 years and was previously Director of Global Health Technologies at Intellectual Ventures Global Good Fund in the USA, Programme Head for Malaria and Acute Febrile Disease at FIND in Geneva, worked in infectious diseases and coordinated malaria diagnostics strategy at the World Health Organization. He currently consults in biotech and international public health.

Professor Garrett Wallace Brown is Chair in Global Health Policy at the University of Leeds and a long-standing collaborator with the World Health Organization providing evidence and analytics for emergency preparedness and health security. He has conducted research in global health for over 20 years with specialisms in global health financing, health economics, health system strengthening in African contexts, global health security and pandemic preparedness. He has acted as a global health policy expert at the G7 and G20, for the UK Cabinet Office COVID-19 Round table Group and with over 15 national health and regional bodies.

The International Health Reform Project

The IHRP’s two recent publications — the policy report The Right to Health Sovereignty and the accompanying technical report — provide a detailed analysis and practical template. They argue that the current WHO model has drifted toward excessive centralisation, mission creep, reliance on earmarked (specified) funding from a small number of powerful donors (including private entities), and a legalistic “treaty-based” approach that can override evidence and local contexts.

Key recommendations include:

· Strong emphasis on health sovereignty — respecting individual informed consent and national decision-making.

· Decentralisation and subsidiarity: Decisions should be taken at the most local effective level, with regional coordination where epidemiologically and culturally appropriate rather than one-size-fits-all global directives.

· Greater financial independence through assessed contributions from states, strict conflict-of-interest rules, and firewalls around private funding.

· Deep staffing reforms, including term limits.

· Time-bound mandates and a focus on core functions such as normative standards, managing cross-border issues like substandard medicines, and supporting (rather than directing) national capacity-building.

· Proportional responses that reflect actual global disease burdens — shifting away from over-emphasis on rare high-profile outbreaks toward enduring drivers of poor health such as poverty, sanitation, and nutrition.

The reports note significant shifts since the WHO’s founding: a dramatic decline in infectious disease mortality, a rise in non-communicable diseases better addressed through national and cultural approaches, and changes in funding that have made the organisation increasingly dependent on a handful of specified donors. The panel stresses that effective multilateral cooperation remains morally and practically essential for building sustainable health capacity in low-income countries and enhancing global stability.

However, they argue that any reformed or successor organisation must be designed for today’s realities — not locked into an 80-year-old structure prone to bureaucratic drift and donor influence. The IHRP aims to stimulate informed debate among policymakers, member states, and the public as negotiations on the WHO’s proposed pandemic agreement continue and a new Director-General is selected. The reports offer a constructive alternative template that priorities evidence, ethics, proportionality, and genuine partnership over top-down control. For more information or to access the reports, visit the Brownstone Institute’s International Health Reform Project page.

The panel welcomes engagement and feedback from governments, parliamentarians, and health leaders committed to building a more effective, accountable, and ethical system of international health cooperation.