If the World Health Organisation’s only defender was Anders Nordstrom, then it would be fucked already. Thankfully, that’s not the case. Despite sounding like a Bond villain, Nordstrom is in fact – or was – a diplomat. Looking at his resume, it’s not entirely clear what he currently does but he is a former Acting and Assistant Director-General of WHO and a former Swedish Ambassador for Health. Imagine being identified by what you used to do (Andrew Harmer is a former Gardener for Lambeth Council). Oh, wait, he is a board member of the Alliance for Health Systems and Policy Research. So at least he has that going for him.
I suppose the point of it all is to establish one’s credentials. Nordstrom can write about the WHO because of what he used to do. He also floats in stellar company, as you can see from the list of collaborators in a recent Comment he wrote in the Lancet – A WHO worth fighting for: the case for focused, ambitious reform. They are so important that it took them almost 400 words to summarise all their accomplishments – sometimes, a list of email addresses just isn’t enough. Why, why, you might be asking, does it require eight people to write a Comment in the Lancet – can’t Nordstrom write it himself? Well, he probably did, maybe with a bit of help from Kazatchkine (who is the last author in the Comment in the Lancet) – just enough to get him the second best placing in the list of authors. The others are just the padding – Nkengasong, Piot, Robalo Correia e Silva, Alwan, Maciel, and Minghui – whose primary function is to add gravity to the position Nordstrom is taking. And to guarantee publication of a Comment in the Lancet, of course.
Note that Nordstrom is taking a position; he is not making an argument. There is nothing in his Comment in the Lancet that hasn’t been said by him and his cronies before (you will know them well: Nordstrom, Piot, Clarke, Rottingen, Kazatchkine, Kickbusch, Dybul, et al – the Geneva Gliterati), but he’s repeating it again in his Comment in the Lancet to keep the pressure up, to maintain the narrative he is trying to push so that his words become a reality. If you say something often enough, people will accept it just to shut you up. This is what power looks like – a bunch of pals using their collective mass to get their views down on paper and into policy. It happens. All. The. Time. If you don’t have guns and bombs, network instead and write a Comment in the Lancet.
But I can hear you at the back, “Bruce, Bruce, you pelican, we know that that’s how power works, stop rambling and clean the bloody drain!” I know, I know, I’m getting to that! For the TLDR crowd (i.e. all of you), let me pick out the key points and give you a one (maybe two) sentence reply to each. Ready?
- Refocus on core normative and scientific role.Thanks, Dad. WHO does this already and doesn’t need reminding to do it ad infinitum. But wait, what’s this? “WHO should help to set research priorities and norms but should not conduct research itself”. First off, The Welcome Trust won’t be very pleased to hear you say that – everyone knows that it’s the Trust’s job now to set global health research priorities. Second, WHO does research all the time – how else do you think its staff write their reports? Third, as you well know, WHO is working with academics all over the world to produce all manner of research – like on climate change and health. The idea that WHO should stop doing that is just dumb.
- Make governance more effective. OMFG, not this again. The WHO governs – get over it. What this is really about is FENSA and getting WHO to collaborate more with the private sector. Red flag, red flag!
- Reduce operational and delivery functions. “WHO should scale back operational roles, particularly in emergencies”. Wrong. Member States want WHO to do this kind of work. As I’ve argued previously, emergencies work is the heart and soul of WHO and it should do more not less of it. And don’t let the author’s caveat that “this should not be misinterpreted as a withdrawal from the emergency context” fool you. That’s exactly how it will be interpreted.
- Strengthen technical excellence and workforce. Read the room, FFS! WHO’s workforce has just taken a major kicking. You want to strengthen its technical excellence and workforce? Then stop firing people! And this made me laugh: “open and competitive recruitment for senior leadership is essential to building credibility and trust”. Lol – you guys! Comments in the Lancet like yours are interfering with the ‘open and competitive recruitment’ process, as you well know – you are deliberately closing the Overton window so that you get the DG you want.
- Improve country-level relevance. Thanks, the WHO knows that, and it’s on it.
- Prioritise financial independence. Thanks, the WHO knows – it REALLY knows that and – like point 1 – doesn’t need reminding. But – and see every single one of my previous 32 posts on this topic – it’s not just about financial independence.
What Nordstrom is forgetting to mention is that Member States don’t seem to give a fuck about the WHO – at least not enough to fund it adequately. Here’s an image from the just-published Audited Financial Statement for 2025.
Notice anything peculiar? Yes, correct, only one Member State (Germany) contributed more to the WHO in 2025 than Rotary International! What the fuck is wrong with you, Member States? Do you want a WHO or don’t you? The reason why we have to read tedious Comments in the Lancet from grey commentators like Nordstrom is because you won’t fund the Organisation to do the work it needs to do – and should be doing! No research? That’s because you won’t fund it to do research. No emergencies work? That’s because you won’t fund it to do emergencies work. You want technically skilled and valued staff – then pay up so that the Secretariat doesn’t have to sack them all to cover your funding shortfalls.
The fact that Nordstrom et al focus entirely on financial independence is predictable, and irritating. I wrote a whole paper on this once. I agree that relying on a small number of donors is unsustainable – after all, the Organisation’s current number one donor is headed by someone who associated with someone who turned out to be a sex trafficker. That’s not a good look for WHO and I’d be expecting the next DG to address that. Hey, Nordstrom, you could add it to your review of FENSA. No funding from NSAs whose leads are in any way connected to Jeffrey Epstein. It hasn’t been a total disaster (yet) that the WHO’s historically top donor – the United States – has walked off. It may yet be, of course. But the correct response from Member States is to contribute more through flexible voluntary contributions. But that’s not what they are doing.They’re doing the opposite of that, in fact. Not only are they contributing less voluntary contributions year on year (in 2025, gross VCs were down by $399m), they’re contributing less of the flexible (core) VCs (down $104m in 2025).
Much like capitalism and the end of the world, currently it seems easier to imagine the end of WHO than imagine Member States paying more to save it.
Andrew
