World Health Summit in Berlin - Calls for Fewer Agencies : Shared by Madeline Eisner

 Global Health Leaders Urge Fewer Agencies Amid Funding Crisis

By Stefan Anderson – Health Policy Watch
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Summary
At the World Health Summit in Berlin, global health leaders called for a sweeping consolidation of international health institutions, describing the system as overly fragmented, duplicative, and unfit for purpose amid an escalating funding crisis triggered by the withdrawal of U.S. aid under Donald Trump. Executives from WHO, the Global Fund, Gavi, and others acknowledged that the loss of billions has exposed long-standing flaws — heavy donor dependence, overlapping mandates, and inefficient competition among agencies.

Peter Sands of the Global Fund said bluntly that “there are too many underfunded institutions,” while Gavi’s Sania Nishtar urged that “this fragmentation and duplication really needs to come to an end.” Global health assistance has fallen 21% between 2024 and 2025, largely due to a 67% drop in U.S. financing, cutting $9 billion from international health programs and threatening tens of millions of lives.

The WHO’s Dr. Tedros Adhanom Ghebreyesus acknowledged the U.S. right to withdraw funds but criticized the absence of an exit strategy that could have prevented deaths from abrupt program shutdowns. Meanwhile, European donors have also scaled back aid as resources shift toward defense and security. WHO now faces a $1.9 billion shortfall, the Global Fund a $1.4 billion gap, and Gavi a $2.9 billion deficit, while pandemic preparedness funding remains far below recommended levels.

Speakers including Helen Clark and German Health Minister Nina Warken warned that defense budgets are rising even as preventable diseases surge. African leaders such as Jean Kaseya of the Africa CDC used the summit to demand greater sovereignty over health financing, emphasizing local production and regional procurement. Yet debt burdens make this difficult — more than 60 countries now spend more on debt service than on health.

The summit ended with a consensus that global health must shrink and reform to survive — with fewer agencies, clearer mandates, and stronger regional ownership — or risk collapse under the weight of political disinterest and financial austerity.

Quotes

• “The system is too fragmented. There are too many underfunded institutions. There’s too much duplication.” – Peter Sands, Global Fund

• “There’s got to be far fewer agencies in the ecosystem. This fragmentation and duplication really needs to come to an end.” – Sania Nishtar, Gavi

• “People have died… if there was some exit strategy, we wouldn’t have people dying because of the withdrawal of the U.S. funding.” – Dr. Tedros Adhanom Ghebreyesus, WHO

• “The abrupt U.S. withdrawal will cost lives… but it also exposed that our system already needed renewal.” – Axel Pries, World Health Summit President

• “All developing countries… need fair terms in investment, trade, and loans — not charity.” – Dr. Tedros Adhanom Ghebreyesus

• “By denying debt relief, the IMF acts as a debt collector for rich creditors, while harming millions in debtor countries.” – Heidi Chow, Debt Justice