---
title: "WHO & the Global Health Governance System Explained"
description: "Learn the WHO's constitutional mandate, the International Health Regulations, the pandemic treaty talks and reform debates in health governance for the exam."
url: "https://modeldiplomat.com/learn/lessons/exam-global-institutions-who-global-health-governance"
---

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WHO & global health governance

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# WHO & global health governance

The WHO's constitutional mandate, the International Health Regulations (2005), the pandemic treaty negotiations, and the structural reform debates in global health governance.

## The WHO's Constitutional Foundations

The World Health Organization was established on 7 April 1948 (now World Health Day) as the UN specialized agency for health, under Article 57 of the UN Charter and its own Constitution adopted at the 1946 International Health Conference in New York. The Constitution's preamble enshrines the foundational principle that 'the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being.' The WHO succeeded the League of Nations Health Organization and the older Office International d'Hygiène Publique (1907).

## Governance Organs

The WHO operates through three principal organs. The **World Health Assembly (WHA)**, comprising all 194 member states, is the supreme decision-making body; it meets annually in Geneva, sets policy, approves the budget, and elects the Director-General. The **Executive Board** of 34 technically qualified members gives effect to WHA decisions. The **Secretariat**, headed by the Director-General (Dr Tedros Adhanom Ghebreyesus, elected 2017, re-elected 2022), administers the organization across six regional offices — AFRO, AMRO/PAHO, SEARO, EURO, EMRO and WPRO. India falls under SEARO (South-East Asia Regional Office, New Delhi).

## Quasi-Legislative Powers

Unlike most UN agencies, the WHO wields genuine norm-setting authority. Under **Article 19** of its Constitution, the WHA may adopt binding conventions by a two-thirds vote — the only instance being the **WHO Framework Convention on Tobacco Control (FCTC), 2003**, which entered into force in 2005 and has over 180 parties. Under **Article 21**, the WHA may adopt **regulations** that bind all members unless they opt out — the basis for the International Health Regulations and the Nomenclature Regulations. Under **Article 23**, it issues non-binding recommendations. This treaty-making capacity distinguishes the WHO from purely advisory bodies.

## Financing Vulnerabilities

The WHO's budget reveals its core weakness. Assessed contributions (mandatory dues) fund under 20 percent of the budget; the remainder comes from **voluntary contributions**, much of it earmarked by donors such as the Bill & Melinda Gates Foundation and the GAVI Alliance. This earmarking constrains the Secretariat's autonomy and skews priorities toward donor preferences. The 2022 WHA approved a landmark sustainable-financing reform to raise assessed contributions to 50 percent of the base budget by the 2030-31 biennium. The United States' announcement of withdrawal in 2020 (rescinded in 2021, then re-initiated in January 2025) exposed dependence on a single large funder, the US historically being the largest contributor.

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