Reforming the World Health Organization to strengthen scientific independence and public trust

Abstract The World Health Organization (WHO) has grown markedly since its inception and has achieved major successes in global public health, including the eradication of smallpox and leadership in vaccination programmes and disease surveillance. Nevertheless, WHO has come under increasing scrutiny over its handling of recent international health emergencies, its governance, and its financial dependence on a relatively small number of major contributors. Much of its budget now derives from voluntary, highly specified contributions that limit organisational flexibility and raise legitimate questions about institutional independence and priority setting. Recent controversies surrounding the COVID-19 measures, together with broader debates about global health governance, have exposed concerns extending beyond emergency response. Critics have questioned WHO’s transparency, accountability, responsiveness and ability to balance technical advice with the political realities of an organisation governed by sovereign member states and increasingly influenced by earmarked funding. Calls for reform have emerged from across the political and academic spectrum, ranging from proposals for incremental organisational restructuring to more fundamental redesign of global health governance. We argue that the world continues to require a credible international health organisation, but that restoring WHO’s legitimacy will require more than additional funding or administrative restructuring. It will require greater transparency, financial independence, clearer institutional priorities, stronger external accountability and renewed confidence that scientific evidence rather than political expediency drives decision-making. Without such reforms, future global health emergencies risk exposing the same structural weaknesses that have increasingly undermined public confidence.