Last year, the partner countries of the World Health Organisation (WHO) signed a so-called ‘pandemic agreement’ on how to tackle future pandemics, such as COVID-19. The aim is to work together more effectively to prevent pandemics, but also to respond to them more effectively. Diplomats are currently meeting again in Geneva to negotiate the details of this agreement.
Confidence in the WHO has fallen between 2022 and 2025, according to a poll conducted in a number of countries, including Japan and Indonesia. This should come as no surprise. The WHO’s handling of the coronavirus crisis must, at the very least, be described as questionable.
In the epidemic plans of Western countries, a lockdown was not envisaged as a policy tool. In 2020, this type of policy was imposed in most countries following the Chinese example. Italy was the first Western country to act in this way.
However, an alternative approach to Covid was already evident at that time, namely that of Taiwan, which did not impose a lockdown, despite being right next door, but instead implemented a policy of strict border controls and quarantine.
The reason for this is not hard to find. The WHO was the crucial international forum for health policy, and there the Taiwanese approach is taboo, which is also due to the significant Chinese influence on the organisation.
Taiwan and Sweden
The fact that Taiwan had already warned at the end of December 2019 that a new disease had emerged in the Chinese city of Wuhan therefore had little effect. The WHO continued to claim that there was nothing much to worry about, in line with the Chinese government, which, according to Le Monde, was the result of Chinese lobbying to avoid declaring a global pandemic. Taiwan’s vice-president, Chen Chien-jen, himself an epidemiologist, complained in 2020 that “none of the information shared by our country is posted” on the WHO’s website.
The Belgian microbiologist Herman Goossens, who acted as coordinator of the EU platform for epidemics, also lamented in May 2020 the approach of following the WHO’s recommendations. He stated:
“We should have looked to other countries. To Taiwan or South Korea. Countries that have kept the virus under control, thanks to a policy of immediate and targeted testing, combined with extensive contact tracing and the isolation of infected individuals. Taiwan had already been systematically quarantining infected individuals since early January. But it is not a member of the WHO and was not on our radar. When we look back on this in a few months’ time, we will sigh: ‘Come on, guys, we could have avoided that lockdown.’”
Whether those lockdowns were such a good idea is highly questionable. In a study from 2023 for the American think tank Cato Institute, the Swedish commentator Johan Norberg makes it clear that the lockdowns were useless. He compared countries on the basis of excess mortality figures, because Covid statistics were notoriously unreliable. His own country, Sweden, which, like Taiwan, never imposed a lockdown, comes out best.
Norberg stated at the time:
“Sweden’s excess mortality during the three pandemic years 2020–2022 compared to the three preceding years was 4.4%. Remarkably, this is the lowest mortality rate of all European countries, including our Scandinavian neighbours.”
In other words: in 2020, 2021 and 2022, Sweden not only suffered less economic and mental damage than all other European countries that did impose a lockdown. The country was also better protected against the coronavirus. It should come as no surprise that this particularly embarrassing finding receives little coverage in the media, given the overwhelming support among the media and politicians for lockdown policies. Whether this is due to the “herd immunity” that the Swedes built up is a plausible hypothesis, but one that warrants more in-depth research. Perhaps just as many Swedes ultimately died from Covid, but fewer died as a result of inadequate medical care caused by the lockdowns.
The fact is, in any case, that the WHO favoured lockdowns over the Swedish approach, and the fact is that there was less excess mortality in Sweden in 2020, 2021 and 2022 than in the rest of Europe.
How to reform the WHO?
A group of experts wants to restore trust in the WHO. The International Health Reform Project (IHRP) states that it was “founded in response to a growing crisis of confidence in international public health governance. Although this crisis became clearly visible during the Covid-19 pandemic, its roots go back further than 2020 and reflect deeper structural and ethical problems within the World Health Organisation (WHO) and the broader global health architecture.”
The IHRP comprises a panel of ten independent experts drawn from six continents with direct experience of the WHO, the UN and global health policy. The group recently published a policy brief, setting out principles for deep structural reform of global health governance.
According to the experts, the WHO’s main problems are “mission creep, centralisation of authority, dependence on earmarked funding, preference for technological interventions, treaty-based rigidity, and weak accountability.”
Regarding the latter, the focus is on how the money is spent. In 2017, The Associated Press obtained internal documents revealing that the WHO spends approximately $200 million annually on travel expenses, which is more than the organisation spends on combating AIDS, tuberculosis and malaria combined. It is just one of the many scandals that have plagued the organisation for years.
Experts also view dependence on funds that come with conditions as a major problem. Naturally, one immediately thinks of the Bill & Melinda Gates Foundation, which contributed 9.5% to the WHO’s income through voluntary contributions between 2010 and 2023. In this way, it was the second-largest funder of the international organisation.
Almost 80 per cent of the WHO’s budget now comes from voluntary contributions, which donors have earmarked for specific purposes, particularly now that the United States has withdrawn from the WHO, following President Donald Trump’s directive. A 2025 study by Queen Mary University of London revealed that one foundation alone contributed $5.5 billion to the WHO between 2000 and 2024, earmarked for its own chosen priorities in the field of infectious diseases.
It is positive that private donors are committed to health, but the significant influence this consequently gives them on the global health policy forum does raise questions.
Lack of transparency
Furthermore, the IHRP experts also complain of “institutional overreach”, “institutional meddling”, which they say is accompanied by “lack of transparency, conflicts of interest, and misalignment between global health priorities and actual disease burdens, particularly in low- and middle-income countries.” Imposing policies on poorer countries is certainly not in line with the frequent calls during WHO discussions to “decolonise” health policy. The IHRP therefore advocates “subsidiarity”, as “decisions should be taken at the lowest level capable of acting effectively.”
The experts conclude: “International cooperation derives legitimacy from voluntary state participation, which weakens when authority drifts to centralised technocratic bodies.”
The WHO would do well to take this criticism seriously. Many assume that international intergovernmental organisations have a long “lifespan”. In reality, however, more than a third of the international intergovernmental organisations established since 1815 have disappeared, according to a study. One of its findings is that states often prefer to establish new organisations rather than reform existing ones. If the WHO fails to implement the much-needed reforms, it risks cutting off the branch on which it sits. Perhaps other countries will then follow the US’s example.
