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Mid-term Results Report

The world needs WHO
Now more than ever

Programme budget
2020–2021
Dr Tedros Adhanom Ghebreyesus Director-General's foreword

When I penned the Foreword to last year’s WHO Results Report, 4 million cases of COVID-19 had been reported to WHO, and some 300 000 people had lost their lives. A year later, the number of cases has ballooned more than 40-fold, to almost 160 million, and the number of deaths has increased 11 times, to more than 3.3 million.

A year ago, vaccines were still a distant hope; now they are giving us real hope of bringing the pandemic under control. Even so, the shocking disparity in the global distribution of vaccines is another painful reminder of the inequities that blight our world and lie at the root of so many of its problems.

The past year has been the most testing in our Organization’s history. However, it has also demonstrated why, more than ever, the world needs a strong and sustainable WHO. Our transformation is continuing to take root and bear fruit: many of the changes we have made have been tested by fire during the past year, and have shown their worth. Already many lessons have been learned, more changes have been made, and new initiatives have been launched to strengthen the world’s pandemic preparedness and response capacities.

This report showcases the incredible breadth and depth of WHO’s work over the past year, in responding to the pandemic, supporting countries to minimize disruption to essential health services, and in continuing our normative work at all three levels of the Organization.

Reflecting our commitment to transparency, accountability and delivering an impact, the report presents WHO’s achievements in the past year against the Output scorecard, a unique reporting mechanism in the United Nations system that provides a detailed accounting of our achievements against each of the “triple billion” indicators agreed by Member States.

Even before the pandemic, the world was lagging behind in its efforts to achieve the “triple billion” targets and the health-related Sustainable Development Goals. There is no doubt that the pandemic has blown us even further off course. At the same time, it has reminded us why the targets are so important, and why we must pursue them with even more determination and innovation.

A crisis often helps us to see with greater clarity what really matters. COVID-19 has robbed us of people we love, deprived millions of their livelihood, plunged the world into economic turmoil, torn at the social fabric and fanned the flames of inequity. But it has also reminded us that life is fragile, and that health is not a luxury item for the rich. Rather, it is the most precious commodity on earth, and the foundation of the healthier, safer, fairer and more sustainable future we all want.

Feature stories

2020, a year like no other. A special look into the indispensable role of WHO in the COVID-19 pandemic.

Health emergency preparedness after COVID-19: building for the future In 2020, we saw that the world was not adequately prepared for a pandemic. COVID-19 is providing pointers for better preparedness. 
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WHO: the world's guiding light in health emergencies WHO’s response to COVID-19 has been its fastest and most far-reaching to a health emergency. 
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Fighting on two fronts: to eradicate polio and to defeat COVID-19 The pandemic has underscored the vital need to transition the polio network to continue serving national health programmes.
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Fighting COVID-19 in a transforming WHO As knowledge about COVID-19 was emerging in January 2020, the fourth phase of WHO transformation - implementation and continuous improvement – had just begun.
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An infant battling pneumonia in De-Martini hospital in Somalia

PROGRESS TOWARDS

Impact on health, well-being and security

The aim of the GPW triple billion targets is to improve the health of millions of people around the world by 2023. They will provide a near-term snapshot of the world’s progress towards the Sustainable Development Goals (SDGs) for 2030. Current progress in reaching each of the three billion targets is summarized below. (The projections do not yet include the impacts of the COVID-19 pandemic.)

    ACHIEVING 1 BILLION MORE PEOPLE BENEFITING FROM UNIVERSAL HEALTH COVERAGE
    An additional 290 million people are projected to have access to high-quality health-care services without incurring financial hardship by 2023, which will nevertheless leave a significant expected shortfall of 710 million. With accelerated progress, it may be possible to close the shortfall by about 30%. Progress is expected to be greatest in low-income countries. The COVID-19 pandemic threatens progress, however, because of severe service disruptions and increasing financial hardship. Redoubled emphasis on primary health care, which also supports the other two billion targets, will be key for recovery from COVID-19.
    ACHIEVING 1 BILLION MORE PEOPLE BETTER PROTECTED FROM HEALTH EMERGENCIES
    About 920 million people are projected to be better protected from health emergencies in 2023 because of improvements in emergency preparedness, vaccination and more timely responses. COVID-19 has shown that the world was unprepared for such a pandemic; additional considerations for readiness capacity and effective response are needed. The current roll-out of COVID-19 vaccines is an opportunity to accelerate routine and emergency vaccination, with equity as a focus.
    ACHIEVING 1 BILLION MORE PEOPLE LIVING WITH BETTER HEALTH AND WELL-BEING
    Around 900 million people could be enjoying better health and well-being by 2023. Progress is uneven, with limited progress in low-income countries and over a third of countries showing negative overall trend. Focus should be directed to the indicators that lag most behind the SDG targets, including water and sanitation, air quality and tobacco use. Tackling the world-wide trend of increasing obesity will also be important.
A MORE EFFECTIVE AND EFFICIENT WHO PROVIDING BETTER SUPPORT TO COUNTRIES
COVID-19 pandemic has demanded strong global health leadership. At every twist and turn of the evolution of the pandemic, there was a demand for a strong WHO – for a lead health authority that was evidence-based, data-driven, results-focused and impact-driven. The pandemic placed many demands on WHO, severely testing the Organization. Yet WHO has responded to the pandemic at a scale and pace never seen before, helping to ensure essential supplies, coordinate the response and prepare for the delivery of vaccines, therapeutics and diagnostics for even the most vulnerable communities. COVID-19 has demonstrated the benefits of WHO’s transformation into an agile organization able to rapidly leverage global technical expertise and operate on a global scale. With every major health crisis, WHO has transformed. The Organization will continue to evolve alongside shifting disease patterns and innovations in science. But WHO will continue to remain grounded in its core values of solidarity and equity to build its vision of a healthier, safer, fairer world in the 21st century.
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Budget implementation summary

WHO’s biennial Programme budget is based on the principles of transparency, accountability and providing value for money

  • The World Health Assembly approved a total budget of US$ 5.84 billion for the 2020–2021 biennium.
  • The Programme budget for this biennium was presented in four distinct segments: the Base programmes, Polio eradication, Special programmes and Emergency operations and appeals.
  • As of 31 December 2020, budget utilization in all major offices is in line with that of previous biennia, and by the end of 2020 it had reached 60%.
  • The Programme budget is fully funded at the segment level, despite the impacts of the COVID-19 crisis on the world’s economy .

    Approved Programme budget
    US$ 5840.00 MILLION
    Available funds
    US$ 8260.00 MILLION
    Utilization
    US$ 3505.90 MILLION
The budget segment for Base programmes represents WHO’s core mandate and constitutes the largest part of the Programme budget in terms of strategic priority setting, detailing of deliverables and budget figures. The overall Base programme segment of US$ 3.8 billion is 106% funded and has a utilization of 39%. Despite the COVID-19 pandemic, the Secretariat is committed to deliver on the promises of the Base programmes in the Programme budget and will continue striving for a high level of utilization.

 

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Health outcomes

Health outcomes we achieve together with Member States and partners to contribute to the triple billion targets.

3.1 Determinants of health addressed
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Improving the social and environmental determinants of health contributes significantly to the overall health of populations and reduces health inequities.

The strong leadership of WHO in the area of health and environment has yielded important results, including the Manifesto for a healthy and green recovery from COVID-19, which advocates more than 80 practical actions, and also high-level policy dialogue and engagement with partners to mobilize funding.

In January 2020, WHO was approved as a partner in Green Climate Fund Readiness. This will allow WHO to support countries in accessing funds for planning and otherwise preparing to build their capacity in addressing climate change and health. In December, the first projects were approved: a regional US$ 1 million project for the Caribbean and one for Argentina. Proposals are being prepared for 12 more countries.

The pandemic put a spotlight on air pollution, the most important environmental determinant of health, which caused an estimated 7 million premature deaths in 2020. Evidence is accumulating that fine particulate matter, which is affected by government policies, is a risk factor for severe COVID-19. WHO has stepped up work on air pollution in recent years, with increased leadership, evidence synthesis and monitoring, and is currently updating a global assessment of ambient air quality. Some countries have placed green development at the heart of their COVID-19 recovery plans.

COVID-19 has also highlighted the importance of safe water, sanitation and hygiene (WASH) to protect humans from infectious diseases. Various guidance in this field was issued, including for protecting health workers. A global initiative on hand hygiene for all was launched in response to the pandemic, which will ensure lasting infrastructure. Other work is being done to scale up WASH services, including training in health-care facilities, training in planning sanitation safety, “learning laboratories” to improve the quality of care and a tracker to follow country progress.

The objective of the health and energy platform is to strengthen cooperation between the two sectors to ensure access to clean, sustainable energy. Strategic engagement in policy events within and beyond the health sector has included areas such as sustainable development, climate change and chemicals.

The worldwide COVID-19 pandemic has highlighted and sometimes exacerbated social, gender and health inequities. WHO has called consistently for social determinants of health to be part of any national response to COVID-19. Disadvantaged and minority communities are not only at increased risk of exposure to COVID-19 – in front-line jobs or overcrowded housing – but are also more likely to have precarious, unstable income and less access to health services and thus suffer disproportionately from lockdowns and school closures. Lockdowns have also resulted in increases in certain types of violence, child neglect and maltreatment.

WHO has supported Member States in mitigating the severe social and economic shocks caused by the pandemic. The Regional Office for Europe has issued evidence and indicators of the socioeconomic impacts, while the Regional Office for the Western Pacific has issued advocacy briefs and guidance.

The resources made available include information on lockdown-related violence against children; guidance on public transport, ageing and homelessness in the context of COVID19; and a resource centre with innovative examples of responses to the pandemic.

WHO also provided input on equity for the United Nations framework for the socioeconomic response to COVID-19 and for COVID-19 control in humanitarian settings. Briefings and tools to address social protection are being produced with partners.

WHO is widely acknowledged as a global leader in advancing evidence-based approaches to addressing violence against children. A report published in 2020 was described as seminal. The Global status report on preventing violence against children 2020 provides baseline information on national work to advance the INSPIRE evidence-based strategies for preventing violence from 155 countries and is a strong foundation for future technical support.

In the area of road safety, WHO continues to advocate for greater recognition of this issue in international and multisectoral fora. Important milestones include the Ministerial Conference on Road Safety in February 2020, which was followed by a United Nations General Assembly resolution that proclaimed 2021–2030 as the Second Decade of Action for Road Safety. WHO is coordinating development of a Global Plan to respond to the resolution with other stakeholders so that it can respond to country needs and coordinate technical input.

While COVID-19 has delayed some technical work on this outcome, it has provided opportunities to integrate social determinants of health into discussions on both the pandemic response and building back better.

To find progress on health outcome indicators, visit the World health statistics

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How the WHO secretariat contributes to health outcomes

To demonstrate greater accountability, the WHO Secretariat measures the delivery of its outputs through the Output Scorecard.

Choose output
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Scale: 1-Emergent 2-Developing 3-Satisfactory 4-Strong
These are the narratives
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Stories of WHO’s impact in countries

Selection of stories that exemplify how WHO is achieving impacts where it matters most