The World Health Organization (WHO) is undergoing sweeping restructuring amid a severe financial crisis triggered by the United States' decision to halt funding and withdraw from the agency. With the loss of its largest donor and reduced aid from other countries, the WHO is now slashing operations, laying off staff, and consolidating departments.

Addressing member states on Tuesday, WHO Director-General Tedros Adhanom Ghebreyesus warned that the organization is grappling with a deepening budgetary crisis. "The sudden drop in income has left us with a large salary gap and no choice but to reduce the scale of our work and workforce," he stated.

The financial blow comes after President Donald Trump formalized a full US withdrawal from the WHO, set to take effect in January 2026. In addition to pulling out, the Trump administration has refused to pay its assessed membership dues for 2024 and 2025. Historically, the US provided nearly $1 billion over the 2022–2023 period, accounting for 18% of the agency's budget. The sudden freeze of virtually all US foreign aid, especially in health, has exacerbated the impact.

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Other traditional donors, including several European countries, have also begun scaling back their official development assistance, compounding the pressure on WHO's budget. As a result, the agency now faces an estimated salary gap of between $560 million and $650 million for the 2026–2027 biennium, which amounts to roughly a quarter of total staff costs. "The refusal of the US to pay its assessed contributions for 2024 and 2025, combined with reductions in official development assistance by some other countries, means we are facing a salary gap for the 2026–27 biennium of between $560 and $650 million," Tedros explained.

While the Director-General noted that the budget shortfall "doesn't necessarily mean a 25-percent cut to the number of positions," the reorganization is already underway. The most significant reductions will hit WHO's Geneva headquarters. "We are reducing the senior leadership team at headquarters from 12 to seven, and the number of departments will be reduced by (more than) half, from 76 to 34," he said. The organization will now focus its resources on core pillars such as health systems, emergency response, and disease control.

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According to internal WHO planning documents, the overall shortfall for the 2025–2027 period could reach as high as $2.5 billion, with program areas like polio eradication, HIV treatment, and disease outbreak response facing significant disruptions if alternative funding is not secured.

Tedros described the choices ahead as painful but necessary. "These are very painful decisions for all of us," he said, urging member states and partners to step up support to preserve WHO's ability to respond to global health crises.

The unprecedented retrenchment comes at a time when the global burden of disease remains high and the need for coordinated health governance is intensifying. As the WHO fights to stay operational, the future of international public health cooperation hangs in the balance.