Bhutan is set to experience significant funding cuts from the World Health Organization (WHO) due to the United States’ withdrawal as the organization’s largest donor. This decision is already creating ripple effects across the global health community, and Bhutan is no exception.
Bhupinder Kaur Aulakh, WHO Representative to Bhutan, recently informed the Ministry of Health (MoH) and the Ministry of Finance that the WHO will need to implement efficiency measures, including a minimum 25% reduction in funding and programs.
Bhutan had anticipated receiving Nu 1.170 billion from the WHO as part of the 13th Five-Year Plan. Traditionally, these indicative estimates are agreed upon with only minor adjustments. However, given the current situation, substantial cuts are expected. The WHO’s budget cycle operates on a two-year calendar basis. For 2024 and 2025, Nu 520.62 million (USD 6 million) was allocated, of which Nu 347 million (USD 4 million) has already been utilized. This leaves Nu 823 million, with a potential 25% cut equating to approximately Nu 205.75 million.
Given Bhutan’s emphasis on health and education, any major funding reduction will have a significant impact. Key programs supported by the WHO during the 2024-2025 period include universal health coverage (Nu 413 million), health emergencies (Nu 20.82 million), better health and well-being (Nu 43.38 million), improved WHO support for countries (Nu 52 million), and the National Influenza Pandemic Preparedness Plan (NIPPP) (Nu 8.67 million).
Aulakh emphasized that the funding cuts mean the WHO will need to prioritize essential programs over less critical ones. “If there are ten things WHO is doing in Bhutan, we cannot do all ten,” she said. “Each program may argue its importance, but we must focus on the health system’s most pressing needs.”
While acknowledging the challenges, Aulakh also highlighted this situation as an opportunity for WHO to reform its operations, reduce dependence on a single donor, and enhance efficiency. WHO Bhutan is collaborating with MoH to reprioritize activities, exploring ways to merge functions and streamline processes. For example, village health workers might now be trained on multiple health issues in a single session rather than separate sessions for each topic.
Cost-saving measures include reducing unnecessary travel, holding meetings in Thimphu instead of hotels in Paro, and using government halls without catering services. The WHO Bhutan office will also freeze recruitment and optimize the roles of existing staff, avoiding layoffs that have affected WHO offices in other countries.
Despite these cutbacks, WHO assures that essential activities will continue, albeit with more inventive approaches. Major programs include non-communicable diseases (NCD) screening, pandemic preparedness through support to RCDC and testing labs, digital health initiatives like the Electronic Patient Information System (EPIS), and improvements in neonatal care and maternal mortality rates.
The US withdrawal from WHO stems from concerns over the organization’s handling of the COVID-19 pandemic, its governance reforms, and perceived political influence from member states, particularly China. The US also criticized the disproportionate financial burden it bore compared to other countries. In 2024 alone, the US contributed USD 959 million to WHO’s USD 6.8 billion biennial budget. In contrast, China contributed USD 202 million, ranking eighth behind countries like Germany and the UK.
With the US exit, the WHO is striving to maintain its programs worldwide, albeit with constrained resources. In Bhutan, the focus now shifts to maximizing efficiency to ensure that critical health initiatives continue to serve the population despite financial limitations.
