Global health. The current scenario and future perspectives

35 the Gates Foundation to the WHO is notable, making it the third, or even second if GAVI is also considered, largest contributor to its total budget and it surpasses many industrialized countries. For the biennium 2020-21, Germany became the largest contributor (17%), followed by the Bill and Melinda Gates Foundation (9.5%), the US (7%), the European Commission (6.5%), GAVI (6.4%), the UK (6%), the World Bank (2.5%) and Rotary International (2.4%) (WHO, 2019; WHO, 2022). All contributions are welcomed but, although member countries approve the priorities of the WHO, parties that contribute more extrabudgetary funds and foundations like Gates or Rotary, which establish their own priorities independently, can bias the Organization’s policies and operations. Naturally, the WHO does not accept contributions for topics outside its competence, but excessive dependence on funds allocated at will, can distort global priorities and favor some regions or countries more than others. The WHO’s dependence on voluntary funds has been raised as a problem for years and is cause for significant concern within the global Official Development Assistance (ODA) system. However, it seems unlikely that member countries will increase their non-specific contributions in the short term. Therefore, it is necessary to seek a governance mechanism that enables funding priorities to be set in a way that ensures the universality of the right to quality health while incentivizing the non-state or philanthropic sector to continue contributing. Evolution of Mandate The governance of the WHO has been affected by the changing nature of its interventions, like other UN entities. It was initially conceived as a regulatory entity, with sporadic meetings of government representatives being sufficient as governments themselves implemented the recommendations. However, with the decolonization processes of the 1960s and 1970s, the focus of the WHO shifted towards technical cooperation with emerging countries by placing a strong emphasis on national needs. From the late 20th century pandemics (HIV/AIDS, SARS, Asian Flu, Ebola, etc.) to Covid- 19, WHO has been under increasing pressure to take a leadership role in the global management of emergencies. National interventions, no matter how well-designed and resourced, are insufficient to effectively address situations that require collaboration and coordination among countries and even continents. The WHO has responded as well as possible by utilizing mechanisms that were not initially designed for this purpose, such as the disaster department,