Who's leading WHO? A quantitative analysis of the Bill and Melinda Gates Foundation's grants to WHO, 2000-2024

The Bill and Melinda Gates Foundation (BMGF) has been the World Health Organization's (WHO) second biggest source of funding in recent years, contributing 9.5% of WHO's revenues between 2010 and 2023 through voluntary contributions. It is widely assumed that BMGF's financial power allows it to exert considerable influence over WHO. However, very little empirical research has been undertaken into the BMGF-WHO relationship. Our study investigates how the money that BMGF gives to WHO is spent.

We constructed a dataset of BMGF grants to WHO for the period 2000-2024 by extracting and coding data retrieved from BMGF's website. The dataset was analysed to examine the number and value of grants, and the diseases or health issues and activities that were funded.

BMGF made 640 grants worth $5.5 billion to WHO between 2000 and 2024. This is 6.4% of all BMGF's grants by value in the period. Grants worth $4.5 billion focused on infectious diseases. This amounts to 82.6% of all BMGF contributions to WHO by value. Of these, $3.2 billion (58.9%) went to polio. $2.9 billion - 53.3% of the money BMGF disbursed to WHO - funded vaccine programmes and projects. Relatively little BMGF funding went to non-communicable diseases, strengthening health systems, and broader determinants of health, despite their importance to WHO strategy and global health more generally.

WHO's reliance on earmarked voluntary contributions means that global health challenges favoured by major donors' are well funded while other issues receive insufficient funding. As one of WHO's biggest donors, BMGF contributes to this problem by pursuing its narrow approach to global public health - one that focuses on technical solutions to infectious diseases - through WHO.