The history of the WHO goes hand in hand with the post–World War II move to unite the globe and maintain security and peace internationally. Around the time the United Nations (UN) was founded, in 1945, the idea of funding a system to coordinate global health affairs like malaria, tuberculosis, and women and children’s well-being was proposed. By 1948, the UN had created the WHO, with the principal thought that health care is a human right—an issue still being debated across political stages in the United States.

Today, the WHO, still operating under the larger umbrella of the UN, has 194 member countries, 150 offices around the world, and a biannual budget of $4.84 billion.

Together these member states form the World Health Assembly, which is the guiding body of the organization. They set policy and supervise the budget. They also elect a director-general to a five-year term. Tedros Adhanom Ghebreyesus, a former minister of health in Ethiopia, is currently in charge of the program.

The WHO operates on a voluntary level, and countries are under no obligation to allow the organization in or to follow its guidance, but member states tend to cooperate.

Okay, so who funds it?

The United States is currently by far the largest supplier of WHO funding. The U.S. contributed about $893 million during the two-year budget cycle spanning 2018 to 2019. The President has threatened to end that, but more on that later.

The next largest member-contributor is the United Kingdom, which pledged about $430 million. China pledged just over $75 million.

But there are two ways the WHO collects money: One is through “assessed contributions,” which are the dues member countries pay, and the other is through voluntary contributions, which is the major driver of funds. From 2018 through 2019, the United States pledged $237 million in assessed contributions and $656 million in voluntary contributions.

The second-largest funder of the WHO is the Bill & Melinda Gates Foundation, which granted the organization $531 million in voluntary payments over that same period. Much of the WHO’s funds come from charity organizations like Rotary International, which donated $143 million, and the National Philanthropic Trust, which pledged $108 million.

In its earlier years, most of the WHO’s funding came from assessed contributions, but as of late that has shifted to voluntary cash infusions. From 2018 through 2019, assessed contributions totaled $956.9 million—just 17% of revenue. Voluntary contributions, meanwhile, added up to $4.49 billion or 80% of revenue. “Other revenue” provided an additional $178.1 million.

The WHO has requested another $700 million from donors to help with the COVID-19 crisis and is expected to increase that ask shortly.

What role has the WHO played in solving past crises?

Since its founding, the WHO has played a critical role in partnering with countries to eradicate infectious ailments. Its successes, however, have come slowly.

In the late 1950s, the organization began a campaign with Russia to end smallpox, but by 1980, the vaccination for the illness was deemed no longer necessary. In the 1970s, the WHO moved to promote family planning and safe sex, as well as vaccinating children from preventable illnesses around the world. The organization set a goal of vaccinating all children against diphtheria, pertussis, tetanus, measles, poliomyelitis, and tuberculosis. The goal was very lofty, and so, some 40 years later, the WHO is still working on achieving it, but some progress is being made. According to 2018 data, the most recent available, 116 million children have completed vaccinations, up 30% since 2000.

In the 1980s the organization set its sights on preventing maternal mortality, and while it missed its initial goalposts, it now hopes to reduce the global maternal mortality rate to less than 70 per 100,000 births by 2030. Additionally, the WHO began its goal of eradicating polio, also yet to be achieved.

More recently, the WHO has focused largely on the HIV/AIDS crisis, particularly in Africa. They have established testing clinics, subsidized and provided treatments, and poured millions into awareness campaigns that focus on how the disease is spread.

“They do work around the world that no one else will do,” explains Protect Our Care chair Leslie Dach, who served as the global Ebola coordinator for the Department of Health and Human Services under the Obama administration. “They put doctors and public health resources on the ground and also strengthen the ability of countries’ own public health systems. They are in many ways the global response organization that we all rely on.”

Dach says that while the organization’s “forest for the trees” viewpoint means that it tends to get ignored for successes and blamed for failures, it was essential in procuring a quick vaccine that tempered what could have become an Ebola pandemic in 2014.

“On Ebola, they made significant contributions, particularly on speeding up the development of a vaccine and its ultimate deployment,” he notes. It’s the well-established localized infrastructure of the WHO that enables it to “perform a unique and critical role.”