If you followed last week’s 77th World Health Assembly (WHA) – the WHO’s governing body composed of its 194 member states – through press release headlines, it was a historic success. WHO’s Director-General Dr. Tedros closed the week by stating WHA77 had been a “victory for multilateralism”. “Landmark” resolutions were passed on climate and health, social participation, mental health, and AMR, among others. These decisions took place alongside the launch of a new strategy period (the 14th General Global Programme of Work), which for the first time includes climate as a strategic priority, and an ambitious investment round (aiming to raise an additional US$ 7 billion) to ensure WHO is better placed to do its work.

If you were in Geneva or followed negotiations more closely, you could sense an increasing feeling of panic as the week progressed. After member states failed to reach a consensus on the Pandemic Agreement (the initial timeline of which had arguably set negotiations to “fail”), pressure to at least deliver on international health regulation (IHR) amendments (and agree on a new Pandemic Agreement negotiation deadline) rose with each day. Finally reaching a consensus on these (albeit at the eleventh hour) was a huge relief and deemed “a critical confidence boost for WHO”, yet also as insufficient to deliver on equity, financing, information sharing, early notification, and compliance.

The pressure to deliver (both legally binding commitments and funding) during WHA77 was immense – for both WHO’s leadership and staff and member state representatives negotiating resolutions and agreements. Why? In 2024, more than 4 billion people are voting for new governments in nearly 80 countries around the world (plus the European Union). A massive shift to the political right (and radical and extreme right) is expected, which tends to go hand-in-hand with less global solidarity, less support for multilateral institutions (and in the case of the US and possible re-election of Trump, removing the US from WHO again), and less official development assistance (ODA) and funds for global and public health. The upcoming US elections, and India’s election that was ongoing during WHA, were mentioned multiple times.   

Take the case of elections for the European Parliament (scheduled for 6-9 June), where over 360 million people are eligible to vote in the EU’s 27 member states. European elections affect not only global health policies and budgets in Brussels, but are “essentially 27 national elections”, influencing also national policy positions and budgets in all EU member states. For example, in France, the radical-right National Rally (RN) is most likely to win the election and could put its leader, Marine Le Pen, in pole position for the French presidency in 2027. In Germany, the extreme-right Alternative for Germany (AfD) is polling second and is likely to influence policy positions and the outcome of parliamentary elections in Germany in 2025. As in the US, if extreme or radical right-wing positions are popularised, normalized and elevated through social media platforms such as X, and gain power, this is really bad news for WHO, its ability to shepherd international collaboration and consensus and raise sufficient funds for its important work.

If we don’t all “vote like our lives depend on it” in these 2024 elections, this year’s WHA may indeed have been the last time headlines will claim “historic, landmark victories for multilateralism”.