Time to Rethink Health Financing: It’s Not Just a Public Sector Concern

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Parents and caregivers line up with their children at an immunization centre in Janakpur, southern Nepal. Meanwhile recent funding cuts have caused “severe disruptions” to health services in almost three-quarters of all countries, according to the head of the UN World Health Organization (WHO), Tedros Adhanom Ghebreyesus. April 2025. Credit: UNICEF

LONDON, Jun 19 2025 (IPS) – As G7 leaders of the world’s wealthiest nations wrapped up their summit in Kananaskis June 16, a critical issue was absent from the agenda: the future of global health financing.

Amid escalating geopolitical tensions, trade conflicts and cuts to development aid, health has been sidelined – less than five years since COVID-19 devastated lives, health systems and economies.

With the fiscal space for health shrinking in over 69 countries, it’s time to recognise that health financing is no longer solely a public sector concern; it is a fundamental pillar of economic productivity, stability, and resilience.

A glimmer of hope has emerged from South Africa, the current G20 Presidency host, and from the World Health Organization (WHO). A landmark health financing resolution, adopted at last month’s World Health Assembly calls on countries to take ownership of their health funding and increase domestic investment.

While this is a promising step, the prevailing discourse continues to rely on outdated solutions which are often slow to implement and fall short of what is needed.

Invest Smarter, Not Just More, in Health

Recent trends among G20 countries show that annual healthcare expenditure is actually declining across member states. In 2022, health expenditure dropped in 18 out of 20 G20 nations, leading to increased out-of-pocket expenses for citizens.

While countries like Japan, Australia, and Canada demonstrate a direct correlation between higher per capita health expenditure and increased life expectancy, others, such as Russia, India, and South Africa, show the opposite.

This disparity underscores a crucial point: the quality and efficiency of investment matters more than quantity. Smart investment encompasses efficient resource allocation, equitable access to affordable care, effective disease prevention and management, and broader determinants of health like lifestyle, education, and environmental factors.

Achieving positive outcomes hinges on balancing health funding – the operational costs – with sustainable health financing – the capital costs.

Private capital is already moving into health, what’s missing is coordination and strategic alignment

Despite the surge in healthcare private equity reaching USD 480 billion between 2020 and 2024, many in the sector remain unaware of this significant shift. Recent G20 efforts have focused on innovative financing tools, but what’s truly needed are systemic reforms that reframe health as a core pillar of financial stability, economic resilience, and geopolitical security, not just a public service.

This year’s annual Health20 Summit at the WHO, supporting the G20 Health and Finance Ministers Meetings, addresses this need by launching a new compass for health financing: a groundbreaking report on the “Health Taxonomy – A Common Investment Toolkit to Scale Up Future Investments in Health.”

Why do we need an investment map for health?

The answer is simple: since the first ever G20 global health discussions under Germany’s G20 Presidency in 2017, there has been no consistent effort to rethink or coordinate investments. G20 countries still lack a strategic dialogue between governments, health and finance ministries, investors and the private sector.

Market-Driven, Government-Incentivised: The Path Forward

Building on the European Union’s Green Taxonomy, the health taxonomy aims to foster a shared understanding and common language among governments, companies, and investors to drive sustainable health financing. Investors, Asset Managers, Venture Capitalists, G20 Ministries of Health and Finance, Multilateral Development Banks (MDBs), and International Organisations broadly agree that a market-driven taxonomy is both credible and practical.

Governments can have greater confidence knowing it has been tested with investors and is grounded in market realities.

The Health Taxonomy report identifies a key barrier to progress: the fundamental confusion between health funding and health financing: Health financing refers to the system that manages health investments, such as raising revenue, pooling resources and purchasing services. In contrast, health funding refers to the actual sources of money.

Increasing health funding alone will not improve health outcomes if the financing system is poorly designed. Conversely, a well-developed health financing framework won’t succeed without sufficient funding. Both are essential and must work together.

The health taxonomy has the potential to serve as a vital tool for policy planning sessions, strategic boardroom discussions and investment committees, thereby enabling health to be readily integrated into existing portfolios and strategies. It could also support more systematic assessments of health-related risks and economic impacts, including through existing processes like the IMF’s Article IV consultations and other macroeconomic surveillance frameworks.

The report urges leading G20 health and finance ministers to rethink and align on joint principles for health funding and financing.

The next pandemic could be more severe, more persistent, and more costly. Failure to invest adequately in health before the next crisis is a systemic risk our leaders can no longer afford to ignore.

Hatice Beton is Co-Founder, H20Summit; Roberto Durán-Fernández; PhD, is Tec de Monterrey School of Government, Former Member of the WHO’s Economic Council; Dennis Ostwald is Founder & CEO, WifOR Institute (Germany); Rifat Atun is Professor of Global Health Systems, Harvard T.H. Chan School of Public Health

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Agenda for Nuclear Non-Proliferation Review Conference Still Unclear

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Nuclear Disarmament

The closing session of the Preparatory Committee for the 2026 Review Conference of the Parties to the Treaty on the Non-Proliferation of Nuclear Weapons (NPT). Credit: UN TV

The closing session of the Preparatory Committee for the 2026 Review Conference of the Parties to the Treaty on the Non-Proliferation of Nuclear Weapons (NPT). Credit: UN TV

NEW YORK, May 21 2025 (IPS) – The Treaty on the Non-Proliferation of Nuclear Weapons must not be allowed to collapse under the weight of geopolitical cynicism, the preparatory committee at the UN heard.

This year, the Third Session of the Preparatory Committee for the 2026 Review Conference of the Parties to the Treaty on the Non-Proliferation of Nuclear Weapons (NPT) (April 28-May 9) was intended to address procedural issues related to the treaty and the upcoming conference next year. The meeting was the third and final preparatory session before the review conference next year. As such, the session was an opportunity for countries to reaffirm the principles of the NPT by agreement.

Throughout the two weeks, delegations expressed their positions and deliberated over recommendations that would shape the agenda for the 2026 conference. Beyond member states, other stakeholders such as civil society groups were emphatic in expressing the urgency of the nuclear issue and calling for member states to take action.

“The continued existence of nuclear weapons remains one of the most urgent and existential dangers facing life on this planet,” said Florian Eblenkamp, an advocacy officer for the International Coalition Against Nuclear Weapons (ICAN). He went further to state, “The non-proliferation norm must not be allowed to collapse under the weight of geopolitical cynicism. If the NPT is to have a future, States Parties must send an unambiguous signal: Nuclear weapons are not to be spread. Not to be shared. Not to be normalized.”

The committee’s chair, Ambassador Harold Agyeman, who serves as the Permanent Representative of Ghana to the United Nations, told reporters early on that the success of the review conference in 2026 would be “dependent on the political will of state parties” in demonstrating progress on their obligations of the treaty and to “strengthen accountability for the related implementation of existing commitments.”

“Indeed, many around the world are concerned by the lack of raw progress on nuclear disarmament, and emerging proliferations risk that could undermine the hard-won norms established to bring about a world free of nuclear weapons and a regime to achieve that goal,” said Agyeman.

The third preparatory session took place in a time of increasing global anxiety over nuclear proliferation and even escalation. The most recent conflict between India and Pakistan has the world on edge that two nuclear powers might engage in war. Since April, Iran and the United States have been in negotiations over a new nuclear deal, which at times has seen both sides at a deadlock over limiting Iran’s nuclear programme.

Given that context, plus pre-existing tensions between other global powers, such as Russia and the war in Ukraine, this session was an opportunity for countries to act with urgency towards non-proliferation and to respect their obligations under the NPT. By the end of the conference, however, it seemed no agreement was reached. Revised recommendations for the review conference failed to reach consensus. This continues a concerning pattern of preparatory meetings that also failed to adopt an outcome.

As the meeting reached its conclusion on May 9, delegations expressed regret that the draft agreement did not reach consensus. “We regret that the desired breakthrough on transparency and accountability in the context of the strengthened due process was not reached,” said one delegate from Egypt. “The discussion was mature and based itself on mutual respect and commitment to multilateralism.

Many delegations made sure to reaffirm their commitment to the NPT and to strengthening the review process. Yet there was also a recurring acknowledgement of the “complex geopolitical situation” that presented a challenge in reaching consensus.

Civil society organizations have also been vocal in their disappointment at the lack of agreement or outcome document. ICAN stated that the lack of an agreement reflected a “horrifying lack of urgency in response to current risks.” Reaching Critical Will went further to criticize nuclear-armed states for refusing to comply with international law and their obligations to the NPT, which calls for them to eliminate nuclear weapons.

The NPT Review Conference (RevCon) is expected to be held in New York from 27 April to 22 May 2026. The PrepComm nominated Vietnam to chair the RevCon. Ambassador Dang Hoang Giang, Permanent Representative of Vietnam to the United Nations, stated that the presidency would be “characterized by inclusive, transparent, and balanced proceedings” that would ensure that the perspectives and interests of all state parties would be respected.

“The road ahead will be challenging, but we remain confident that through collective wisdom and shared determination, meaningful progress is not only possible but achievable. A robust and effective treaty ensures a safer and more secure work for everyone,” said Giang.

The presence—and threat—of nuclear weapons looms large. For good reason, they cannot simply be relegated to history as a relic of hubris and ambition when we can observe their influence in modern geopolitics. If the spirit for nuclear nonproliferation is indeed still there, then the international community must be vigilant in advocating for the NPT and other disarmament treaties, rather than let a small percentage of parties dictate the global agenda. This must be an ongoing process, lest we see the continued undermining of nonproliferation and multilateralism.

Note: This article is brought to you by IPS Noram in collaboration with INPS Japan and Soka Gakkai International in consultative status with ECOSOC.

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UN Needs to Protect its Vital, Yet Underfunded, Human Rights Work

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Louis Charbonneau is UN director, Human Rights Watch

Karla Quintana (centre), head of the Independent Institution on Missing Persons in Syria, visits Al Marjeh Square in Damascus, a place where families of missing persons display photos in the hope of finding their loved ones. Credit: IIMP Syria

May 8 2025 (IPS) – Major-power cutbacks and delayed payments amidst conflict and insecurity are testing the very principles and frameworks upon which the international human rights infrastructure was built nearly 80 years ago.

Human rights need defending now more than ever, which is why the United Nations leadership needs to ensure that its efforts to cut costs don’t jeopardize the UN’s critical human rights work.

The Trump administration’s review of US engagement with multilateral organizations and its refusal to pay assessed UN contributions—which account for 22 percent of the UN’s regular budget—have pushed the cash-strapped international organization into a full-blown financial crisis.

China, the second biggest contributor, continues to pay but has been delaying payments, exacerbating the UN’s years-long liquidity crisis. With widespread layoffs looming, UN Secretary-General Antonio Guterres has been forced to dig deep for cost-saving measures.

A six-page memo seen by Human Rights Watch—entitled “UN80 structural changes and programmatic realignment” and marked as “Strictly Confidential”—outlines proposals for eliminating redundancies and unnecessary costs across the UN.

The proposals include consolidating apparently overlapping mandates, reducing the UN’s presence in expensive locations like New York City, and cutting some senior posts.

While some UN80 proposals have merit, the section on human rights is worrying. It suggests downgrading and cutting several senior human rights posts and merging different activities. But at a time when rights crises are multiplying and populist leaders hostile to rights are proliferating, any reduction of the UN’s human rights capacities would be shortsighted.

Efficiency and cost-effectiveness are important, but the UN’s human rights work has long been grossly underfunded and understaffed. The Office of the High Commissioner for Human Rights gets just 5 percent of the UN’s regular budget.

Countless lives depend on its investigations and monitoring, which help deter abuses in often ignored or inaccessible locales. Investigations of war crimes and other atrocities in places like Sudan, Ukraine, Israel/Palestine, and elsewhere are already struggling amidst a UN-wide hiring freeze and pre-Trump liquidity shortfall.

For years, Russia and China have lobbied to defund the UN’s human rights work. There is now a risk that the United States, which has gutted its own funding for human rights worldwide, will no longer oppose these efforts and will instead enable them.

During these trying times, the UN should be reminding the world that its decades-long commitment to human rights is unwavering.

IPS UN Bureau

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Genocide Prevention & Responsibility to Protect

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Commemorating Genocide Prevention and Awareness Month

NEW YORK, Apr 15 2025 (IPS) – April marks Genocide Prevention and Awareness Month, a time to reflect on the history, causes and victims of past genocides and to mobilize the necessary resolve to confront risks facing populations around the world today who face the threat of genocide and other mass atrocity crimes not for anything they have done, but for who they are.

As we solemnly observe this month of commemoration, we also reflect on the 20th anniversary of the UN General Assembly’s unanimous adoption of the Responsibility to Protect (R2P) principle – a concept which emerged in particular response to the international community’s failure to prevent the atrocity crimes committed in Rwanda and the former Yugoslavia.

By shifting the focus to every state’s ‘responsibility to protect’ rather than the big powers’ ‘right to intervene,’ by emphasizing prevention as well as reaction, and by committing to international collective action – including, when necessary, through the collective security provisions of the UN Charter – R2P made possible a global consensus completely lacking in previous decades.

The 2005 World Summit brought us closer than ever to translating the post-Holocaust dream of “never again” into a meaningful reality. It was a significant diplomatic achievement for all heads of state and government worldwide to acknowledge that genocide, crimes against humanity, war crimes and ethnic cleansing – even when committed within a sovereign state – are matters of international concern and thus demand timely and decisive response.

But 20 years later – with all too obvious horrors and civilian suffering still occurring in Gaza, Sudan, the DRC, Myanmar and elsewhere – it is clear that R2P is still at best a work in progress. It is time to reflect on what we have learned about preventing and responding to the atrocity crimes outlined in the World Summit Outcome Document, and to focus on how we can do better.

On the plus side, considerable progress has been made in our collective knowledge of the risk factors, causes and dynamics that drive mass atrocity crimes and in enhancing our responsiveness to warning signs, including through the development of the UN’s Framework of Analysis for Atrocity Crimes. There is now a solid understanding of the wide range of preventive measures available, which includes not only a response to imminent and emerging risks, but also instituting policies, practices and structures that build long-term societal resilience to atrocity crimes.

Alongside these advances is a growing awareness that the different tools available for changing the behavior of would-be perpetrators, or for making victims less vulnerable, must be situated in a more coherent preventive strategy that is tailored to each context.

Moreover, the atrocity prevention agenda has been operationalized across the UN system. The creation of the Joint Office on Genocide Prevention and the Responsibility to Protect has been central to strengthening the UN’s early warning capabilities, as well as for developing the conceptual and practical aspects of R2P.

Since the inception of the Special Adviser on the Responsibility to Protect role, successive Special Advisers have been instrumental in identifying risk factors and clarifying best practices by states, regional organizations and the UN system in response to the threat of atrocity crimes.

In addition, the regular cycle of UN Secretary-General reports and General Assembly debates has reinforced the principle and fostered greater consensus and shared understanding within the UN system. The Group of Friends of R2P, with over 55 members from across all regions, is an important mobilizing force within the UN to advance effective atrocity crime prevention and response.

Over 60 countries from all regions of the world, along with the European Union and Organization of American States, have also appointed an R2P Focal Point, an important step for institutionalizing atrocity prevention at the national level. The appointment of a national R2P Focal Point is crucial for strengthening domestic capacity to fulfill the responsibility to protect, including by improving intra-governmental and inter-governmental efforts to prevent and halt atrocity crimes.

Furthermore, the international community has also made strides in its willingness and capacity to hold perpetrators responsible through international investigative bodies and mechanisms, international courts and tribunals, and in national courts under the principle of universal jurisdiction. Transitional justice and memorialization also remain hallmarks of a broader commitment to deal with the past and promote truth, justice and non-recurrence.

Nonetheless, for all these significant institutional advances, we are all acutely aware that, 20 years on from the World Summit, the principle of R2P is under acute strain. There is a deeply troubling disconnect between the unanimous commitment to protecting populations from atrocity crimes and achieving consistent implementation and concrete preventive action.

All too often, effective national, regional and international action is inhibited by self-interested political arguments advanced in key institutions with a capacity to make a difference, including the UN Security Council. When principles and their practical application are contested it is time, more than ever, for UN member states to stand firm and do the hard work of continuing to find and build the consensus needed to protect populations at risk.

Moreover, there is a worrying decline in attention to atrocity crime prevention and the role of the Special Adviser on R2P within the UN Secretariat. This stands in stark contrast to the still very strong support from the great majority of UN member states and from civil society, human rights defenders, affected communities and victims’ and survivors’ groups around the world.

To consolidate the effectiveness of R2P, there is much more that needs to be done, and the work needs to start at home – not least at the UN Headquarters, but also on a national and regional level. At the core of R2P is a responsibility to invest in the institutional architecture to prevent the drivers of atrocity crimes from emerging or intensifying.

This anniversary year presents a crucial opportunity for the UN system, and particularly the UN Secretary-General and the Secretariat, to demonstrate ongoing commitment to fulfilling the responsibility to protect across all regions of the world.

The UN has proven time and again that it can mobilize resources and expertise to safeguard those at risk, with a notable track record of defending human rights and protecting vulnerable populations despite facing immense challenges. Rather than retreating from these efforts, it is critical that the UN and its member states redouble them, by honing and strengthening the capabilities needed to deliver effective prevention and response. Political and ideological differences must not be allowed to distract us from identifying signs of increased risk, wherever they may be, and taking early action to prevent atrocity crimes.

The strong commitments made in 2005 are as relevant today as they were 20 years ago. At a time of escalating conflicts, as well as threats to multilateralism and international justice, the UN Secretary-General and the UN must provide an alternative vision for the future in which a key element is the consistent implementation of R2P.

The future of R2P will only be secured if we – the UN system, intergovernmental and regional organizations, governments, civil society organizations and affected communities – fight for it and generate the political will to act. It would be a tragedy to give in to cynicism and skepticism, to overlook the continuing power of R2P as an inspiring ideal and to abandon the goal of seeing it fully and effectively implemented in all its dimensions.

This month of commemoration must serve as a reminder that indifference and inaction should never be an acceptable response whenever and wherever populations face the threat of genocide and other atrocity crimes.

Professor Gareth Evans is Co-Chair, International Advisory Board, Global Centre for the Responsibility to Protect; Dr. Jennifer Welsh is Chair, International Advisory Board, Global Centre for the Responsibility to Protect.

IPS UN Bureau

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Migrant Smuggling: Europe Must Make a U-Turn

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Picture Alliance / Pacific Press | Geovien So

BRUSSELS, Belgium, Apr 11 2025 (IPS) – Europe must understand that the only reasonable and humane way to tackle migrant smuggling is to open regular routes for people to reach Europe in safety and dignity.

Europe’s approach to migrant ‘smuggling’ is harmful and absurd.

Instead of tackling the lack of regular pathways, thereby forcing people to embark in dangerous migration journeys, European countries are targeting migrants, human rights defenders, journalists, lawyers and ordinary citizens — all while injecting billions into the border surveillance industry.

People rely on smuggling because there are no better ways to get to Europe. But cracking down on alleged ‘smugglers’ – often migrants themselves – does not create better options. On the contrary, it pushes more people onto ever more dangerous routes, while threatening those who help them — and the EU’s new Facilitation Directive is likely to make things worse.

Criminalising solidarity

Proposed by the European Commission at the end of 2023, this Directive is meant to update previous rules to counter migrant smuggling (the 2002 Facilitators Package). However, in reality, it follows the same old broken pattern.

The current text, largely validated by the EU Council last December, expands the definition of what can be considered ‘migrant smuggling’ and ups prison sentences across the board.

The European Parliament is set to start debating its own position on the Directive this month, with a final vote expected in the summer, before entering final negotiations with the Commission and Council towards the end of the year.

What’s more, the text fails to clearly protect solidarity with people in an irregular situation from criminalisation. There is no ‘humanitarian clause’ included among the legally binding provisions; member states are simply invited not to criminalise acts of solidarity.

This generates significant legal uncertainty, as recognised by a recent study requested by the European Commission itself. With far-right and other anti-immigration forces in power in several member states and leading in polls in others, it’s easy to see how such a failure leaves the door wide open to the criminalisation and harassment of family members, NGOs, human rights defenders and ordinary citizens who are helping people in need.

This is not a fantasy scenario. At PICUM we have been documenting a steady increase in the criminalisation of solidarity with migrants in recent years. Between January 2021 and March 2022, at least 89 people were criminalised, in 2022 at least 102 and in 2023 at least 117.

Migrants themselves are also increasingly being prosecuted for simply helping fellow travellers through routes made irregular and dangerous by repressive policies.

These figures are most likely an undercount. Statistical and official data on those accused, charged or convicted of smuggling and related offences are often lacking. Many cases go unreported by the media or because people, especially migrants themselves, fear retaliation.

Behind these numbers are people who have saved lives at sea, given a lift or provided shelter, food, water or clothes. In Latvia, two citizens were charged with facilitating irregular entry simply for giving food and water to migrants stranded at the border with Belarus.

In Poland, five people are facing up to five years in prison for providing humanitarian aid to people stranded at the border with Belarus.

Just a few weeks ago, Italian judges in Crotone acquitted Maysoon Majidi, a Kurdish-Iranian activist and filmmaker, who was arrested in 2023 on human trafficking charges following a landing of migrants in Calabria. Majidi faced a sentence of two years and four months in prison.

The prosecutor in Crotone had accused her of being ‘the captain’s assistant’ because, based on the unverified testimonies of two people on board, she distributed water and food on the vessel. The ‘witnesses’ later retracted their statements, but Majidi still spent 300 days in pre-trial detention.

In Greece, an Egyptian fisherman and his 15-year-old child were charged with smuggling, simply because the father reluctantly agreed to pilot their boat in order to afford the journey. The father was placed in pre-trial detention and sentenced to 280 years in prison. Not only has the child been separated from his father, but he is now facing the same charges in a juvenile court.

Who benefits?

Counter-smuggling policies clearly fail to make migration safer. As migration expert Hein De Haas has written: ‘It is the border controls that have forced migrants to take more dangerous routes and that have made them more and more dependent on smugglers to cross borders.

Smuggling is a reaction to border controls rather than a cause of migration in itself.’ So, who actually benefits from these policies — besides politicians chasing short-term electoral gains?

Between 2021 and 2027, the EU’s budget dedicated to the management of borders, visa and customs controls increased by 135 per cent compared to the previous programming period, from €2.8 billion to €6.5 billion.

Europe must understand that the only reasonable and humane way to tackle migrant smuggling is to open regular routes for people to reach Europe in safety and dignity.

Much of this budget increase is driven by private corporations, including major defence companies such as Airbus, Thales, Leonardo and Indra, which have a vested economic interest in border surveillance.

According to research by the foundation porCausa, the Spanish government awarded over €660 million for the control of Spain’s southern border between 2014 and 2019. Most of this money went to 10 large corporations, mainly for border surveillance (€551 million), detention and deportation (€97.8 millions).

In the negotiation phase of the Facilitation Directive, the Council has already adopted a position that would leave the door open to the criminalisation of migrants and the provision of humanitarian aid.

The European Parliament still has the opportunity to adopt an ambitious mandate. MEPs should understand what is at stake if a binding clause to protect migrants and solidarity from criminalisation is not introduced.

Beyond this Directive, Europe must understand that the only reasonable and humane way to tackle migrant smuggling is to open regular routes for people to reach Europe in safety and dignity.

Michele LeVoy is Director, Platform for International Cooperation on Undocumented Migrants (PICUM), a network of organizations working to ensure social justice and human rights for undocumented migrants.

Source: International Politics and Society (IPS), Brussels.

IPS UN Bureau

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Civil Society’s Reform Vision Gains Urgency as the USA Abandons UN Institutions

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Credit: Fabrice Coffrini/AFP via Getty Images

LONDON, Apr 2 2025 (IPS) – Today’s multiple and connected crises – including conflicts, climate breakdown and democratic regression – are overwhelming the capabilities of the international institutions designed to address problems states can’t or won’t solve. Now US withdrawal from global bodies threatens to worsen a crisis in international cooperation.

The second Trump administration quickly announced its withdrawal from the Paris Agreement and the World Health Organization (WHO), terminated its cooperation with the UN Human Rights Council, walked out of negotiations on a global tax treaty and imposed sanctions on International Criminal Court officials.

Although the USA has sometimes been an obstructive force, including by repeatedly blocking Security Council resolutions on Israel, global institutions lose legitimacy when powerful states opt out. While all states are formally equal in the UN, the reality is that the USA’s decisions to participate or quit matter more than most because it’s a superpower whose actions have global implications. It’s also the biggest funder of UN institutions, even if it has a poor record in paying on time.

As it stands, the USA’s WHO withdrawal will take effect in January 2026, although the decision could face a legal challenge and Trump could rescind his decision if the WHO makes changes to his liking, since deal-making powered by threats and brinkmanship is how he does business. But if withdrawal happens, the WHO will be hard hit. The US government is the WHO’s biggest contributor, providing around 18 per cent of funding. That’s a huge gap to fill, and it’s likely the organisation will have to cut back its work. Progress towards a global pandemic treaty, under negotiation since 2021, may be hindered.

It’s possible philanthropic sources will step up their support, and other states may help fill the gap. The challenge comes if authoritarian states take advantage of the situation by increasing their contributions and expect greater influence in return. China, for example, may be poised to do so.

That’s what happened when the first Trump administration pulled out of the UN Educational, Scientific and Cultural Organization (UNESCO). China filled the vacuum by increasing its contributions to become UNESCO’s biggest annual funder. Presumably not coincidentally, a Chinese official became its deputy head, while China was able to block Taiwan’s attempts to join. It was out of concern about this growing influence that the Biden administration took the USA back into UNESCO in 2023; that decision could now be reversed, as Trump has claimed UNESCO is biased against the USA and ordered a review.

The Human Rights Council may be less immediately affected because the USA isn’t currently a member, its term having ended at the close of 2024. It rejoined in 2021 after Trump pulled out in 2018, and had already made the unusual decision not to seek a second term, likely because this would have provoked a backlash over its support for Israel. Apart from its relationship with Israel, however, during its term under the Biden administration the USA was largely recognised as playing a positive role in the Council’s business. If it refuses to cooperate, it deprives US citizens of a vital avenue of redress.

The USA’s actions may also inspire other states with extremist leaders to follow suit. Argentina’s President Milei, a keen Trump admirer, has imitated him by announcing his country’s departure from the WHO. Political leaders in Hungary and Italy have discussed doing the same. Israel followed the USA in declaring it wouldn’t engage with the Human Rights Council. For its own reasons, in February authoritarian Nicaragua also announced its withdrawal from the Council following a report critical of its appalling human rights record.

It could be argued that institutions like the Human Rights Council and UNESCO, having survived one Trump withdrawal, can endure a second. But these shocks come at a different time, when the UN system is already more fragile and damaged. Now the very idea of multilateralism and a rules-based international order is under attack, with transactional politics and hard-nosed national power calculations on the rise. Backroom deals resulting from power games are replacing processes with a degree of transparency aimed at achieving consensus. The space for civil society engagement and opportunities for leverage are in danger of shrinking accordingly.

Real reform needed

Revitalising the UN may seem a tall order when it’s under attack, but as CIVICUS’s 2025 State of Civil Society Report outlines, civil society has ideas about how to save the UN by putting people at its heart. The UNMute Civil Society initiative, backed by over 300 organisations and numerous states, makes five calls to improve civil society’s involvement: using digital technologies to broaden participation, bridging digital divides by focusing on connectivity for the most excluded, changing procedures and practices to ensure effective and meaningful participation, creating an annual civil society action day as an opportunity to assess progress on civil society participation and appointing a UN civil society envoy.

Each of these ideas is practical and could open up space for greater reforms. A UN civil society envoy could, for example, promote best practices in civil society participation across the UN and ensure a diverse range of civil society is involved in the UN’s work.

Civil society is also calling for competitive Human Rights Council elections, with a civil society role in scrutinising candidates, and limits on Security Council veto powers. And as time approaches to pick a new UN Secretary-General, civil society is mobilising the 1 for 8 billion campaign, pushing for an open, transparent, inclusive and merit-based selection process. The office has always been held by a man, and the call is for the UN to make history by appointing a feminist woman leader.

These would all offer small steps towards making the UN system more open, democratic and accountable. There’s nothing impossible or unimaginable about these ideas, and times of crisis create opportunities to experiment. States that want to reverse the tide of attacks on international cooperation and revitalise the UN should work with civil society to take them forward.

Andrew Firmin is CIVICUS Editor-in-Chief, co-director and writer for CIVICUS Lens and co-author of the State of Civil Society Report.

For interviews or more information, please contact research@civicus.org.

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