Delivering for impact: a leaner Regional Office moving closer to countries
A health system in any of the 47 Member States of WHO in the African Region can only act on what reaches it: a workforce with the right skills deployed at the right time; the procurement and supply of goods and services delivered on time; audit recommendations that are closed promptly and sustained; and operational decisions taken close enough to the country to reflect national needs and priorities. During the reporting period, the global transformation agenda continued to enhance enabling functions and operational efficiency despite significant funding constraints Under the WHO Director-General’s leadership, the prioritization and realignment process was initiated alongside the UN80 system-wide reform (1).
The WHO Regional Office for Africa downsized its workforce from 2540 in January 2025 to 2046 in January 2026, and further to 1948 by July 2026. This restructuring represents and overall staffing reduction of 23.3%. Three quarters of the remaining staff (1434) now deployed directly in country offices. It transitioned all 47 country offices to a global, function-based operating model, the Core Country Office Model (CCOM). It also clarified decision-making across the three levels of the Organization through a well-defined delegation of authority. It identified more than US$ 8 million in recurring annual savings and projected up to US$ 15.5 million in additional gains over the next biennium. Furthermore, it strengthened institutional oversight through internal and external audits, implementing efficiency mechanisms to ensure high performance and strict compliance with organizational rules and policies.
01Responses and what was achieved
WHO country office support to ministries of health must be high quality and timely. However, the 2025 funding reduction resulted in a 13% drop in the approved Base Programme Budget for the Region, falling from 1.31 billion in 2024–2025 to 1.14 billion in 2026–2027. This contraction affected the level of technical support WHO country offices could provide to host countries. In response, the Region implemented the global adjustment framework, restructuring operations and staffing through a comprehensive prioritization and realignment exercise.
02Challenges and priorities
These reforms and initiatives are substantial and commensurate with the financial environment of the reporting period. The focus remains on the residual financing gap; digital and AI utilization; country data monitoring and reporting; and workforce diversity.
Residual financing gap. Reforms do not automatically offset the residual 2026–2027 funding gap of US$ 662 million in the Region’s base programmes, against the backdrop of a WHO-wide funding gap for base programmes of approximately US$ 1.1 billion (1). For progress to be sustained, Member States will need to support the WHO Investment Round, honouring their commitments to the 20% increase in assessed contributions agreed at the Seventy-eighth World Health Assembly. Equally necessary will be continued advocacy under resolution WHA75(8) to finance 50% of base programmes with flexible funds by 2030–2031.
Digital and AI strand. The modernization of connectivity, including the purchase of Starlink units and the decommissioning of legacy very-small-aperture-terminal systems, has been delivered. The next biennium must add a deliberate AI and automation strand to back-office processes, including cloud-native enterprise resource planning and AI-enabled efficiencies (5).
Country-level indicators of service-delivery improvement. The Regional Office will introduce service-level indicators of efficiency savings, including procurement lead time, human-resources transaction time and emergency deployment speed, to demonstrate the country-level value of the new operating model. These indicators will serve as the background for next year’s report. Over the next 18 months, the Regional Office will institutionalise and monitor the impact of the new operating model.
03Chapter 5 references (5)
- 1. World Health Organization (2026) WHO’s prioritization and realignment process in 2025. Executive Board, Document EB158/52 Add.1. Geneva: World Health Organization https://apps. who.int/gb/ebwha/pdf_files/EB158/B158_52Add1-en.pdf
- 2. World Health Organization Regional Office for Africa (2026) Core Country Office Model: implementation guidance and rollout report. Brazzaville: World Health Organization Regional Office for Africa.
- 3. Multilateral Organisation Performance Assessment Network (2025) Doing better with less: Unlocking efficiency in the UN. Paris: MOPAN. Octobre 2025. https://www.mopan.org/ en/our-work/performance-insights/multilateral-effectiveness-in-a-shifting-landscape/efficiency-thematic-brief-summary.html
- 4. Boston Consulting Group (2022) Shared services can ignite transformation in government. Boston: Boston Consulting Group. https://www.bcg.com/ publications/2022/transformation-in-government
- 5. United Nations Development Programme (2025) Analysis related to proposed UNDP initiative. Geneva: United Nations Development Programme. https://www.undp.org/analysis-related-proposed-un80-initiative