Can the World Health Organization still be the World’s health conscience? -1 | The cracks in global trust

Ümit Kartoğlu

The World Health Organization has always lived in the narrow space between science and politics, a delicate balance on which its very survival depends. To be credible enough for scientists and acceptable enough for politicians has never been easy. Yet as long as its funding remains politically steered, genuine independence will continue to be institutionally constrained: not through malice, but by design.

In recent years, trust in international institutions has grown fragile. Political bias, uneven crisis communication, bureaucratic inertia, and the absence of accountability have all contributed to what sociologists call institutional trust contagion, a kind of reputational infection that spreads from one global body to another. When one institution falters, the entire multilateral system is perceived as diseased. To most citizens, WHO, UNESCO, UNDP, UNICEF, or UNHCR are indistinguishable parts of the same distant bureaucracy known simply as “the United Nations (UN).” Thus, when one of them appears politically constrained or fails in its communication, the loss of faith resonates across the rest.

The data tell the same story. The Edelman Trust Barometer, an annual global survey of attitudes toward governments, business, non-governmental organizations (NGO), and more recently international organizations such as the UN, World Health Organization (WHO), and World Bank, shows how public confidence in global institutions has weakened since the pandemic years. Conducted each year across nearly thirty countries, the Barometer scores trust on a 0–100 scale: above 60 signals trust; below 50 means distrust.

The 2021–2024 period is particularly revealing, spanning the years before, during, and after COVID-19. In the early aftermath of the pandemic, trust in governments plummeted, following chaotic national responses. WHO and the UN lost credibility in North America and Western Europe, though they remained relatively trusted in parts of Asia. At first, scientists and health experts were seen as the most reliable voices, far ahead of politicians and media figures. But as misinformation flourished and geopolitical tensions deepened, 2022 brought a cycle of distrust: faith in all institutions, from governments to NGOs, eroded further. By 2023, polarization itself had become the default condition. Divides widened across democracies; international cooperation began to appear futile. And in 2024, Edelman’s headline theme, “Innovation Under Fire”, captured the public’s growing suspicion of science, technology, and global governance. Business and NGOs remained more trusted than either governments or the media, while international bodies faced doubts about their independence and effectiveness.

Because WHO is part of the UN family, its fortunes rise and fall with the broader system. When confidence in the UN declines, WHO’s reputation usually follows. Since 2021, trust in global institutions has been steadily falling, and with it, the perception of WHO’s credibility. The 2024 Barometer placed trust in the UN around 58 percent, a modest majority, but clearly downward from previous years. The erosion of trust seems to move in tandem between WHO and the UN: when one loses ground, the other soon follows.

The malaise runs deeper than survey numbers. There is a growing belief that the United Nations itself faces a legitimacy crisis born of fading trust. In September 2024, member states acknowledged as much by adopting the Pact for the Future, pledging to rebuild confidence in global institutions. Yet that promise was soon undermined by severe funding cuts from Donald Trump’s second administration, which pushed the multilateral system into a deeper financial and moral crisis. At a Security Council session in early 2025, delegates spoke openly of a “crisis of confidence in the UN,” a “devastating loss of trust,” an “unprecedented crisis of credibility.” Few seemed to recognize their own complicity in the very mistrust they lamented.

While the collapse of confidence in the United Nations forms part of a wider erosion of faith in international organizations, it deserves its own separate discussion. In this series, I choose instead to focus on the trust deficit facing the World Health Organization.

HOW MUCH OF WHO MISTRUST IS REALLY ABOUT COVID-19?

COVID-19 was an accelerator, a force that magnified existing doubts and exposed old fractures. The pandemic thrust WHO into daily headlines and political disputes, revealing the cracks in its communications: shifting mask guidance, evolving recommendations, and the delicate dance of science adjusting to new evidence in real time. These were natural features of an unfolding emergency, yet they became easy fodder for partisan attacks. Still, COVID is only part of the story. The roots of mistrust predate it: chronic dependence on donor funding, geopolitical rivalries, and earlier criticisms - from the Ebola and H1N1 responses - all shaped how the public interpreted WHO’s actions in 2020 and beyond. In truth, COVID did not create distrust; it amplified and politicized it.

To explore this more deeply, I turned to Dr. Monir Islam, one of the rare WHO veterans with over twenty-five years inside the organization. His career spanned headquarters, regional offices, and country postings, including service as WHO Representative in Thailand and Namibia. Serving under five Director-Generals, he led programmes in family and community health, maternal and newborn care, and health systems development across continents. He played a pivotal role in the Making Pregnancy Safer initiative, the Integrated Management of Pregnancy and Childbirth tools, and the H4 partnership with UNICEF, UNFPA, and the World Bank. Combining field experience with diplomatic insight, he shaped global health reforms.  After retiring from WHO, Dr. Islam continued teaching and advising universities and international agencies, remaining a sought-after voice in health diplomacy and policy dialogue worldwide. Few have observed the institution’s inner workings across as many layers of hierarchy and history.

Dr. Islam notes that trust in any global body is inevitably tested during crises of such scale and complexity. “Having served in WHO for over 25 years across headquarters, regional, and country levels, I’ve seen the organization respond to many public health emergencies. But COVID-19 was different, not only in scale and complexity, but in the unprecedented global scrutiny it brought. Trust in the WHO declined during COVID-19 for several reasons, some structural, some political, and some related to leadership. First, the rapidly evolving nature of the pandemic meant that scientific guidance changed over time, a natural part of science, but one that was sometimes perceived by the public as inconsistency. Second, communication challenges, compounded by a fast-moving media and misinformation environment, made it difficult to maintain a consistent global narrative.”

This, I remind him, is the oldest dilemma in outbreak response. As Dr. Keiji Fukuda, former WHO Assistant Director-General who led the H1N1 response, once said, “The WHO is always at risk of being criticized as doing too much or too little.” Act slowly, and you are condemned for failing to prevent deaths; act swiftly, and you are accused of overreaction. There is, in essence, no escape.

Dr. Islam acknowledges this paradox. “Additionally, geopolitical tensions during the pandemic played out publicly, placing WHO under intense scrutiny. In that context, perceptions of delay or lack of transparency, whether accurate or not, affected public trust. However, beyond the crisis itself, there were deeper concerns about WHO’s independence and transparency.”

“One issue raised by many observers is the leadership style of the current Director-General, Dr. Tedros, whose background in a government with an authoritarian record has raised legitimate concerns about governance culture. His re-election, notably not supported by his own country but rather by a group of mainly European states led by Germany, further fuelled perceptions of political manoeuvrings rather than consensus-based, merit-driven leadership.”

“These concerns, coupled with centralized decision-making and occasionally opaque communication, made some stakeholders, especially in civil society and among technical experts, question WHO’s neutrality and accountability during the pandemic.”

At the same time, Dr. Islam insists that these criticisms should not obscure the scale of the organization’s effort: the vast coordination of global response, the technical guidance issued under relentless pressure, and the constant support offered to countries overwhelmed by crisis.

While the United Nations wrestles with a loss of legitimacy, the World Health Organization faces a quieter but equally perilous illness: the erosion of trust at its moral core.

Tomorrow - A house built on donor sand: Inside WHO’s struggle to stay scientific when its lifeblood, money, is political.