PAHO’s Own Budget Cut by 19%
When the Supporter Shrinks

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On June 3, PAHO Director Jarbas Barbosa presented the 2025 Annual Report to the Permanent Council of the Organization of American States (OAS). The report itself laid out achievements in an upbeat tone, yet it contained one figure that could shape the future of the region’s health systems: PAHO’s own budget will be cut by 19% over the next two years.

The Weight of a 19% Cut

For the 2026–2027 budget period, PAHO’s budget fell 19% from the prior period. Cuts to fixed posts, restrained travel and tighter recruitment are set to continue, amounting in practice to a reduction in staff. PAHO says its internal modernization, “PAHO Forward 3.0,” produced more than US$7 million in efficiencies in 2025 — but the budget being lost is on a scale far larger than those savings.

As the regional office of the World Health Organization (WHO) for the Americas, PAHO has worked on infectious-disease control, maternal and child health, and health-system strengthening across 37 countries and territories. The cut feeds directly into how large and how fast these programs can continue.

Why Now

Behind it lies the funding squeeze facing WHO itself. As the United States, once the largest contributor, tightens its contributions and steps back from international cooperation in health, the ripple reaches PAHO as a regional office. When the funding that has held up the “foundation” of global health thins, the first to feel it are the front lines of countries with limited resources of their own.

A “Double Withdrawal” Overlapping USAID’s Exit

What makes this cut feel heavy is that another withdrawal is already under way. USAID (the U.S. Agency for International Development), sharply scaled back in 2025, hit the funding base of public-health research and disease control in Latin America head-on (→ When Outside Funding Disappears: The Question USAID’s Exit Posed). The path of PAHO filling the hole USAID left becomes hard to picture once PAHO itself is shrinking. A “double withdrawal,” with the providers of support thinning at the same time, is taking shape across the region’s health infrastructure.

There is a brighter number too. The Alliance for Primary Health Care in the Americas, run jointly by PAHO, the World Bank and the Inter-American Development Bank (IDB), mobilized over US$1 billion in resources in its first two years. Peru joined in May 2026, bringing membership to ten countries. Yet much of the money is led by the World Bank and IDB; what PAHO carries is technical support and coordination. How the budget cut affects that coordinating function bears watching (for the wider context of care and social security, → What Latin America’s “National Care Systems” Mean).

My View: Guidance Only Moves When Funds and People Are There

From the vantage of someone who has studied assistive-device funding schemes and social-security systems, the policy guidance international bodies issue does not, on its own, change the front lines. This year PAHO published policy guidance on long-term care, showing that about 14.4% of those aged 65 and over — some 8 million people — need daily support in the region (→ 8 Million on the “Supported” Side). For supporting an aging population and people with disabilities, such guidance matters greatly. But translating guidance into each country’s programs requires the funds and staff to back it. With budgets shrinking, the guidance comes while implementation lags — that gap is what frightens me most.

The kind of “pre-emptive public health” that shores up Ebola preparedness while cases are still zero (→ The Americas Moved With Zero Cases) also only holds up when there is strength in peacetime. The double withdrawal of USAID and PAHO means the region’s health systems must, once again, face head-on the question of who does the supporting.

Glossary

PAHO (Pan American Health Organization) = WHO’s regional office for the Americas. Founded in 1902, it covers 37 countries and territories.
Biennium = a two-year budget period. WHO/PAHO set their budgets in two-year cycles.

The guidance comes, but the funds and staff to implement it do not keep up — when budgets shrink, that gap is the most frightening thing.

※ This article is the author’s commentary based on public information. Please confirm the latest figures, dates and procedures with governments and primary sources. Quotations are kept minimal and sources are cited.