A Cri de Cœur: Don't sit by as the United Nations is diminished

In recent years, we have seen that countries across the world have been moving towards nationalism and away from working together at an international level. More and more, countries are choosing to go it alone, or work directly with one other country rather than in wider partnerships (what we call multilateralism).

We have seen this in the UK's Brexit decision, the reduction in foreign aid spending across many high-income countries, and even in the Swedish government's decision to close important embassies in the Global South. The UN Secretary General himself expressed concerns in 2024 that multilateralism is falling behind.

This move away from multilateralism is seen most famously in America, where everything from the global tariffs, the war in Iran, and the closing of USAID have all demonstrated that the Trump administration is interested in unilateral action over multilateral action.

But with so many headlines about wars and tariffs, it has been easy to miss that America and other nations have been causing a crisis within the global institutions that we rely on for our health, development, and rights.

The UN system is facing an enormous financial crisis because states are either withdrawing their funding or refusing to pay what they owe. Earlier this year, the UN Secretary General warned that the UN was running close to “imminent financial collapse.”

20%

The percentage of staff that the UN and its agencies are believed to have lost at the start of 2026.

30%

The UN High Commissioner for Refugees said it would downsize its headquarters and regional offices to reduce costs by 30% and cut senior-level positions by 50%.

$60m

The funding shortfall faced by UN OCHA, the UN's Humanitarian Agency.

15%

The percentage of WHO's funding that has been lost now that the US has withdrawn.

$1.76bn

The amount of money that has gone unpaid to the UN by the US, China, and Russia.

$557m

The UN's 2026 budget saw a drop of 15% on 2025, equivalent to $557m, ultimately leading to 2,681 jobs lost.

What would we lose in the fight to defeat leprosy if we did not have the UN, WHO, UNICEF, and other UN entities?

World Health Organization

No disease will be eliminated by a single organisation on itsown, but if we remove WHO from the equation for leprosy and other Neglected Tropical Diseases (NTDs), we are making our work much, much harder.

WHO's role can be summarised across three areas:

Information management: developing strategies and guidelines and formulating recommendations to Member States
Convening and advocacy: bringing actors working on leprosy together with the aim of raising the profile of the disease and ensuring its inclusion in global and national agendas and budgets
Country and humanitarian support: ensuring health for all by providing support to those in need. This includes strengthening national health systems to improve detection management, care, and rehabilitation of patients. For example, WHO facilitate the donation and supply of medicines for leprosy.

Here is a snapshot of some WHO achievements

Providing the cure for leprosy: In the 1980s, WHO was essential to recommending MDT as the cure for leprosy and has provided the medication to all countries free of charge since 1995.

Giving our collective work direction: WHO is the organisation behind both the Global Leprosy Strategy 2021-2030 and the Global NTD Roadmap 2021-2030. These documents give us a framework to understand what needs to be done and whether we are making progress.

Driving us to a world without leprosy: Through WHO's Leprosy Elimination Monitoring Tool (LEMT), we can track our progress towards the elimination of leprosy, something that both Jordan and Chile have been verified by WHO as having done.

UN Human Rights Frameworks

In every country, persons affected by leprosy face challenges accessing their fundamental human rights, including their right to health, education, employment, and family. Without systems of peer accountability through UN structures and the recommendations and guidelines made by human rights experts who champion the rights of persons affected by leprosy, it is all too easy for governments to leave persons affected by leprosy without access to their rights.

United Nations Special Rapporteur
In 2017, the UN Human Rights Council acknowledged that the human rights violations faced by persons affected by leprosy are so severe that a rapporteur should be assigned specifically to study these challenges and suggest ways for countries to improve. Since then, two different rapporteurs have worked to bring us crucial reports on everything from access to medication and health, the human rights challenges that face women affected by leprosy, and the situations of countries including Brazil, Bangladesh, and Japan. These reports are an invaluable tool for advocates and activists.

Human rights conventions
You are guaranteed human rights because your country's government at one time ratified human rights conventions that were developed at the UN. These conventions are now law in the vast majority of countries and cover issues such as disability, discrimination against women, the rights of children, and more. At the UN, countries hold each other accountable to these conventions, ensuring that the rights of citizens are upheld. For persons affected by leprosy, this means their rights are being advocated for at the highest levels, whether that is the right to healthcare, education, social protection, or assistive devices.

Human Rights Council Resolution
Even as this article is being written, a resolution on NTDs is being proposed to the Human Rights Council. The resolution frames NTDs as not only a health issue, but a human rights issue that affects all areas of a person's life. This resolution, if it passes, would then lead to countries adjusting their policies to reflect the needs on the ground, bringing much-needed attention to these neglected diseases. The efforts of in-country campaigners willl be strengthened by a global desire to achieve rights for persons affected by NTDs that influences policymakers, something that would be hard to achieve without UN human rights frameworks.

The wider UN network

The WHO and human rights frameworks are the most often recognised UN supports that persons affected by leprosy receive. There are, however, a number of other agencies that are engaged in communities to build resilience and health so that these communities are less at risk of leprosy. Here are a just a few examples.

UNICEF

Data: 2025

158 million

children reached to prevent malnutrition

Over 17 million

people gained access to at least basic sanitation services

139

countries that worked on disability-inclusive programming

UNDP

Data: 2022-25

252 million

people gained services to help them leave poverty

76.5 million

people gained direct benefits from clean energy projects

$920bn

in public and private finance aligned and leveraged for the SDGs

UN OCHA

Data: 2024

116 million

people reached across 33 countries in humanitarian need

$54m

OCHA was the largest funder helping communities prepare for predictable crises

28 million

people affected by displacement assisted through the UN emergency fund

So what would we lose without these multilateral organisations?

Neglected Tropical Diseases have this name because both the diseases and the people affected by them are largely neglected. The diseases are under-considered within public health policy and within funding. The people affected live within communities that lack access to basic services and where poverty is common.

In this context, having global institutions that are dedicated to upholding human rights, especially the rights of minority groups, is essential. Without these institutions, we likely would not even have acknowledged that these diseases are neglected at all, never mind taken extensive and coordinated steps to end the neglect.

This is not to say that these institutions and the systems are perfect, and perhaps some of the current challenges will prompt healthy reform as part of the UN80 process. But that does not mean we should surrender to an inexorable slide away from the UN, WHO, and multilateralism.

Perhaps it is unlikely that these insitutions will disappear entirely, but if we continue to allow them to be undermined, their power to support and bring change for persons affected by leprosy - and countless others - will be hampered.

Duck Drop: Do we need the WHO and UN?

In the latest opinion piece from our Global Advocacy Lead, Mathias Duck, Mathias delves deeper into how the accountability and communication that these organisations provide are essential for our fight to defeat leprosy.

Read here >