ABSTRACT The World Health Organization (WHO) has shown systemic vulnerabilities in pandemic response, resource mobilization and allocation, and political coordination, prompting strong demands for reform from member states and the international community. Against the background of global health system restructuring, WHO reform should be carried out in four aspects: adapting to changes in global disease burden and demographic structure, conforming to the trend of multipolar health governance, building an agile and efficient modern governance framework, and improving sustainable financing mechanisms. This paper constructs a hierarchy-function coupling model integrating horizontal core functions and vertical organizational hierarchies (headquarters, regional offices, and country offices) to analyze the challenges of WHO in three core functions: global health leadership, norms and standards setting, and national health capacity-building and partnership promotion. It proposes targeted reform strategies at headquarters, regional, and national levels to streamline management, decentralize authority, promote the localization of norms and standards, and shift from vertical aid to sovereign empowerment. The reform of WHO is not only an institutional adjustment but also a strategic transformation to adapt to the paradigm shift of global health governance, aiming to enhance its leadership and build a more agile, equitable, and resilient global health architecture.
Ren et al. (Mon,) studied this question.