Chan Issues Clarion Call For Increased WHO Funding

World Health Organization Director General Margaret Chan today warned of serious funding shortfalls for the current biennium endangering the implementation of certain programmes. Areas most in need of financing include non-communicable diseases (such as cancer, diabetes and cardiovascular diseases), food security, and antimicrobial resistance. The high-profile Health Emergencies Programme is also underfunded and Chan proposed to ask countries to raise their assessed contributions at the next World Health Assembly.

WHO third financing dialogue, which is aiming to provide an update on underfunded programme areas in the Programme Budget 2016/2017, an update on the WHO Health Emergencies Programme, and initiate discussions on the proposed increased assessed contributions, ahead of the governing body meetings to be held in 2017, is taking place on 31 October.

In her opening speech, Chan alerted member states to “serious funding shortfalls in the 2016/2017 budget programme budget.” Without further financial contributions, she said, the current programme budget cannot be fully financed and implemented.

Member states expect a “great deal from WHO,” but requisite funds must be invested, she said.

“The new financing model introduced as part of WHO reform took us some steps forward in terms of the predictability, alignment, and flexibility of funding,” she said in her statement.

However, the WHO faces a double challenge for this biennium, Chan said, remarking: “You have asked us to do more, especially through the health emergencies programme. At the same time, income from voluntary contributions has not increased. In the case of core voluntary contributions, income has decreased.”

The most important underfunded programme, with only 56 percent of the required US$485 million is the health emergencies programme, she said, recalling the “hard lessons from the Ebola outbreak” which underscored the need for WHO to have sufficient core capacity and readiness in place before the next crisis emerges.

“These are not capacities that can be built in the chaotic fray of a crisis,” said Chan.

Chan also voiced concerns about the polio eradication programme, and the non-communicable diseases programme, which she said is chronically underfunded. “We have previously well-funded programmes that are now in trouble,” she deplored.

She gave the example of the financing of HIV, a third of which is received through the UNAIDS secretariat. In 2016, she said, these funds shrunk by 50 percent, and in 2017, it is expected that those funds will be further reduced to only 15 percent of the previous amount.

She remarked on the progress made in exercising budgetary discipline, such as staff expenditure. “Corporate-wide finance, human resources, and information technology services were outsourced to Malaysia and Hungary, at lower staff costs than in Geneva,” she said.

Travel costs have been cut back with more teleconferences and online consultations, she said, and better procurement planning allowed the use of economies of scale to get costs down, but “we continue to face a long-standing problem of budgetary imbalance,” she said.

Assessed contributions finance only some 20 percent of the budget, and the stagnant level of assessed contributions and the decline in the portion of the budget they finance puts into question the sustainability of WHO’s work, she said, adding that she will ask the next World Health Assembly to consider an increase in assessed contributions.

Chan also announced that WHO will be a member of the International Aid Transparency Initiative (IATI) as of 1 November. “Countries and their partners, and parliamentarians and their taxpayers need accurate information about aid flows in order to manage resources and hold governments accountable,” she said.  “IATI makes this information publicly available in a standard electronic format that improves transparency.”

WHO Financial Situation: Financial Gap

According to a document on WHO’s financial situation [pdf] as 30 September 2016, “the financing situation for the third quarter of 2016 is US$ 4347.1 million (96%) against the total approved programme budget.”

“This situation appears relatively healthy, and is due to a higher level of funds for the component on polio eradication, outbreak and crisis response, tropical disease research and research in human reproduction,” the document said.

However, the base programme component of the programme budget is only 86 percent financed, it said, “which is significantly less than in the previous biennium.” If compared to the third quarter of 2014 (previous biennium), the financing gap grew from US$88.5 million to US$472.1 million.

According to the document, this is due to two factors, the first one is that the new WHO Health Emergencies Programme led to an increase of the base programme of US$ 496.6 million, and there was a decrease in the overall level of flexible fund financing due to a lower level of financing received through the core voluntary contribution account in 2016 compared to the one received in 2014, it said.

Imre Hollo, director, Planning Resource Coordination and Performance Monitoring, General Management at WHO, presented the financial situation during the first session of the dialogue, focused on the funding of WHO programme budget 2016/2017.

He said more flexible funds are needed to ensure a much better alignment of the programme budget, and for donors not to concentrate on only a few areas.

Member States: Broader Donor Base, Priority Setting

Most member states taking the floor during the first session underlined the success of the ongoing WHO reform programme but said they are concerned about the funding shortcomings. They also praised the decision of the WHO to join the IATI.

States mentioned the role of WHO in health emergencies and the need for further financing. They suggested that the WHO broaden its donor base, and that it prioritise its programmes.

The United States committed US$35 million to the Health Emergencies Programme. Sweden also committed to increase the contribution made by the Swedish International Development Cooperation Agency (Sida) by US$7 million.

Answering to some member state concerns, Chan said that the WHO respects the earmarking of funds by member states but gave the example of Sweden, which, once the programmes they funded reach their target, allows the WHO to go back to them and apply the remaining funds to other programmes. She engaged countries to consider this possibility to make funds more flexible.

She also said that the WHO’s efforts to expand the donor base are beginning to show progress, mentioning that Middle East countries are new donors, for example.

She also committed to leave her successor with a financially smooth transition, and “not empty the coffer and leave.” However, she said, the new WHO director general must win the confidence of member states. Chan’s term ends in June 2017 and the election process for her successor is underway.

Private Donors: Continued Support

Meanwhile, Rotary International confirmed continued funding from the Polio Global Eradication Initiative and said the initiative is “the gold standard of private-public partnerships.”

The Bill and Melinda Gates Foundation said it strongly supports the financing dialogue and said that according to its latest estimates, the foundation is on track to its financial commitments to the WHO.