Proposal By WHO To Increase Country Contributions Receives Mixed Reactions

As the head of the World Health Organization warned of funding shortfalls at this week’s financing dialogue, she also proposed to raise assessed country contributions by 10 percent to help mitigate the situation. However, countries had a different take on the suggestion, which is expected to be further considered in the discussions on the budget for 2018/2019, at the Executive Board meeting in January, and at the annual World Health Assembly next May.

WHO Director General Margaret Chan

The third WHO financing dialogue took place on 31 October. One of the sessions of the dialogue focused on the proposed increase in assessed contribution. [Update: WHO has released a report on the financing dialogue here.]

According to a WHO meeting document [pdf] on the proposal for increasing the assessed contribution, “WHO’s work is financed through dues paid by Member States to the Organization (assessed contributions) and through voluntary contributions from Member States, international organizations and non-State actors. A small part of voluntary contributions and the assessed contributions make up the flexible resources of the Organization.”

A raise of 10 percent of the assessed contribution would represent a total increase of US$93 million. The WHO currently receives a total of US$929 million in assessed contributions, according to the document. These contributions finance about 20 percent of the programme budget.

Assessed contributions are sustaining the governing body mechanism of the WHO, such as governance and leadership functions, including the salaries of the director general, the regional directors, and WHO representatives in countries. The contributions also serve to fund in part the management and administrative functions of the organisation, including finance, human resource management and security, as well as helping to compensate for insufficient alignment of specified voluntary contributions, according to the document.

A raise in assessed contributions would in particular ensure security for critical programmes and functions of the organisation; safeguard the gains achieved when programmatic priorities change; and allow multi-year investments, said the document.

The 10 percent increase proposed would be apportioned to member states on the basis of the scale of assessments adopted by the World Health Assembly in May 2016, which would mean that for about 40 countries, when the new scale of assessment is applied in 2017, even with the projected increase, their contributions would decrease.

The document provides a graph of countries with the largest expected increase in their assessed contributions for 2018 (in US$ million): China (16.56), US (11.35), Brazil (5.91), Russia (4.45), Argentina (2.55), Australia (2.31), Saudi Arabia (1.84), South Korea (1.16), Canada (1.06), Indonesia (0.97), Switzerland (0.96), and Iran (0.75).

Ian Smith, executive director, Office of the WHO Director General, during the financing dialogue presented the advantages and the necessity of increasing assessed contributions.

“The assessed contributions have a particular value in securing the entirety of the programme budget,” he said.

However, he said “we won’t get the increased financial security for this organisation without increased stewardship.” Equally, financial security contributes to better stewardship, he said.

“We do recognise that an increase in assessed contributions is challenging for several countries,” he said.

Some Countries Reluctant

The Czech Republic, speaking on behalf of Austria, Bulgaria, the Czech Republic, Hungary, Latvia, Poland, Slovakia, and Spain, said those countries have “serious doubts that the DG’s proposal to increase the assessed contribution” is really going to address the problem of the long-term financial sustainability of the WHO.

WHO still has room to manoeuvre, the Czech Republic delegate said, to address inefficiencies and prioritise its work, as well as to mobilise flexible and predictable financial contributions from donors.

In particular, the delegate said, referring to the newly adopted Framework of Engagement with Non-State Actors (FENSA) – such as private entities, foundations, academia, and civil society – that no category of non-state actors should be automatically excluded if their contributions amount to, or exceed the threshold of one million US$.

Mexico was of the opinion that the WHO budget should be restructured, to do more with less. Colombia did not support the increase either.

Some Enthusiastic, Some Undecided

Some countries, on the contrary, were supportive of the proposal to increase assessed contributions as a mean to bring financial sustainability to the WHO, such as the Netherlands, Germany, Monaco, Norway, and Zimbabwe.

Those countries asked for more information before committing themselves to the proposal, and to a “value-for-money” plan.

According to the meeting document, the WHO “is currently developing a comprehensive and detailed value-for-money plan to be submitted to the Executive Board in 2018. This will include further plans to reduce costs associated with meetings and travel, among other measures that yield high efficiencies and lower administrative costs across the enabling functions and technical programmes.”

Other countries agreed to consider the proposal but under conditions, such as Sweden, who said results should be improved at country level. India suggested WHO explore the possibility of voluntary increase to those member states that can commit themselves and reserved its opinion.

The United Sates also said it does not consider the lack of budget growth in the past to be a sufficient justification for budget increases for the future. The proposed increase in the assessed contributions should be examined against several criteria, the US delegate said, such as whether the proposed work programme and budget is transparent, and if it demonstrates actual or proposed cost savings.

WHO Director General Margaret Chan, reacting after the member states comments, underlined the need for WHO to have financial support but also moral and political support. She said the financing dialogue has been constructive and informative.