WHO Faces Big Impact On Workers, Costs As Polio Strategy Ends In 2018

The World Health Organization faces a significant shift in its human resources status when polio eradication efforts come to an end in 2018, and so far, transition planning has been “sporadic and limited,” according to an independent study.

WHO is at the centre of a global effort, funded by the Bill & Melinda Gates Foundation and others, to eradicate polio worldwide by 2018. The effort has faced some recent setbacks due to the inability to vaccinate in several areas of extreme conflict, but the targeted end date of the programme does not appear to have moved yet. The number of cases of disease due to wild poliovirus increased 82 percent (405 cases compared with 223 cases) from 2012 to 2013, with eight countries reporting cases in 2013 instead of five countries in 2012, WHO said.

Looking ahead at the impact of shifting human resources, the WHO Programme, Budget and Administration Committee of the Executive Board in May 2013 called for the independent study. They also called for the WHO secretariat’s proposals on how to mitigate risk of long-term liabilities related to the high levels of staffing in the polio programme.

“When polio funding runs out in five years time, WHO will look very different than it does today” – European official

The findings were based on an independent study entitled, Polio eradication and endgame strategic plan 2013-2018, in which consultants collected and analysed human resources data from August to October 2013.

“The interruption of poliovirus transmission and eventual certification of polio eradication will result in a change in workforce needs and a reduction in polio-specific funding, leading up to programme closure,” the study found, according to the annex of the WHO annual human resources report, A67/47 [pdf]. The report was presented to the 67^th World Health Assembly last week.

Also presented at the WHA was a secretariat report on “Poliomyelitis: intensification of the global eradication initiative,” A67/38 [pdf]. The secretariat looked at pricing of polio vaccines, among other things.

According to the human resources report, WHO has 7,283 personnel financed from polio-specific funds, including 1,104 with staff contracts and 6,269 with non-staff contracts, for a total annual cost of US$ 145.7 million. Some 82 percent of staff contracts (827) and 39 percent (2449) of non-staff contracts financed from polio-specific funds are in the African Region.

Using WHO figures, well over 10 percent of WHO staff are funded through the polio programme, and the figure appears to be vastly higher for non-staff workers.

“When polio funding runs out in five years time, WHO will look very different than it does today,” an official from a western European government said during the Health Assembly.

Financial Liabilities

The polio report notes that progress made in the fight against polio in recent years does not seem to be reflected in changes in staffing. Furthermore, WHO could be hit by costs for staff departures as high as $122 million if it does not plan properly.

“Across regional offices and countries there are different approaches to planning for the future of activities not related to polio eradication currently being undertaken by the workforce financed from polio-specific funds beyond the biennium 2018-2019,” the independent study said. “Transition planning has been sporadic and limited.”

The study recommends synchronising contract end dates with programme closure and a higher proportion of reassignments could reduce indemnity costs. It also said that if the time horizon was extended into the post-certification period, total indemnity costs could be brought down to approximately $50 million.

The secretariat laid out steps it plans to take by mid-2014, by standardising and improving the polio programme human resources management processes and practices across WHO offices in order to start reducing financial liabilities.

The steps include aligning the workforce with the polio status of countries; reviewing existing vacancies and limiting recruitment on longer-term contracts; transitioning to shorter contracts and temporary assignments; synchronising non-staff contracts and temporary appointments to the end date; planning the synchronisation of existing fixed-term appointments to the end date and timely discontinuation of positions, and establishing a moratorium on new fixed-term positions, except for management and highly specialised positions.

An official from the WHO polio cluster told member states in committee at the Health Assembly that an update to member states will be coming. She described five steps that will be undertaken, including: monitoring; establishing a fund for indemnities; initiating a study on activities and transition options; a long-term planning process looking at staff (by mid-2015); and undertaking to discuss with member states about transition measures (by 2015).

Overall Human Resources at WHO

In 2013, staff and other personnel costs amounted to US$ 890.5 million or 39.4% of the organisation’s total expenditure of US$ 2.261 billion, according to the human resources report. Almost half of all personnel costs are at the headquarters, some $390.5 million, almost double the next office, the African region, which was $202.6 million. The other regional offices were significantly less.

As of 31 December 2013, WHO had a total of 7,296 staff members, comprising 6,452 holding long-term appointments and 844 holding temporary appointments.

“Of those holding long-term appointments, 2143 (33.2%) were in the professional and higher categories, 905 (14.0%) were in the national professional officer category and 3404 (52.8%) were in the general service category. The number of staff members holding long-term appointments has decreased by 97 (1.5%) compared with the number reported in the staffing profile as at 31 December 2012,” it said. Meanwhile, the number of temporary staff members rose slightly.

The percentage of staff in the professional and higher categories who are women has risen from about 22 percent in 1990 to about 41 percent in 2013, and is projected to reach parity by 2022.

And as of December 2013, about 44 percent of professional and higher staff were from developing countries, a slight decrease from the previous year. But at the headquarters, 45 percent are from Europe.

Several European countries – France, UK, Germany, Italy, Netherlands, and Belgium – were considered overrepresented at WHO based on the approved formula for geographical representation: contribution, 45 percent; membership, 45 percent; population, 10 percent (not including posts paid by governments). Based on this, India was far overrepresented. Others who were considered overrepresented included: Australia, Canada, Ethiopia, Kenya, Nigeria, and Uganda. Meanwhile, the United States (the top WHO contributor) was far under-represented. Also under-represented were Japan and China.

Retirements at all levels of staffing are forecast to rise steadily over the next 10 years. More than 15 percent of staff are slated to retire in the next five years, and more than 33 percent in the next 10 years.