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World Health Organization Reform Agenda Must Address Budget Issue While Not Reducing WHO’s Impact
May 18, 2011

World Health Organization Reform Agenda Must Address Budget Issue While Not Reducing WHO’s Impact
World Health Organization Reform Agenda Must Address Budget Issue While Not Reducing WHO’s Impact



Statement by Dr. Nils Daulaire
Director of the Office of Global Health Affairs
Department of Health and Human Services
and U.S. Representative on the
Executive Board of the World Health Organization

May 17, 2011

Agenda Item 11: The Future of Financing for WHO

The United States strongly supports the Director-General’s leadership in promoting a comprehensive reform package for the organization. We believe the future of financing discussion has sparked an important discussion on the role of WHO at the center of global health and how to ensure the organization is best placed to respond to the challenges of the 21st century.

We commend the DG and Member States for the inclusive and transparent way the discussions around this issue both before and following the January Executive Board have taken place. We wish to take this opportunity to urge that same spirit and practice continue as we move forward into implementation.

Recognizing the paper for this agenda item remains necessarily general, we believe it is a solid basis from which to move forward, particularly in view of the strong consultative role envisioned for Member States in the draft resolution. We support the resolution as drafted and urge others to do so as well.

The further development of a detailed implementation plan will be an important piece of this effort, both for elaborating details around partially fleshed out concepts like the World Health Forum, and for bringing greater clarity concerning some of the interesting ideas that still need more work. I would cite, for example, the idea of WHO examining “the advantages of a replenishment model for attracting more predictable voluntary contributions.”

From our perspective, the link between the WHO budget and the broader reform agenda cannot be emphasized enough. We appreciate the work that has gone into improving and grounding the proposed 2012-2013 budget as a “transitional budget.” We know there is strong support for moving to a results based budgeting model. In our view, we believe we must get this right, while not downsizing or reducing the impact of the organization. We believe budget reform is a key piece of the puzzle of how we get the efficient and effective WHO we all need.

We also appreciate the DG’s leadership in promoting independent evaluation. We believe that shows the strength and confidence she has, and we all should have, in the organization. In our view, the DG, through her paper and draft resolution, have gotten this exactly right in terms of an evaluation that is limited in scope and duration, that will feed directly into the reform process, and that relies on strong Member State input for its direction.

We favor taking this forward in a way that builds on well-known and successful WHO practices for such outside reviews, such as the work of the recently concluded IHR Review Committee. We also believe that such an evaluation should look at a limited area of the WHO’s broad remit and focus on one, or a small set, of strategic objectives or themes that will likely best illuminate where changes need to take place to achieve the aims the DG has set out for us through this process. The DG’s earlier mention of health systems as a possible area of this attention seems eminently reasonable to us.