The World Health Organization, or WHO, is the United Nation's agency responsible for coordinating issues related to health. In this lesson, we are going to talk about how WHO's budget works and where its funding comes from. WHO operates on what’s called a biennium budget process, meaning their budgets are approved for a two year period. Currently, WHO’s biennium budget for 2016 to 2017 is $4.4 billion. While this sounds like a lot of money, when you think about the range of health issues they cover, emergencies they respond to and number of countries they have offices in, suddenly the number doesn't seem quite as large. Let's review the WHO budget and how it's allocated. The WHO budget is divided generally into eight broad categories. First, is communicable diseases which recieves 795 million dollars and covers HIV-AIDS, TB, malaria, neglected tropical diseases and vaccine preventable diseases. Non-communicable diseases include mental health, disabilities, and nutrition, and has a budget of 340 million dollars. The next category is called Health throughout the Life Course. It includes maternal, newborn and child health with $382 million allocated for this work. Health system strengthening receives $595 million. Corporate services, which covers staff and administrative costs, receives $733 million. Outbreaks and emergency response receives $380 million as a standing line item. In addition, there is a special fund of $204 million allocated as a contingency in case there is an outbreak during the biennium period. Finally, Polio is by far the largest line item with about $895 million for the two year period. So where does this money come from? There are two sources for the WHO budget, assessed contributions and voluntary contributions. Assessed contributions are a fixed fee that each member state pays to be a member of WHO. The assessed contributions are of varying amounts depending on the size and wealth a nation. These fees account for approximately 25% of WHO's overall budget which in this spanium equals $929 million. Voluntary contributions are funds that are given to the WHO to support specific activities. When WHO was formed, its budget was based only on assessed contributions. However, as the WHO needed additional funding, they started accepting voluntary contributions. While assessed contributions come only from member states, voluntary contributions can come from a range of sources, including member states and philanthropic organizations. Voluntary contributions have risen significantly in recent years. In the 1970's, voluntary contributions were approximately 25% of the total WHO budget. Today, voluntary contributions now make up 75% of WHO's budget or 3.5 billion dollars. In 2011 just over half of the WHO's voluntary contributions came from donor governments. Other groups providing voluntary contributions were other UN agencies, such as multilaterals, such as Unicef or Gavi, which provided 21%. Philanthropy has provided 18%, non-governmental organizations provided 7%, and most of that came from Rotary International in support of polio eradication. And finally private industry provided 1%. In total, 80% of WHO's overall budget came from governments. The largest funder to WHO is the US Government. And the Bill & Melinda Gates Foundation is the second largest. The US Government Funding is a mix of assessed a voluntary contributions, while the Gates funding is solely voluntary. Let's take a moment to review what we've learned so far. There are several challenges regarding the WHO budget. First, many believe that the budget is too low to cover the WHO's vast global responsibility. Adding to this challenge is the fact that the assess contribution formula has not changed in a number of years. Therefore, the formula has not kept pace with inflation, nor does it reflect economies that have grown. Another challenge is that voluntary contributions can distort the funding structure of the organization. For example, if a philanthropy wants to fund a program, it can do so regardless of whether that program is a priority of WHO's leadership. A final challenge is that non-member states have been contributing an increasing larger portion of WHO's budget, yet they have no responsibility in the governance of the WHO, as that role is limited to members states. So there's a growing difference between a list of member states vs the list of donors. Non-member donors don't have ownership or oversight of how the organization is structured or organized, so their financial constitutions may not be as effective. In response to these challenges, WHO Director General Margaret Chan held a meeting in 2010 to discuss WHO's financing situation which lead to the creation of the WHO financing dialog. The purpose of this effort is to have a collaborative discussion on the organization's budget and resource mobilization efforts, and ensure transparency and predictability on the budget. What is unique about this meeting when compared to the challenges we just discussed is that in addition to member states being invited, non governmental donors who have contributed at least $1 million to WHO are also included. In summary, I believe that WHO's role is essential to address long term health issues as well as respond to outbreaks and emergencies. And funding the WHO at an effective level remains an ongoing challenge that we must continue to grapple with.
