AFR/RC57/11 25 June 2007
REGIONAL COMMITTEE FOR AFRICA Fifty-seventh session Brazzaville, Republic of Congo, 27–31 August 2007 Provisional agenda item 7.9
ORIGINAL: ENGLISH
WHO PROGRAMME BUDGET 2008-2009: ORIENTATIONS FOR IMPLEMENTATION IN THE AFRICAN REGION Report of the Regional Director Executive Summary 1. The WHO Programme Budget 2008-2009 is structured around 13 strategic objectives as presented in the WHO Medium-Term Strategic Plan 2008–2013. Each strategic objective has various proposed organization-wide expected results, and budgetary resources have been allocated accordingly. 2. The World Health Assembly has adopted the WHO Programme Budget 2008-2009 amounting to US$ 4.2 billion. The African Region will receive a share of US$ 1.2 billion, representing 28.2% of the total budget. The funds will be provided through Assessed contributions (18%) and Voluntary contributions (82%). 3. The present document recalls the health priorities of the African Region and proposes orientations for the implementation of the WHO Programme Budget 2008-2009. 4. The Regional Committee is requested to note and adopt the proposed orientations.
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CONTENTS Paragraphs INTRODUCTION ............................................................................................................................. 1–7 PRIORITIES .................................................................................................................................... 8–16 LESSONS LEARNT ..................................................................................................................... 17–19 PROGRAMME BUDGET 2008-2009 .......................................................................................... 20–25 GUIDING PRINCIPLES FOR IMPLEMENTATION.................................................................. 26–30 ROLES AND RESPONSIBILITIES ............................................................................................. 31–33 CONCLUSION.............................................................................................................................. 34–35 ANNEX Page Table 1: WHO budget by strategic objective and major office, 2008-2009......................................... 7 Table 2: WHO African Region budget by strategic objective and source of financing, 2008-2009 ......................................................................................................... 8 Table 3: WHO African Region budget by countries and Regional Office (including Intercountry Team), 2008-2009 ................................................. 9 Table 4: WHO African Region budget allocation to countries by source of financing, 2008-2009............................................................................................................ 10 Table 5: WHO African Region budget allocation to the Regional Office (including Intercountry Team) by source of financing, 2008-2009 ..................................... 11 Table 6: WHO African Region budget: Distribution by country and source of financing, 2008-2009............................................................................................ 12 DRAFT RESOLUTION AFR/RC57/WP/5 WHO Programme Budget 2008-2009: Orientations for implementation in the African Region
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INTRODUCTION 1. The global health environment is characterized by gaps in terms of social justice, responsibility, implementation and knowledge. There is inequitable access to health services to the disadvantage of the poor and the underprivileged. Inadequate choices and activities often result in harmful environmental modifications with health consequences and human sufferings for which no one claims responsibility.1 2. Proven health interventions are not fully implemented in some parts of the world, especially in Africa. While unprecedented scientific and technological advances have been achieved during past decades, there is still insufficient knowledge on effective ways to address some of the most important health challenges facing Africa and the rest of developing world. 3. The WHO Eleventh General Programme of Work (GPW)2 sets a global agenda for action to fill in the gaps mentioned above. The responsibility for action lies with all stakeholders: communities, governments, civil society and the private sector. The current GPW acknowledges the unique opportunity provided by an ever-increasing number of health partners who recognize WHO as the lead agency in international health. 4. In this environment, WHO has defined its contribution to the global health agenda in its Medium-Term Strategic Plan 2008–2013 (MTSP) recently adopted by the WHO governing bodies. The MTSP articulates 13 strategic objectives and various organization-wide expected results for each objective. The MTSP will be implemented through three biennial Programme Budgets and related operational plans (workplans), respectively formulated for the periods 2008-2009, 2010-2011 and 2012-2013. 5. The Programme Budget 2008-2009 has been approved by the World Health Assembly. In the WHO African Region, the 2008-2009 operational plans will be informed by the Strategic orientations for WHO action in the African Region, 2005–20093 founded on the priorities identified by Member States in their national health development plans and also reflected in the WHO country cooperation strategies. 6. In its efforts to maximize support to Member States, the WHO Regional Office for Africa is strengthening partnerships with regional and global organizations. In addition, to ensure efficiency and closer support to Member States, the Regional Office has established three Intercountry Support Teams (ISTs) based in Ouagadougou for west Africa, Libreville for central Africa, and Harare for southern and eastern Africa. The Regional Office is striving to provide the ISTs with the necessary human, financial and logistical resources to quickly address country requests. The ISTs establish technical linkages with the health desks of regional economic communities for synergistic action to the benefit of Member States.
1
WHO, Engaging for health: A global health agenda, Eleventh General Programme of Work 2006–2015, Geneva ,World Health Organization 2006. 2 WHO, Engaging for health: A global health agenda, Eleventh General Programme of Work 2006–2015, Geneva ,World Health Organization 2006. 3 WHO, Strategic orientations for WHO action in the African Region, 2005–2009, Brazzaville, World Health Organization, Regional Office for Africa, 2005.
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7. The present document recalls the health priorities of the African Region and proposes orientations for the implementation of the WHO Programme Budget 2008-2009. It is submitted to the Regional Committee for review and approval. PRIORITIES Global priorities 8. Upon assuming duty, the WHO Director-General indicated that, under her leadership, the success of WHO action would be measured by the results obtained in Africa and through interventions aimed at improving the health of women. These are significant challenges which present numerous opportunities for both Member States and the WHO Regional Office for Africa. 9. All partners and development agencies now recognize the crucial role of national health systems in delivering quality health interventions. However, the health systems in the African Region are facing insufficiency of resources for infrastructure, equipment, essential medicines and operations. Moreover, the world currently faces a major crisis in human resources for health. Poor countries bear the brunt of this crisis as they are unable to train qualified health workers in adequate numbers. The crisis is exacerbated by the increased migration of trained staff due to several factors. 10. The occurrence of severe acute respiratory syndrome and avian influenza has highlighted major threats to global health security, and the African Region is ill-prepared for these and other threats. In response, the World Health Assembly resolved to bring into force, by 15 June 2007, the revised International Health Regulations (2005).4 Therefore, there is an urgent need to strengthen national capacities for detection, confirmation, notification and rapid response to public health emergencies of international concern. 11. The global community has invested enormous resources in interventions aimed at poliomyelitis eradication. As a result, the disease has been eradicated from the European, American and Western Pacific regions of the World Health Organization. The African, Eastern Mediterranean and SouthEast Asian regions still need to maintain the momentum to definitely free the world of wild poliovirus. Regional priorities 12. An analysis of the WHO Country Cooperation Strategy documents as well as Strategic orientations for WHO action in the African Region, 2005–2009 show major regional concerns. Priorities are: fighting HIV/AIDS, tuberculosis and malaria; strengthening health policies and systems; enhancing effective rapid response to disease outbreaks such as cholera, and to emergencies, including human-made and natural disasters; improving maternal and child health; combating neglected diseases; controlling the common risk factors of noncommunicable diseases; and promoting the scaling up of proven cost-effective health interventions.
4
Resolution WHA58.3, Revision of the International Health Regulations. In: Fifty-eighth World Health Assembly, Geneva, 16– 25 May 2005, Volume 1, Resolutions and decisions, and list of participants, Geneva, World Health Organization, 2005.
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13. Noncommunicable disease surveys conducted in more than two thirds of Member States have revealed an alarming high prevalence of risk factors.5 Effectively controlling the common risk factors of noncommunicable diseases is feasible and cost-effective and could help prevent 80% of related morbidity and mortality.6 14. In its efforts to better support Member States to respond to the above priorities, the Regional Office needs to further decentralize resources and delegate programme implementation to the Intercountry Support Teams. Decentralization and delegation will allow the Regional Office to give greater prominence to strategic planning for technical excellence, managerial efficiency and strengthening WHO country offices. 15. While an increased number of partners and global initiatives are involved in providing support to countries for the improvement of health outcomes, the World Health Organization is recognized as the lead agency in health. More than ever before, there is need to strengthen WHO presence and action at country level in order to support national authorities to promote and coordinate internal and external efforts and partnerships for improving the health of their populations. 16. Most of the countries in the Region are not on track for the achievement of the Millennium Development Goals. There is therefore need to mobilize and sustain political commitment and advocacy to increase resources; realize effective intersectoral collaboration; enhance awareness and response to key determinants of health; and promote the scaling up of essential health interventions related to priority health problems. LESSON LEARNT 17. One lesson learnt during implementation of previous Programme Budgets is that Voluntary contributions are often earmarked. Therefore, there is a need to advocate for an increase of the portion of non-earmarked funds, which should take care of attractive non-donor programmes. However, it should be noted that while the amount available from Assessed contributions is known and can be easily allocated, the amount available from Voluntary contributions has a degree of uncertainty. 18. There is a need to constitute a reserve to address unforeseen expenditures. Therefore, 4% of Assessed contributions, totalling US$ 8.5 million, will be withheld at the beginning of the biennium by the Director-General (3%) and the Regional Director (1%). The proportion of the amount withheld is less than that for 2006-2007 which was 6%. The reserve funds will be released during the second year of the biennium. 19. During Programme Budget implementation, careful consideration needs to be given to the possible budgetary impact of the fluctuation of the US dollar vis-à-vis local currencies. Indeed, there are no provisions in the Programme Budget for reimbursement of exchange rate losses due to US dollar depreciation.
5
6
http://www.who.int/ncd_surveillance/infobase/web/InfoBasePolicyMaker/Reports/reportListCountries.aspxHO/ (accessed 9 April 2007). WHO, Preventing chronic diseases: A vital investment, Geneva, World Health Organization, 2005.
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PROGRAMME BUDGET 2008-2009 20. The Programme-Budget 2008-2009 is founded on the principles of result-based management and integration. The WHO governing bodies have agreed on the strategic objectives to be attained at the end of the six-year period (2008–2013) to address global health challenges. The WHO Secretariat has defined organization-wide expected results for the biennium. On this basis, the Regional Office proposes regional expected results, directing the different Divisions and the country offices to devise office-specific expected results. 21. The approved WHO global budget amount is US$ 4 227 480 000. The African Region will receive US$ 1 193 940 000, representing 28.2%, which is in line with the validation mechanism of the principles for strategic financial resource allocation.7 In terms of sources, US$ 213 342 000 (18%) will be provided by Assessed contributions, and US$ 980 598 000 (82%) will come from Voluntary contributions (Annex tables 1 and 2). 22. The budget allocations to the Regional Office and country offices and by source of financing are detailed in Annex tables 3–6. This budget represents an increase of 4.8% for Assessed contributions and of 32% for Voluntary contributions as compared to the Programme Budget 20062007. The distribution of the budget shows that WHO country offices as a whole will receive 51% of regional funds and the Regional Office, including the Intercountry Support Teams, will receive 49% of funds. In fact, the intercountry allocations are earmarked to be spent in countries. This brings the proportion of the total amount that will be used in countries to 66%. The balance of 34% constitutes the real portion that will be spent at the Regional Office (Figure 1). Figure 1: Distribution of budget allocations for the WHO African Region, 2008-2009
23. The proposed Programme Budget (PB) distribution reflects the emphasis on communicable diseases (Strategic objective 1; 26.5% of PB), in particular the global efforts towards poliomyelitis eradication. With 20.3% of PB, efforts to tackle HIV/AIDS, malaria and tuberculosis are the second priority. WHO Secretariat work, including strengthened presence in Member States (Strategic objectives 12 and 13), will benefit from 14.6% of PB.
7
WHO, Document EB118/7/2006, Strategic resource allocation, Geneva, World Health Organization.
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24. Strengthening health systems (Strategic objectives 10 and 11) has also been given preeminence with 13.8% of PB. Child and maternal health, along with adolescent health, sexual and reproductive health and ageing are given due attention with 9.7% of PB (Strategic objective 4). A sizeable proposition (5.5%) of the PB is devoted to emergency response (Strategic objective 5). 25. The other strategic objectives to be met by Programme Budget 2008-2009 relate to nutrition and food safety (3.3%) of the PB; health promotion and reduction of risky behaviour and risk factors for communicable and noncommunicable diseases (2.1%); the fight against noncommunicable diseases (1.7%); healthy environment (1.6%); and socioeconomic determinants of health (0.8%). GUIDING PRINCIPLES FOR IMPLEMENTATION 26. The Programme Budget 2008-2009 will be implemented in the overall framework of resultbased management. The priorities discussed above will be addressed through the 13 strategic objectives. Regional expected results have been defined. The different Divisions of the Regional Office and WHO country offices will devise their office-specific expected results. These expected results will provide the basis for the preparation of biennial workplans detailing the necessary activities, responsibilities, timeline and both human and financial resources. Country workplans will be jointly approved by the Ministry of Health and the Regional Director by 30 October 2007 to allow for timely allotment of financial resources and implementation from January 2008. 27. The ongoing decentralization process will be pursued in order to reinforce decision-making and action at the most appropriate level. Financial, human and logistical resources will be decentralized accordingly, enhancing technical support at intercountry and country level. 28. Accountability for the implementation of this Programme Budget is the responsibility of both Member States and the WHO Secretariat and is an obligation to WHO governing bodies and partners. To this end, there is need for strengthening the monitoring, evaluation and reporting processes at all levels. 29. For greater efficiency, the global management system will be rolled out across the Organization. This system standardizes and streamlines key managerial processes and procedures. Most processes will be automated and Internet-based, providing increased speed, real-time action, transparency and better control. Significant economies of scale are expected over time. The introduction of the global management system will have a major impact on the way business is conducted across the Organization, and it will impact on the staffing profile. 30. WHO will pursue efforts to strengthen partnerships for health in the Region. Collaboration with the African Union and regional economic organizations will be strengthened for synergistic action. The WHO Secretariat will participate in the ongoing United Nations reform process while ensuring fulfilment of its Constitutional mandate. There is a shared responsibility to ensure compliance with the Paris Declaration on Aid Effectiveness, specifically on the principles of harmonization and alignment, by UN agencies, bilateral and funding agencies, and the private sector and civil society groups involved in health action.
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ROLES AND RESPONSIBILITIES 31. The implementation of the Programme Budget is a shared responsibility between Member States and WHO Secretariat who are both accountable for the use of WHO resources and the achievement of planned and expected results. 32. Countries are urged to agree to the prioritization of activities in line with their national health plans, country cooperation strategies and strategic objectives of the Medium-Term Strategic Plan 2008–2013. Each Ministry of Health should ensure that appropriate action is taken for approval of workplans before the end of October 2007. 33. WHO will continue decentralization and delegation of authority. The Secretariat will take appropriate steps to roll out the global management system in the Region, committing necessary efforts and resources, and introducing necessary adjustments in structure and staffing profile. The Regional Director will approve 2008-2009 workplans by the end of October 2007. CONCLUSION 34. The Medium-Term Strategic Plan 2008–2013 defines 13 strategic objectives for WHO contribution to the global health agenda. For the biennium 2008-2009, the African Region will receive a budget of US$ 1 193 940 000, representing 28.2% of the WHO global budget. This document provides orientations for the implementation of the Programme Budget 2008-2009. 35. The Regional Committee is invited to note and adopt the proposed orientations for implementation of the Programme Budget 2008-2009 in the African Region.
AFR/RC57/11 Page 7 ANNEX Table 1: WHO budget by strategic objective and major office, 2008-2009 (US$ thousand) Strategic Objective 1 2 To combat HIV/AIDS, malaria and tuberculosis 3 To prevent and reduce disease, disability and premature death from chronic noncommunicable conditions, mental disorders, violence and injuries To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, genderresponsive and human rights-based approaches 8 To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health To improve nutrition, food safety and food security throughout the life-course and in support of public health and sustainable development To improve health services through better governance, financing, staffing and management, informed by reliable and accessible evidence and research To ensure improved access, quality and use of medical products and technologies To provide leadership, strengthen governance and foster partnership and collaboration with countries, the United Nations system, and other stakeholders in order to fulfil the mandate of WHO in advancing the global health agenda as set out in the Eleventh GPW To develop and sustain WHO as a flexible, learning organization, enabling it to carry out its mandate more efficiently and effectively 242,912 48,673 53,769 35,926 80,979 59,332 185,341 706,932 To reduce the health, social and economic burden of communicable diseases AFR 316,203 AMR 32,387 EMR 101,095 EUR 29,925 SEAR 134,742 WPR 53,525 HQ 226,166 TOTAL 894,043
20,723
9,848
19,808
15,909
17,679
21,735
52,402
158,104
4
115,695
27,414
39,815
14,418
50,614
25,216
86,661
359,833
5
66,021
19,931
40,912
20,914
24,356
16,722
29,557
218,413
6
25,566
13,862
24,809
9,959
14,590
31,729
41,542
162,057
7 9,116 6,937 11,975 5,975 4,838 2,496 24,568 65,905
18,749
12,057
16,358
17,951
13,827
12,364
39,150
130,456
9
39,778
14,608
8,938
5,975
13,939
19,273
24,423
126,934
10
142,093
37,462
66,206
48,567
57,829
46,607
115,290
514,054
11
22,592
8,940
16,763
6,971
14,290
9,989
54,488
134,033
12
48,966
16,559
26,482
25,341
14,304
15,636
67,056
214,344
13
125,526
29,823
38,040
36,932
49,551
33,214
229,286
542,372
TOTAL Percentage of total
1,193,940 28.2%
278,501 6.6%
464,970 11.0%
274,763 6.5%
491,538 11.6%
347,838 8.2%
1,175,930 27.8%
4,227,480 100.0%
AFR/RC57/11 Page 8 Table 2: WHO African Region budget by strategic objective and source of financing, 2008-2009 (US$ thousand) Strategic Objective 1 2 3 To reduce the health, social and economic burden of communicable diseases To combat HIV/AIDS, malaria and tuberculosis To prevent and reduce disease, disability and premature death from chronic non-communicable conditions, mental disorders, violence and injuries To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, gender-responsive, and human rights-based approaches To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health To improve nutrition, food safety and food security throughout the life-course and in support of public health and sustainable development To improve health services through better governance, financing, staffing and management, informed by reliable and accessible evidence and research To ensure improved access, quality and use of medical products and technologies To provide leadership, strengthen governance and foster partnership and collaboration with countries, the United Nations system, and other stakeholders in order to fulfil the mandate of WHO in advancing the global health agenda as set out in the Eleventh GPW To develop and sustain WHO as a flexible, learning organization, enabling it to carry out its mandate more efficiently and effectively Assessed Contributions 20,049 11,364 9,869 Voluntary Contributions 296,154 231,548 10,854 All Financing 316,203 242,912 20,723
4
18,748
96,947
115,695
5
4,172
61,849
66,021
6
10,118
15,448
25,566
7
6,128
2,988
9,116
8
5,857
12,892
18,749
9
5,162
34,616
39,778
10
23,059
119,034
142,093
11
6,411
16,181
22,592
12
35,704
13,262
48,966
13
56,701
68,825
125,526
TOTAL Percentage of total
213,342 18%
980,598 82%
1,193,940 100%
AFR/RC57/11 Page 9 Table 3: WHO African Region budget by countries and Regional Office (including Intercountry Team), 2008-2009 (US$ thousand) Strategic Objective 1 To reduce the health, social and economic burden of communicable diseases To combat HIV/AIDS, malaria and tuberculosis To prevent and reduce disease, disability and premature death from chronic non-communicable conditions, mental disorders, violence and injuries To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, gender-responsive, and human rights-based approaches To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health 9 To improve nutrition, food safety and food security throughout the life-course and in support of public health and sustainable development To improve health services through better governance, financing, staffing and management, informed by reliable and accessible evidence and research To ensure improved access, quality and use of medical products and technologies To provide leadership, strengthen governance and foster partnership and collaboration with countries, the United Nations system, and other stakeholders in order to fulfil the mandate of WHO in advancing the global health agenda as set out in the Eleventh GPW To develop and sustain WHO as a flexible, learning organization, enabling it to carry out its mandate more efficiently and effectively Countries 130,422 144,179 11,958 Intercountry/ Regional Office 185,781 98,733 8,765 TOTAL 316,203 242,912 20,723
2 3
4
49,461
66,234
115,695
5
47,502
18,519
66,021
6
12,926
12,640
25,566
7
4,995
4,121
9,116
8 9,324 9,425 18,749
17,994
21,784
39,778
10
84,072
58,021
142,093
11 12
13,217
9,375
22,592
37,372
11,594
48,966
13
42,935 606,357 51%
82,591 587,583 49%
125,526 1,193,940 100.0%
TOTAL Percentage of total
AFR/RC57/11 Page 10 Table 4: WHO African Region budget allocation to countries by source of financing, 2008-2009 (US$ thousand) Strategic Objective 1 2 To combat HIV/AIDS, malaria and tuberculosis 3 To prevent and reduce disease, disability and premature death from chronic non-communicable conditions, mental disorders, violence and injuries To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, gender-responsive, and human rights-based approaches To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health To improve nutrition, food safety and food security throughout the life-course and in support of public health and sustainable development To improve health services through better governance, financing, staffing and management, informed by reliable and accessible evidence and research To ensure improved access, quality and use of medical products and technologies To provide leadership, strengthen governance and foster partnership and collaboration with countries, the United Nations system, and other stakeholders in order to fulfil the mandate of WHO in advancing the global health agenda as set out in the Eleventh GPW To develop and sustain WHO as a flexible, learning organization, enabling it to carry out its mandate more efficiently and effectively 5,538 138,641 144,179 To reduce the health, social and economic burden of communicable diseases Assessed Contributions 13,991 Voluntary Contributions 116,431 All Financing
130,422
5,858
6,100
11,958
4
11,981
37,480
49,461
5
2,229
45,273
47,502
6
6,118
6,808
12,926
7
3,517
1,478
4,995
8
3,876
5,448
9,324
9
3,013
14,981
17,994
10
12,989
71,083
84,072
11 12
3,357
9,860
13,217
30,944
6,428
37,372
13
33,128 136,539 23%
9,807 469,818 77%
42,935 606,357 100.0%
TOTAL Percentage of total
AFR/RC57/11 Page 11 Table 5: WHO African Region budget allocation to the Regional Office (including Intercountry Team) by source of financing, 2008-2009 (US$ thousand) Strategic Objective 1 2 To combat HIV/AIDS, malaria and tuberculosis 3 To prevent and reduce disease, disability and premature death from chronic non-communicable conditions, mental disorders, violence and injuries To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, gender-responsive, and human rights-based approaches To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health To improve nutrition, food safety and food security throughout the life-course and in support of public health and sustainable development To improve health services through better governance, financing, staffing and management, informed by reliable and accessible evidence and research To ensure improved access, quality and use of medical products and technologies 12 To provide leadership, strengthen governance and foster partnership and collaboration with countries, the United Nations system, and other stakeholders in order to fulfil the mandate of WHO in advancing the global health agenda as set out in the Eleventh GPW To develop and sustain WHO as a flexible, learning organization, enabling it to carry out its mandate more efficiently and effectively 5,826 92,907 98,733 To reduce the health, social and economic burden of communicable diseases Assessed Contributions 6,058 Voluntary Contributions 179,723 All Financing 185,781
4,011
4,754
8,765
4
6,767
59,467
66,234
5
1,943
16,576
18,519
6
4,000
8,640
12,640
7
2,611
1,510
4,121
8
1,981
7,444
9,425
9
2,149
19,635
21,784
10
10,070
47,951
58,021
11 3,054 6,321 9,375
4,760
6,834
11,594
13
23,573 76,803 13%
59,018 510,780 87%
82,591 587,583 100%
TOTAL Percentage of Total
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Table 6: WHO African Region budget, distribution by country and source of financing, 2008-2009 Country Algeria Angola Benin Botswana Burkina Faso Burundi Cameroon Cape Verde Cent. African Rep. Chad Comoros Rep. of Congo Côte d’Ivoire Dem. Rep. Congo Equatorial Guinea Eritrea Ethiopia Gabon Gambia Ghana Guinea Guinea-Bissau Kenya Lesotho Liberia Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Reunion Rwanda Saint Helena Sao Tome & Principe Senegal Seychelles Sierra Leone South Africa Swaziland Togo Uganda United Rep. Tanzania Zambia Zimbabwe Total 2006-2007 Assessed contributions Increase 2008-2009 (Decrease) 1,981 81 2,062 3,567 192 3,759 2,606 106 2,712 2,136 87 2,223 3,243 133 3,376 3,155 133 3,288 2,466 155 2,621 2,223 105 2,328 2,871 116 2,987 3,176 129 3,305 2,576 103 2,679 2,396 120 2,516 2,483 93 2,576 3,664 148 3,812 1,673 278 1,951 2,471 83 2,554 5,033 203 5,236 1,857 302 2,159 2,164 167 2,331 2,471 94 2,565 3,162 129 3,291 2,460 100 2,560 2,884 263 3,147 2,613 107 2,720 2,898 117 3,015 2,827 114 2,941 2,935 119 3,054 3,428 138 3,566 2,717 122 2,839 1,722 69 1,791 3,478 141 3,619 2,243 91 2,334 3,455 139 3,594 4,591 372 4,963 206 9 215 3,277 133 3,410 152 5 157 1,936 51 1,987 2,688 108 2,796 1,631 66 1,697 2,890 114 3,004 3,960 160 4,120 2,215 91 2,306 2,476 128 2,604 3,208 132 3,340 3,315 361 3,676 3,187 282 3,469 3,157 127 3,284 129,923 6,616 136,539 2006-2007 Voluntary contributions Increase 2008-2009 (Decrease) 146 39 185 30,147 7,965 38,112 3,043 804 3,847 482 127 609 9,441 2,494 11,935 3,970 1,049 5,019 1,665 440 2,105 188 50 238 401 106 507 3,130 827 3,957 467 123 590 2,317 612 2,929 3,695 976 4,671 46,715 12,343 59,058 605 160 765 3,741 988 4,729 45,783 12,096 57,879 1,156 305 1,461 2,293 606 2,899 6,335 1,674 8,009 3,339 882 4,221 168 46 214 13,323 3,520 16,843 1,154 305 1,459 2,706 715 3,421 11,333 2,994 14,327 8,763 2,315 11,078 2,747 726 3,473 2,428 642 3,070 39 10 49 7,607 2,010 9,617 1,144 302 1,446 4,235 1,119 5,354 63,511 16,780 80,291 4,543 1,200 5,743 108 29 137 3,123 825 3,948 18 5 23 9,327 2,464 11,791 6,115 1,616 7,731 2,282 603 2,885 1,926 509 2,435 9,286 2,453 11,739 21,417 5,659 27,076 6,521 1,723 8,244 18,746 4,953 23,699 371,629 98,189 469,818 All financing 2,247 41,871 6,559 2,832 15,311 8,307 4,726 2,566 3,494 7,262 3,269 5,445 7,247 62,870 2,716 7,283 63,115 3,620 5,230 10,574 7,512 2,774 19,990 4,179 6,436 17,268 14,132 7,039 5,909 1,840 13,236 3,780 8,948 85,254 215 9,153 157 2,124 6,744 1,720 14,795 11,851 5,191 5,039 15,079 30,752 11,713 26,983 606,357
ORIGINAL: ENGLISH AFR/RC57/WP/5 22 June 2007 DRAFT RESOLUTION WHO PROGRAMME BUDGET 2008-2009: ORIENTATIONS FOR IMPLEMENTATION IN THE AFRICAN REGION (document AFR/RC57/11) The Regional Committee, Having examined the World Health Organization Programme Budget for the biennium 20082009; Noting with appreciation the increase of all sources of funds in the approved Programme Budget necessary for strengthening WHO support for national health development; Noting that an estimated 4% of the global assessed contributions will be withheld (3% by the Director-General and 1% by the Regional Director) as a reserve to address unforeseen expenditures; Noting that the WHO Programme Budget adopted at the Sixtieth World Health Assembly was prepared by the Director-General with the full participation of all levels of the Organization and followed a results-based management approach; Further noting the proposed guiding principles for strategic resource allocations; Welcoming the efforts of the Director-General and the Regional Director in allocating more resources to priority strategic objectives; Further welcoming the effort of the Regional Director in decentralizing more resources to support countries; 1. NOTES the guiding principles for Programme Budget implementation in the African Region;
2. NOTES the allocations for the Regional Office and approves the allocations for WHO country offices; 3. NOTES the establishment of a contingency fund of 3% of the Regular budget by the DirectorGeneral and approves the withholding of 1% by the Regional Director (approximately US$ 8.5 million in total), to provide for unplanned activities, with any unused balance being reallocated to countries during the second half of the second year of the biennium; 4. ADOPTS document AFR/RC57/11 "WHO Programme Budget 2008-2009: Orientations for implementation in the African Region";
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5.
REQUESTS the Regional Director: (a) (b) (c) to ensure that operational planning, implementation, monitoring and evaluation are undertaken in close collaboration with the national authorities; to continue efforts to mobilize voluntary funds, especially non earmarked funds, to ensure adequate funding for the implementation of workplans for priority strategic objectives; to pursue advocacy with donors and development partners to relax the conditionalities attached to voluntary contributions.