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W O R L D
H E A L T H
REGIONAL OFFICE FOR SOUTH-EAST ASIA
ORGANIZATION
REGIONAL COMMITTEE
Provisional Agenda item 6.2 SEAfRC51119 10 September 1998
Fjffy-first Session 7-1 1 September 1998
REPORT OF THE SUB-COMMITTEE ON PROGRAMME BUDGET
1.
INTRODUCTION
During its plenary meetings, held on 8 September 1998, the Regional Committee elected Dr Pakdee Pothisiri (Thailand) as Chairman of the Sub-committee on Programme Budget. The working papers were distributed to the participants at its first meeting held on 8 September 1998. The Sub-committee met twice on 9 September 1998 to discuss the working papers relating to the following terms of reference and prepare its report: (1) (a) To note the recommendations of the Consultative Committee for Programme Development and Management (CCPDM) on the implementation of WHO collaborative programmes during 1996-1997;
(b) To review country and intercountry programme implementation for the period 1 January to 30 June 1998, both in its financial and technical aspects; (2) To note the status of the general issue of Regular Budget allocations to regions; (3) To review the Proposed Programme Budget 2000-2001, and (4) To consider any other matters which the Sub-committee may wish to refer to the
Regional Committee. The meetings were attended by: Dr Pakdee Pothisiri (Chairman) - Thailand Dr A.S.M. Mashiur Rahman - Bangladesh Dr Sangay Thinley - Bhutan Dr Pak Tong Chol (for Dr Pak Chun Taek) Ms Sujatha Rao Mrs Shoba Koshy Dr Dadi S. Argadiredja Mr Ahmed Salih Dr U Ohn Kyaw Dr Shyam Prasad Bhattarai Mr C. Abeygunawardana Dr V. Jeganathan Dr Suwit Wibulpolprasert
- DPR Korea - lndia
-
lndia Indonesia Maldives Myanmar Nepal Sri Lanka Sri Lanka Thailand
From the Regional Office, Dr Uton Muchtar Rafei, Regional Director; Dr Samlee Plianbangchang, Director, Programme Management; Mr Spina R. Helmholz, Director, Administration and Finance; Dr N.T. Cooray, Planning Officer; Dr M. Khalilullah. Programme Development Officer; Mr Y. Younan, Administration and Finance Officer; Mr J.J. Kobza, Ag. Budget and Finance Officer; Mr S.K. Varma. Administrative Officer to the Regional Director; and Mr S. Vedanarayanan, Administrative Officer to the Director, Programme Management, participated in the meetings.
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The following terms of reference were fulfilled:
2.
RECOMMENDATIONS OF THE CONSULTATIVE COMMITTEE FOR PROGRAMME DEVELOPMENT AND MANAGEMENT (CCPDM) ON THE IMPLEMENTATION OF WHO COLLABORATIVE PROGRAMMES DURING 1996-1997 [Term of Reference No. l(a)]
The Sub-committee reviewed the working paper [document SEAIRC51IPBNVP/l(a)], on the status of implementation of the WHO collaborative programmes, during the period 1 January 1996 - 31 December 1997, which was considered by the 33rd session of the CCPDM in April 1998. The Sub-committee was informed that the CCPDM had recommended improvements in the reporting guidelines on technical and financial aspects of programme implementation; monitoring of implementation of the plans of action using the Activity Management System (AMS); development of a mechanism for monitoring the liquidation process; and continued use of the intercountry mechanism for supplementing the countries' efforts to implement their country programme budget. In response to a query, the Sub-committee was informed that the AMS system had been installed in the Regional Office as well as in the countries, and training imparted to the staff. However, currently the system was still underutilized. AMS field-testing was being carried out in Indonesia and its outcome would be conveyed to WHOIHQ in order to improve the model. WHOIHQ was developing guidelines as to how best to use AMS to monitor activity implementation after developing plans of action. The AFI system was already monitoring the financial implementation. The difficulty was on how to monitor progress in activity implementation and achievement of targets. The first model sent by WHOIHQ to the Regional Office was found to be complicated, but this had now been customized. In response to another query, the Sub-committee was informed that the "Emergency Fund", could also be used, in addition to catastrophes, for other emergencies like epidemics. The Sub-committee was further informed that the remaining 25% of the budget would be allocated at the end of 1998, taking into consideration, among other things, the extent to which the implementation in 1998 of the target of 75% of the biennial allocation for activities had been met. While endorsing the recommendations of the 33' CCPDM, the Sub-committee made the following recommendation: At the next CCPDM, the Regional Office should report on a time-bound plan of action for full utilization of the Activity Management System and ensure its usage as a tool for technical monitoring of the programme.
3.
REVIEW COUNTRY AND INTERCOUNTRY PROGRAMME IMPLEMENTATION FOR THE PERIOD 1 JANUARY TO 30 JUNE 1998, BOTH IN ITS FINANCIAL AND TECHNICAL ASPECTS T e r m of Reference No. f(b)]
The Sub-committee reviewed the working paper SURC51/PB/WP/l(b) which, was divided into four parts: (1) regional programme review and general observations, (2) country programme reviews and evaluative comments, (3) Implementation of the intercountry plans
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of action, and (4)and budgetary analysis. The first two parts were prepared on the basis of information received from the countries. The Sub-committee felt that while full-fledged evaluation could be done for the 19961997 biennium, for each activity of the 1998-1999biennium, it was necessary to make a brief mention of the salient outcomes of each activity. In response to a query about cooperation through ASEAN in the field of health, the Sub-committee was informed that the ASEAN countries belonged to two regions - SouthEast Asia Region and Western Pacific Region. Cooperation within the same region posed no difficulty. WR, Indonesia was the WHO focal point in Jakarta. While formulating WHO budgets at country level, the countries in ASEAN might take into account the health activities outlined in the Memorandum of Understanding between WHO and ASEAN to ensure complementarity of activities. The Sub-committee was provided information about quarterly implementation of the Regular Budget in respect of country activities for the bienniums 1994-1995,1996-1 997 and through June 1998. Implementation from January through June 1998 was low. Comparative information on major programme implementation, by country, for the period 1 January to 30 June for the bienniums 1996-1 997 and 1998-1 999 was reviewed and a comparison also made of six-monthly obligations in respect of HQ and each region from June 1996 to June 1998. Regrettably, implementation in SEAR was the lowest. Information was also provided in respect of the six-monthly implementation of extrabudgetary funds from January 1996 to June 1998. The Sub-committee's attention was also drawn to the Executive Board's resolution
EB1Ol.Rl in which the Executive Board had noted the need for timely information on trends in expenditure before it could make recommendations on the 2000-2001 programme budget session in January 1999. This resolution also requested the Director-General to at its 1 0 3 ~ present details of the actual expenditure in the first year of implementation for 1998-1999at this session. Thus, given the lowest rate of implementation to date, when compared with other regions, SEA Region risked further loss of funds. The Sub-committee was also informed that in connection with reporting to the Executive Board, WHOIHQ would take into account 'obligations' instead of 'expenditure'. Even so, the Sub-committee was informed that a system for monitoring the financial transaction needed to be developed so as to better follow up the liquidation of obligations. The Sub-committee was further apprised that quality should not be sacrificed in order to expedite obligations. A lower rate of high quality obligation was preferable to a higher rate of obligation of low quality. Keeping in view the need for more efficient implementation, the Sub-committee felt that there was also a need to establish process indicators and systems to closely monitor the progress and quality of activities and products realized in the process leading up to obligations, as also following obligations, including monitoring and evaluation of expenditure. The Sub-committee was further informed that if the entire allocation was obligated in the first year of the biennium, it would facilitate added attention in the second year to the quality of obligations and for liquidation of funds. The Sub-committee was also informed that programme and budget should be treated as two separate issues. The programme could be carried over to the next biennium, but not the budget. The unutilized funds would have to be surrendered to HQ at the end of the
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biennium. An efficient system to ensure quality implementation was needed for monitoring progress from the preparation of the products and activities to the development of the detailed proposals and to the point of obligation; and then, liquidation, monitoring of activities and evaluation carried out. After discussions, the Sub-committee made the following recommendations: (1) Obligation of funds, both at the country as well as Regional Office levels, should be accelerated in order to achieve the highest possible implementation prior to review by the Executive Board. (2) An efficient monitoring system to ensure quality implementation should be developed.
4.
NOTE THE STATUS OF THE GENERAL ISSUE OF REGULAR BUDGET ALLOCATIONS TO REGIONS (Term of Reference No. 2)
The Sub-committee reviewed the working paper (document SENRC51IPBNVPI2), which reflected the present status of the general issue regarding Regular Budget allocations to regions. The Sub-committee was informed of the salient features of the implications of World Health Assembly resolution WHA51.31 for the South-East Asia Region. The Sub-committee further noted that as a result of adoption of World Health Assembly resolution WHA51.31, there would be smaller reductions in the regional budget over the next three bienniums as compared to those proposed earlier by the Executive Board. The implications of resolution WHA51.31 for SEAR perse would be a need for appropriate distribution of cuts of approximately US$ 3.656 million per biennium over the next three bienniums starting 2000-2001. The Sub-committee was informed of two main factors which rendered the SEA Region susceptible to future cuts e.g., the relatively low overall rate of obligation of the Regular Budget and the large allocations to some countries as compared to countries in other regions. In order to improve the rate of implementation, the Regional Office had evolved a strategy of pooling country funds for programming through the intercountry mechanism (ICP-11). This pooling could be done at the time of formulation of programme budget itself as resolution WHA51.31 provided for the regions to determine the distribution of funds among regional, intercountry and country programmes, thereby improving the balance between country and regional/intercountry programmes. The Sub-committee also noted that the recommendations of the Working Group on Regional Allocations, which met in Bangkok in July 1998, called for the formulation of alternative models for Regular Budget allocations, which were acceptable to countries in other regions and which should be communicated to a wider audience via publication. While endorsing the recommendations made by the 34'h CCPDM on this subject, as contained in Section 6 of document SEAlPDMlMeet.3416, the Sub-committee noted that, given the long-term prospect of continued budget cuts, and in line with current efforts under WHO reform, there was a need to take a critical look at the current management environment. This included development of a compact and efficient administrative machinery at the Regional Office and WHO country offices, including staffing, for effective management of WHO collaborative programmes. There were also issues which should be addressed, such as avoiding wastage, increasing efficiency, evaluating the continued efficiency of programme activity and, interalia, their continuance in the future keeping in
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view the regional health goals. Elaboration of guidelines and mechanisms for a more transparent and consultative system of priorities between the Regional Office, WHO representatives and national governments should also be addressed, including consultation with concerned nationals regarding expertise to be assigned to WHO country offices, and others. The Sub-committee made the following recommendations: (1) The Sub-committee desired that a working group be established to study the subject of efficiency at the Regional Office and in the country offices. The terms of reference and membership of the working group should be formulated in consultation with the Member Countries. The working group should recommend specific solutions, including guidelines to be submitted to the CCPDM in September 1999. (2) Taking note of the large number of programmes in the current plans of action and the inherent difficulty in managing them, the Sub-committee emphasized the need to prioritize programmes and allocate funds appropriately, which would result in more efficient management and implementation. Towards this, the Sub-committee desired that the Regional Office should carry out a critical review of the issue and report to the next meeting of the CCPDM in April 1999. (3) The experiences of high rates and good quality implementation, as well as constraints encountered by countries, should be shared in the Region. The Regional Office should facilitate this exchange of information. Further, to efficiently put in action the concept of rolling plans, guidelines should be developed and shared with countries.
5.
REVIEW THE PROPOSED PROGRAMME BUDGET 2000-2001 (Term of Reference No. 3)
The Sub-committee reviewed the Proposed Programme Budget 2000-2001 (document SEAlRC5113). The Sub-committee was informed of the contents of the document and that it reflected the activities funded from both Regular Budget and extrabudgetary sources. The Proposed Programme Budget for 2000-2001, as prepared, had resulted in a proportion of 74% for the countries. The least developed countries in the Region and the Regional/lntercountry programme retained the 1998-1999 levels of funding. Four countries shouldered the cuts mandated by resolution WHA51.31 in proportions which were largely determined by earlier implementation rates. The Sub-committee was also informed of the need to reduce the proportion of country budgets in order to reduce the adverse attention of other regions. For this purpose, a certain portion of country funds should be pooled at the time of preparation of the budget for implementation through the intercountry mechanism to directly benefit the countries. Planning and development of activities for these funds would be done with the full involvement of the Member States. (This proposal is further described under Term of Reference No. 2). The secretariat, however, did not propose to pursue these proposals further in the light of the views expressed by the 34Ih meeting of the CCPDM and with which the Subcommittee had also indicated its agreement. The secretariat had therefore prepared fresh proposals which reflected the principles endorsed by the CCPDM.
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Page 6 The Sub-committee was informed that, despite the elaboration of a budget for the Regional Committee, the Director-General had reserved her final decision concerning the overall level of the 2000-2001 budget. This would be done after hearing the views of all Regional Committees as also the recommendations of the HQ's Task Force on Budget. It was, in fact, expected that some change in the area of programme priorities, groupings and presentation would occur between now and submission of the global budget document to the Executive Board in January 1999. The Committee particularly noted that instead of the present six appropriation sections, there might be nine, based on the nine clusters organized at HQ. There will also be a revision of the classified list of programmes. The Sub-committee was informed that a Working Group on Partnerships with Countries had been established in WHOIHQ. This Working Group would go into all aspects, including criteria for the establishment and functioning of WHO country offices, the extent to which countries should be consulted regarding the expertise to be assigned to the WHO country offices, the need for its consonance with the needs of the country, funding, etc. The outcome of this review would have important implications for the South-East Asia Region. While WHO country offices were acknowledged to be crucial in all countries to ensure the quality of WHO collaboration, it was suggested that the percentage of Regular Budget allocated to the offices should not affect the collaborative activities, particularly where country allocations were not substantial. While endorsing the observations and recommendations of the 34Ih CCPDM, as contained in document SENPDMlMeet.3416, the Sub-committee made the following recommendations: (1) The 2000-2001 SEAR biennial budget should take into consideration the spirit of resolution WHA51.31. The budgets of the least developed countries/country in greatest need should be protected while country allocations should not be reduced by more than 6% per biennium, keeping 1998-1999 as the base. (2) The budgetary reductions as mandated by resolution WHA51.31 should be applied in equal proportions among the four non-least developed countrieslcountry in greatest need (India. Indonesia, Sri Lanka and Thailand) and the regionallintercountry budget. The change in the budget will be distributed according to the proportion appearing in the four appropriation sections in the Programme Budget 2000-2001, as contained in document SEAlRC5113. (3) Any enhancement of allocations to the intercountry programmes should be considered nearer the end of the biennium, taking into account the progress of implementation by the countries.
6.
CONSIDER ANY OTER MAlTERS WHICH THE SUB-COMMITTEE MAY WISH TO REFER TO THE REGIONAL COMMITTEE (Term of Reference No.4)
No issue was proposed under this term of reference.