SIXT TY-FIFTH WORLD W HEA ALTH ASS SEMBLY Prov visional age enda item 12
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W WHO re eform Sixth report r of f the Prog gramme, , Budget and Adm ministrati ion Comm mittee of f the Exec cutive Bo oard to th he Six xty-fifth World Health H As ssembly
Draf ft Twelfth General G Pr rogramme o of Work an nd explanatory notes 1. Members of o the Progra amme, Budg get and Admi inistration Committee C co ommented fa avourably on n the st trategic overv view of the draft d Twelfth h General Pro ogramme of Work. 2. In the discussions to provide gu uidance for the further developmen nt of the draft d general l progr ramme of wo ork, four gen neral themes emerged. (a) Alth hough the gen neral progra amme of wor rk provides a broad visio on and strate egy, the real l work on pr riority setting will take p place as part t of the preparation of th he programm me budget. It t was pointe ed out that this t would n need to incl lude making negative ch hoices. The budget will l clearly link k the results at output lev vel and the human h and financial fi reso ources neede ed to achieve e them. (b) It wa as the Comm mittee’s view w that the dev velopment of f the general programme of work and d the program mme budget t needed to be reviewed d together, so s that Mem mber States could c ensure e correlation between the em. Specifica ally, the gen neral program mme of work k needed to make m a clear r link betwee en the priorit ties and the c core function ns of WHO. (c) The Committee felt that the analysis to show s how th he criteria ha ad been used d to arrive at t priorities needed n to be strengthened d in the next version of th he document t. In that reg gard, priority y the role of WHO setting needed to reflec ct faithfully t W both in n setting nor rms and standards and in n responding g to country y demand. A At the curr rent stage, the t example es presented d should be e considered as being ind dicative. ly, it was noted that the chart presented p was not an o organization nal diagram: : (d) Lastl achievemen nt of impact required wo ork from acro oss clusters and levels of WHO. 3. Several spe ecific issues were highlig ghted by Com mmittee mem mbers. (a) WHO O’s role in relation to oth her health ac ctors and its role in the g global health architecture e should be analysed a in th he next draft t of the docum ment. (b) Impo ortant points were lost b by using shor rthand terms in the schem matic framew work for the e categories of work rat ther than the e full text ag greed at the Member St tate meeting g on priority y
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settin ng. This was s particularly y important in relation to t setting ob bjectives for the preventi ion of morb bidity and not t just mortali ity, and reco gnizing the role r of health h promotion and risk redu uction in red ducing the bu urden of non ncommunicab able diseases. . These point ts will be ad ddressed in th he full text v version of the e general pro ogramme of w work. (c) Both capac city building g and researc ch are core functions f of WHO. The ey are reflected as such in the schem matic present tation and ar re thus not specifically s mentioned m in n the categor ries or priori ities. The gen neral program mme of work rk needs to cl larify this iss sue and the p programme budget b will n need to show w explicitly how h the core functions ar re financed and how the ey are expressed in terms s of specific outputs in re elation to eac ch category. (d) Several cou untries highl lighted the im mportance of the social determinants d s of health an nd the role o ties and prom of WHO in addressing a health h inequit moting socia al justice. In this regard, some Mem mber States specifically noted that an addition nal category y of work addressing social determ minants of health h could be included d in the general program mme of work k. However, there was n no support fo or this from the Commit ttee. The pro oposed sixth programmat tic category would w encom mpass issues s including the reductio on of health h inequity, social s justice e, and sustainable devel lopment. It is i recognized d that these are cross-cu utting issues for all techn nical program mmes, howe ever they nee ed to be refle ected in the general prog gramme of work w in a wa ay that will ensure e that r relevant activ vities are ade equately reso ourced. More eover, linking g work on so ocial determi inants, equity y and socia al justice with the differ rent categor ries reflects the fact tha at WHO’s role r is conce erned with health h rather r than just d diseases. The e general pro ogramme of f work will clarify c these issues, and the t programm me budget w will identify outputs o linke ed to work on n social, econ nomic and e environmenta al determinan nts of health . The Committee e recommen nded, on b behalf of th he Executiv ve Board, that the Health H Assem mbly note its delibera ations conce erning the draft Twelfth Genera al Programm me of Work k.
Revised m mechanism for f improv ving predict table finan ncing 4. The Committee considered the t issue of f predictable e financing in conjuncti ion with the e item related to th he schedulin ng of the mee etings of the e governing bodies, given the recogn nition of the interlinkages bet tween these two t issues. 5. The Committee expressed su upport for th he underlyin ng principles s of a finan ncing dialogu ue, as described in n document A65/5. The Committee acknowledg ged the respo onsibility of Member Sta ates to finance agre eed priorities s in order to provide an a accurate forecast of poten ntial income for a bienniu um, as well as the need for tra ansparency and predicta ability in fin nancing in or rder to hold d the Organization accountable e for its expected delivera ables. 6. Howe ever, many Committee members ca autioned tha at the details s associated with a fina ancing ould require dialogue wo e further exa amination to o ensure that t the dialogu ue would ad dvance the aim a of achieving a transparen nt and predi ictable finan ncing model l and a rea alistic progra amme budg get. In particular, i it deliberated d on the org ganization an nd structure of a financi ing dialogue e, with Comm mittee members ex xpressing a range of view ws on possibl le mechanism ms of financing. 7. Many y Committee e members expressed e a need to ana alyse in furth her detail th he advantage es and disadvantag ges, includin ng risks and implications s, of the pro oposed finan ncing dialogu gue, in additi ion to ensuring that thinking is i not limited to a single e, limited ap pproach. Ma any Commit ttee member rs also
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reque ested further r information n on addition nal options or possibilit ties available e to achieve e the desired d goal. The Direct 8. tor-General welcomed w th he guidance provided by y the Commi ittee, and confirmed that t the implications would be further expl lored of bot th a financi ing dialogue e and other r predictable e finan ncing options s. The Dire ector-General l emphasize ed the point t made by t the Commit ttee that the e respo onsibility and d commitme ent to finance e WHO’s pr riorities adeq quately ultim mately lies with w Member r States s. The Director-General also expresse ed appreciation for the Committee’s C acknowledg gment that an n appro opriate mode el for the fin nancing of th he Organizat tion is critical to ensurin ng its accoun ntability and d abilit ty to achieve its expected d deliverables s. The Direct 9. tor-General reaffirmed r th he Committe ee’s view tha at the proces ss of ensurin ng a realistic c budge et is intimate ely linked to the scheduli ing and align nment of the meetings of f the governin ng bodies. In n partic cular, the Se ecretariat would be bett tter positione ed to submi it a propose ed budget, that t outlined d expec cted income e and gaps in funding to the Heal lth Assembl ly, if inputs s were recei ived from a gover rning bodies cycle that began with th he regional co ommittees – through the Programme, , Budget and d Admi inistration Committee C to o the Board – and include ed a consequ uent dialogue e with Memb ber States in n the le ead-up to th he Health Assembly. Th he Director-G General confirmed that it is envisaged that the e Comm mittee would d play a critic cal role in th he financial dialogue d face ets of the pro cess. The Committee reco ommended, on behalf f of the Ex xecutive Bo oard, that the Health h Assembly note its deliberation anism for improving ns concern ning a rev vised mecha g predictabl le financing. .
Sche eduling of meetings m of f the govern ning bodies s 10. Committee e members ex xpressed a ra ange of view ws in relation n to the sche eduling and alignment a of f the m meetings of the t governing g bodies, an nd various lev vels of support for the o options for sc cheduling as s outlin ned in docum ment A65/5. 11. Although the t Committee expressed d its agreeme ent with a governance cy ycle that beg gan with the e sessio ons of the re egional comm mittees and e ended with th he Health As ssembly, a n number of co onsiderations s were examined by y the Comm mittee in relat tion to the ra ationale drivi ing the adjus stment of the e schedule of f the m meetings of the governin ng bodies. I In this regar rd, some Co ommittee me embers com mmented that t retent tion of a cyc cle that began n with and m maintained th he linkages between b the r regional com mmittees and d ended d with the Health H Assem mbly, was a m more import tant consider ration than th he specific timing of the e initia ation of the cycle. The Committee also requested information on the feasibility, in terms of f logist tics, of shift fting the Hea alth Assemb bly to the la ast quarter of o the calen ndar year. A Committee e memb ber expresse ed concerns about a the av vailability of f ministers of f health shou uld the Healt th Assembly y be sh hifted to the last l quarter of o the calenda ar year. 12. The Comm mittee examin ned the advan ntages and disadvantages d s of separatin ng the Januar ry session of f the B Board from that t of the Committee, C a and also the implications s of shifting the timing of o these two o overs sight bodies. In particular r, the Comm mittee request ted further in nformation o on the potenti ial increased d availa ability of fin nancial inform mation for its s examinatio on if the sessions were to o be shifted to o later in the e year. The Commi ittee also com mmented on the cost imp plications of f separating th the sessions of o the Board d and it ts Committe ee; it would be b an additio onal cost bur rden for coun ntries to ensu ure represent tation at two o distin nct meetings. . 13. The Secret tariat expres ssed appreci iation for th he guidance e provided b by the Com mmittee, and d inform med it that the annual audited, a fina ancial report t was genera ally not avai ilable for re eview before e 3
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March or A April of the following f fin nancial year. . The Secretariat reiterat ted that Mem mber States would w decide on th he ultimate scheduling s of f the meeting gs of the gov verning bodie es, but the im mplications for f the regional com mmittee sess sions should be consider red if a radic cal revampin ng of the sche heduling cycl le was deemed to b be warranted d. 14. The Director-Ge eneral confir rmed that fu further exam mination of the t feasibilit ty of shiftin ng the Health Asse embly to late e in the year was required d, including necessary n co onsultation w with the confe erence on committ tees in New w York, offic cials associat ted with the e scheduling of the Pala ais des Natio ons in Geneva, an nd the Swis ss authoritie es. The Dire rector-Genera al also brou ught to the attention of o the Committee the need to t consider potential in nter-sessional work requ uired of the e Secretariat t, and of associated d documentation, when d deciding upon n a revised scheduling cy ycle. production o The Committee e recommen nded, on b behalf of th he Executiv ve Board, that the Health H Assem mbly note its i deliberat tions concer rning the sc cheduling of meetings of the gove erning bodie es.
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