REGIONAL COMMITTEE Sixty-sixth Session SEARO, New Delhi, India 10–13 September 2013
Provisional Agenda item 3.3 SEA/RC66/5 22 July 2013
WHO reform and Programme Budget matters: WHO reform: financing dialogue and Programme Budget 2016–2017 Initially, the reform agenda focused on financing and better aligning of the Organization’s objectives and resources. It has now evolved into a Member States-driven process to address more fundamental questions about WHO’s priorities, its governance and management to make the Organization more effective, efficient and accountable. During the Sixty-fifth World Health Assembly in May 2012, a consolidated paper, including background papers with proposals under each main section was submitted for in-depth discussions. During the Sixty-sixth World Health Assembly in May 2013, WHO reform was discussed under documents A66/4 (WHO reform: High-level implementation plan and report) and A66/48 (WHO reform: Financing of WHO). The report update given to the Sixty-sixth World Health Assembly presented a comprehensive overview of progress up to the end of the first quarter of 2013 in the three main areas of WHO reform: programmes and priority-setting; governance; and management, as well as a high-level implementation plan for reform. The report covers 12 elements of reform identified in the monitoring and implementation framework considered by the Sixty-fifth World Health Assembly in May 2012, and includes an additional element on change management. Document A66/4 was noted by the World Health Assembly. The Sixth Meeting of the Subcommittee on Policy and Programme Development and Management (SPPDM), held from 4 to 5 July 2013, reviewed the attached working paper and made the following recommendations: Actions by Member States (1) To ensure appropriate participation, particularly from ministries of health, in the November 2013 financing dialogue, to ensure better understanding of the funding of the Programme Budget 2014–2015. To review for consideration of its future application in respect of 2016 –2017 bottom-up operational planning, the country prioritization methodology as outlined by the Secretariat.
(2)
Action by WHO-SEARO (1) To provide full support to Member States in their preparation for participating in the financing dialogue in November.
The working paper and the SPPDM recommendations are submitted to the Sixty-sixth Session of the Regional Committee for its consideration.
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Background 1. The reform agenda began with the focus on financing and better aligning of the Organization’s objectives and resources. Now it has evolved into a Member States-driven process to address more fundamental questions about WHO’s priorities, its governance and management to make the Organization more effective, efficient and accountable. Extensive discussions on reforms have taken place at different forums, including global and regional governing body meetings. 2. A consolidated paper, including background papers with proposals under each main section was submitted to the Sixty-fifth World Health Assembly for in-depth discussions. The paper covered five prioritization criteria agreed upon by Member States at the Meeting on Programme and Priority Setting held in Geneva in February 2012, when categories (work areas) were identified for development of the Twelfth General Programme of Work (GPW) and Programme Budget 2014–2015. 3. Under each of the three main areas of reform, namely programme and priority-setting, governance, and managerial reforms, it summarized the progress of work in terms of implementation and identified where further guidance or decisions by the World Health Assembly were needed. 4. The following sections highlight the key work reported upon within document A66/4 (SEA/RC66/5 Inf.Doc.1), and provide a focus on the “financing dialogue” which was approved during the Sixty-sixth World Health Assembly.
Governance reform 5. Some examples found in document A66/4 highlight where WHO governance reform stands on the promotion of better health as an outcome of global, regional and national processes, as well as better coordination across the many organizations active in global health, including: WHO Member States and the Secretariat played a critical role to ensure that health had a prominent place in the Rio+20 outcome document. Progress towards universal health coverage is a priority for many countries. The increased importance of universal health coverage and the recommendation that it be considered as part of the post-2015 agenda was due to United Nations General Assembly resolution A/RES/67/81 on Global Health and Foreign Policy in December, 2012. A comprehensive global monitoring framework for noncommunicable diseases was established, with a draft action plan for the prevention and control of noncommunicable diseases 2013–2020, and was considered by the Sixty-sixth World Health Assembly. An operational framework on the hosting terms of individual partnerships was submitted to the Programme, Budget and Administration Committee (PBAC) for its regular review.
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In compliance with revised terms of reference to strengthen the oversight role of the PBAC, reports from the six regional committees were submitted to the Executive Board (first time in January 2013). Steps were taken to improve the methods of work of the World Health Assembly and WHO Executive Board, such as the enforcement of limits on speaking time, enhancement of the role of the bureau of the Executive Board in the establishment and strategic orientation of the Executive Board agenda, study measures to improve electronic access to governing body meetings and minimize the use of paper documents, with the aim of improving the efficiency and effectiveness of meetings.
Management reform 6. Some examples of management reform found in document A66/4 are highlighted below, under the management subsections. Support to Member States A taskforce was established, aiming to resolve the relative lack of clarity on the roles and functions specific to each of the three levels of WHO. The taskforce developed an overarching framework for the work of the Organization, mapping WHO’s six core functions to the three levels of the Organization; this was then applied to the content of Programme Budget 2014–2015 which was approved at the Sixty-sixth World Health Assembly. Internal “category networks” were established in order to plan, coordinate and monitor the work of WHO within each of the six categories of work in the Programme Budget 2014–2015. The Institutional Repository for Information Sharing (IRIS) was published on the Internet in all six official languages, with over 50 000 records, including recent governing body documents, resolutions and reports.
Human resources Recruitment and selection processes were streamlined, resulting in a notable reduction of the average time for the process to move from the initial advertisement to the decision. A global eLearning platform is being developed; launch scheduled in September 2013. A global staff mobility scheme is under development.
Financing of WHO The Sixty-sixth World Health Assembly adopted resolution WHA66.2 approving the entire Programme Budget 2014–2015, and Decision WHA66(8) for the establishment of a financing dialogue with the aim of better managing and aligning of resources with Organizational priorities.
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A WHO taskforce was established on resource mobilization and management strategies, to explore and make recommendations on internal and external ways to improve resource mobilization and resource management in WHO.
Accountability and transparency The new results chain was introduced, where the “outputs” define Secretariat responsibility and accountability, and together with the actions of Member States and other partners, contribute to the achievement of measurable “health outcomes” in each programmatic area over the six-year period of the GPW. These outcomes, in turn, ultimately contribute to eight high-level “impact goals”, which have measurable targets for improvements in the health of populations. An Organization-wide risk management framework and risk register was developed, with the establishment of a Compliance, Risk Management and Ethics Unit in the Office of the Director-General to manage the risk register.
Evaluation A WHO Evaluation Policy was adopted by the Executive Board in 2012. A supplementary WHO Evaluation Handbook was developed, providing guidelines on the conduct of evaluations in compliance with the Policy. Capacity for internal audit and evaluation increased with recruitment of additional staff. A Global Network on Evaluation was established, comprising representatives from the three levels of the Organization, to foster a culture of evaluation, strengthen capacity and improve quality control mechanisms.
Communication A central WHO communications department was established at Headquarters, together with expansion of communication training for staff, and significant growth in the use of social media. A global perception survey was conducted in 2012 to provide feedback on the views of the Organization of 3500 external stakeholders and WHO staff.
Financing dialogue 7. The financing dialogue is presented in detail within World Health Assembly document WHA66/48 (SEA/RC66/5 Inf.Doc.2). In addition, the Director-General launched WHO’s financing dialogue with Member States on 24 June 2013. The report of the launch of the dialogue is provided in document SEA/RC66/5 Inf.Doc.3. 8. The Sixty-sixth World Health Assembly adopted resolution WHA66.2 on the Programme Budget 2014–2015, and approved the full US$ 3.977 billion budget, which does not indicate the proposed allocations of the assessed and voluntary contributions. Resolution WHA66.2,
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paragraph 7 authorizes the Director-General “… to use the assessed contributions together with the voluntary contributions, subject to the availability of resources, to finance the budget…”. 9. It is, therefore, unknown what the assessed contribution/voluntary contribution allocation will be in the US$ 340 million budget space for the South-East Asia Region that has been presented within the approved Programme Budget document. 10. It is important to note that within document WHA66/48, paragraph 20 states “It is recognized that assessed contributions are the most flexible resources available to the Organization and need to be used strategically. It is also recognized, however, that a divergence that is too drastic from previous allocation may create serious risks for existing, long-term programmatic and staffing commitments.” 11. Document WHA66/48, paragraph 21 states “With the shift towards a realistic limit on the programme budget, a new WHO resource allocation methodology is required. WHO needs a transparent, well-coordinated resource mobilization mechanism, with fair allocation of resources that are used and managed effectively and produce desired results. It is intended that resource allocation be rooted in the principles of transparency, equity and support of countries in greatest need, while following a clear definition of resource needs reflecting WHO priorities. Such allocation will be grounded in a robust bottom-up planning process and realistic bottom-up costing of outputs based on clear roles and responsibilities across the three levels of WHO. In addition, due consideration will continue to be given to performance, the core functions of the Organization, and the areas within WHO that work is best and most effectively performed. The new allocation mechanism will be developed and used for the programme budget to be proposed for 2016–2017.”
Concluding comments 12. As seen in the above briefing summarization, and within document A66/4, WHO reform is an ongoing process (33 scheduled action items out of a total of 51 are listed as having “ongoing” status) with a clear implementation plan, and with a solid level of monitoring and reporting provisioned to ensure delivery of this plan. 13. The origins of WHO reform were linked around the future financing of WHO. The most important current matters that fall under the scope of WHO reform appear to be: The agreement at the Sixty-sixth World Health Assembly to proceed with a series of “financing dialogue” meetings in late June and November 2013, and subsequently intended to become a regular event (ref. document A66/48). Feedback of the launch of the financing dialogue held in June 2013 is provided (SEA/RC66/5 Inf.Doc.3). The need to discuss possible planning approaches to be taken within the South-East Asia Region in relation to budget space, especially for 2016 –2017. An internal document is in process of development by WHO headquarters in this regard, and is expected to be available later this year.
REGIONAL COMMITTEE Sixty-sixth Session SEARO, New Delhi, India 10–13 September 2013
Provisional Agenda item 3.3 SEA/RC66/5 Inf.Doc.1 22 July 2013
WHO reform and Programme Budget matters: WHO reform: financing dialogue and Programme Budget 2016–2017
The attached document (A66/4) on “WHO reform: High-level implementation plan and report” was submitted to the Sixty-sixth World Health Assembly in May 2013.
SIXTY-SIXTH WORLD HEALTH ASSEMBLY Provisional agenda item 11
A66/4 10 May 2013
WHO reform High-level implementation plan and report Report by the Director-General
1. The Sixty-fifth World Health Assembly requested the Director-General1 to report, through the Executive Board at its 132nd session, to the Sixty-sixth World Health Assembly, on progress in the implementation of WHO reform, on the basis of a monitoring and implementation framework. This report provides a comprehensive overview of progress up to the end of the first quarter of 2013 in the three broad areas of WHO reform: programmes and priority-setting; governance; and management, as well as a high-level implementation plan for reform (see Annex 1). A comprehensive, detailed and budgeted implementation plan is the basis for managing change, monitoring progress, and mobilizing resources to finance the proposed reform activities. The plan and report are structured around the 12 elements of reform that were identified in the monitoring and implementation framework considered by the Sixty-fifth World Health Assembly,2 and include an additional element on change management. The report provides a narrative describing action taken in each area, and a status update on the outputs and key deliverables. 2. The objectives of WHO reform3 are: (1) Improved health outcomes, with WHO meeting the expectations of its Member States and partners in addressing agreed global health priorities, focused on the actions where the Organization has a unique function or comparative advantage, and financed in a way that facilitates this focus (Programmatic). (2) Greater coherence in global health with WHO playing a leading role in enabling the many different actors to play an active and effective role in contributing to the health of all peoples (Governance). (3) An Organization which pursues excellence; one that is effective, efficient, responsive, transparent and accountable (Management).
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See decision WHA65(9). See document A65/INF.DOC./6. See document EBBSS/2/2.
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3. Over the last two years, Member States have endorsed over 40 specific proposals in the three broad areas of reform through adoption of governing body resolutions and decisions. Several other proposals are currently under discussion.
PROGRAMMATIC REFORM 4. Central to programmatic reform is the development of a set of agreed global health priorities that will guide the work of the Organization in the years ahead. The process for developing these priorities has involved a dialogue among Member States, including a meeting on programmes and priorities held in February 2012, and discussions by the WHO governing bodies, supplemented by informal interactions and a series of web consultations. The Sixty-fifth World Health Assembly welcomed the criteria for priority setting and the six categories for organizing the future work of WHO proposed by the Executive Board: communicable diseases; noncommunicable diseases; promoting health through the life-course; health systems; preparedness, surveillance and response; corporate services and enabling functions. The Health Assembly also requested the Director-General to use the agreed framework and guidance provided by the Sixty-fifth World Health Assembly, especially concerning health determinants and equity, in the formulation of the draft twelfth general programme of work and the proposed programme budget for 2014–2015.1 5. This has been done, resulting in a new presentation of the proposed programme budget,2 and the addition of six programmatic “leadership priorities” to the draft twelfth general programme of work.3 Both the draft general programme of work and proposed programme budget 2014–2015 will be considered by the Sixty-sixth World Health Assembly. 6. The leadership priorities will influence the way that work is carried out across and between the different levels of the Secretariat. They highlight the areas in which WHO seeks to exert its influence in the world of global health. The leadership priorities are: advancing universal health coverage; accelerating work on the health-related Millennium Development Goals; addressing the challenge of noncommunicable diseases; implementing the International Health Regulations; increasing access to essential, high-quality and affordable medical products; and addressing the social, economic and environmental determinants of health. They are complemented by two reform leadership priorities: strengthening WHO’s governance role, and reforming management policies, systems and practices. 7. The draft general programme of work proposes specific outcomes, with indicators and targets that will demonstrate the contribution of the Organization to progress in improving the health of populations. These outcomes will be the primary measure of progress in the programmatic reform of WHO.
GOVERNANCE REFORM 8. Greater coherence in global health is one of the leadership priorities in the draft twelfth general programme of work. This includes promoting better health as an outcome of global, regional and national processes as well as better coordination across the many organizations active in global health.
1 2 3
See decision WHA65(9). Document A66/7. Document A66/6.
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In both of these areas WHO is increasingly active, particularly in areas linked to the programmatic leadership priorities. Examples of this include the following: • WHO Member States and the Secretariat played a critical role to ensure that health had a prominent place in the Rio+20 outcome document.1 Subsequently, WHO has worked with UNICEF and the Governments of Botswana and Sweden to lead the health sector consultation on the post-2015 development agenda, culminating in a high-level meeting in March 2013 in Botswana. • Progress toward universal health coverage is a priority for many countries. As a result of close collaboration between WHO and the group of countries comprising the Foreign Policy and Global Health Initiative, the United Nations General Assembly adopted a resolution on Global Health and Foreign Policy in December 2012, emphasizing the importance of universal health coverage and recommending that it be considered as part of the post-2015 agenda.2 • Following the 2011 mandate of the United Nations General Assembly, WHO Member States have negotiated a comprehensive global monitoring framework for noncommunicable diseases, the draft of which will be considered by the Sixty-sixth World Health Assembly.3 This demonstrates the role of WHO in forging international frameworks and agreements, where there is consensus on results to be achieved and there are clear indicators to monitor progress. 9. The Executive Board at its 132nd session in January 2013 considered the situation of partnerships hosted by WHO and took steps toward harmonizing arrangements for hosted partnerships. In decision EB132(10) it requested the Director-General to develop an operational framework for the Programme, Budget and Administration Committee for its regular review of the programmatic convergence, and hosting terms of individual partnerships. The first of these reviews will be presented to the Board in January 2014. The Secretariat is also conducting a study of the actual costs of hosting these partnerships, with the aim of ensuring full recovery of costs. 10. Discussion by the Board on the development of a policy of engagement of nongovernmental organizations resulted in the following decision,4 inter alia: (1) to submit, for the consideration of the Executive Board at its 133rd session in May 2013, overarching principles for WHO’s engagement with non-State actors, defining separate operational procedures for both nongovernmental organizations and private commercial entities; and (2) to harmonize the development of the draft policy for engagement with nongovernmental organizations with the draft policy on WHO’s relations with private commercial entities, such development being guided by the principles stated by the Sixtyfifth World Health Assembly.5 This guidance and further consultation will contribute to the formulation of draft policies on engagement with nongovernmental organizations and with private commercial entities, which will be presented to the Board at its 134th session in January 2014.
1 2 3 4 5
The future we want. United Nations General Assembly resolution 66/288, Annex. United Nations General Assembly resolution A/67/L.36. Document A66/8. Decision EB132(11). See decision WHA65(9).
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11. The Executive Board has mandated an in-depth analysis of options for streamlining and strengthening reporting by Member States of health data, health policy, laws and regulations and the implementation of resolutions, as well as the communications between Member States and the Secretariat. Proposals will be presented to the Board at its 134th session in January 2014. 12. The Executive Board adopted at its 131st session in May 2012 revised terms of reference for the Programme, Budget and Administration Committee in order to strengthen its oversight role. The oversight role of the Executive Board has also been enhanced by introducing reports from the six regional committees, which were received for the first time in January 2013 from all six regional committees. 13. The Health Assembly and the Executive Board have also taken steps to improve their methods of work. These include the enforcement of limits on speaking time and enhancing the role of the bureau of the Executive Board in the establishment and strategic orientation of the Executive Board agenda. The Executive Board has also requested the Secretariat to study measures to improve electronic access to governing body meetings and minimize the use of paper documents, with the aim of improving the efficiency and effectiveness of meetings. As yet, there is no agreement on the changes to the Rules of Procedure of the Executive Board proposed by the Secretariat, and the Board has commissioned a study on the legal implications of possible changes in those Rules. The results of both these studies will be presented to the Executive Board at its134th session in January 2014. With a view to increasing the strategic focus of its deliberations, the Executive Board has also requested the Director-General to submit options for criteria for inclusion, deferral or exclusion of items on the provisional agenda for consideration at its 133rd session.
MANAGEMENT REFORM Support to Member States 14. In December 2012, the Global Policy Group established a Taskforce with the aim of resolving the relative lack of clarity on the roles and functions specific to each of the three levels of WHO. This lack of clarity can lead to duplication of work and a lack of coordination between the three levels, reducing WHO’s effectiveness and leaving gaps in meeting Member States’ needs. The Taskforce developed an overarching framework for the work of the Organization, mapping WHO’s six core functions to the three levels of the Organization, which was then applied to the proposed programme budget 2014–2015. This has enabled a description of how these functions translate into a set of deliverables specific to each level of WHO, which together contribute to the Organization-wide outputs against which WHO’s performance will be measured. The Taskforce also highlighted the importance of category networks, and proposed institutionalizing them with terms of reference and standard operating procedures. These internal networks have been established in order to plan, coordinate and monitor the work of WHO within each of the six categories of work in the proposed programme budget 2014–2015. In the future they will play a crucial role in ensuring that each level delivers what has been agreed. The Global Policy Group has also decided to conduct a review of organizational design to ensure that structure follows function, and moves WHO towards more effective matrix management across the Organization. This review will take place later in 2013, in preparation for implementation of the programme budget in the period 2014–2015. 15. Increasing the effectiveness of WHO’s work at country level is significantly dependent on the strong leadership of the country office. To this end, a roster of qualified candidates for heads of WHO Offices in countries, areas and territories was established in 2010 through a competitive process. The roster has significantly expanded, and now comprises over 200 candidates. All heads of WHO Offices
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receive an enhanced induction including on effective management and accountability and enrol in a mandatory training on health diplomacy. 16. A public searchable database of WHO knowledge resources and information products known as the Institutional Repository for Information Sharing (IRIS) is now available in all six official languages on the Internet, with over 50 000 records, including recent governing body documents, resolutions and reports.1 The database has been used extensively, with over 12 million site visits since it was launched in June 2012. The database is being further expanded to include all World Health Assembly and Executive Board resolutions and information products and documents from Regional Offices.
Human resources 17. At its 132nd session, the Executive Board confirmed the Director General’s proposed changes to the Staff Rules, based on a draft appointment policy that will support a flexible workforce. 18. Much effort has been made to streamline recruitment and selection processes, which has resulted in a reduction of the average time for the process to move from the initial advertisement to the decision from 5.9 months in 2010 to 4.2 months in 2012. 19. A guide for managers in applying WHO performance competencies has been issued. A policy on rewards and recognition will be issued shortly. Furthermore, a guide to help supervisors manage performance is in the final stages of development. 20. A global eLearning platform will be launched in September this year. Proposals for the development of a management development programme are currently being evaluated. 21. The Western Pacific Region has rolled out a mobility scheme for professional staff. Based on this experience several other regional offices have introduced mobility schemes, and a global staff mobility scheme is currently in development.
Finance 22. The report on proposals to improve WHO’s financing2 presented to the extraordinary meeting of the Programme, Budget and Administration Committee in December 2012 identified several challenges in the current funding model of WHO: misalignment of funds with priorities, lack of predictability, vulnerability, insufficient transparency, and a lack of flexibility of WHO’s funding. Based on this assessment, the Programme, Budget and Administration Committee recommended, inter alia, that the World Health Assembly approve the entire programme budget and establish a financing dialogue with the aim of better aligning resources with Organizational priorities, and requested the Secretariat to explore mechanisms to facilitate receipt of supplements to assessed contributions on a voluntary basis; to explore avenues to broaden WHO’s donor base; and to take measures to strengthen the coordination of resource mobilization, resource management, internal financial controls, and reporting.
1 2
www.who.int/iris. Document EBPBAC/EXO2/2.
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23. To support development and implementation of these proposals, the Global Policy Group has established a WHO taskforce on resource mobilization and management strategies to make recommendations to the Director-General on steps to further strengthen Organization-wide resource mobilization and management. 24. A recently concluded study on the costs of administration and management in WHO will be considered by the governing bodies, and further discussions will be needed on approaches to improve the transparency and sustainability of financing these important areas.
Accountability and transparency 25. The draft twelfth general programme of work and proposed programme budget 2014–2015 have been developed on the basis of the new results chain presented to the Sixty-fifth World Health Assembly. The proposed programme budget for 2014–2015 defines deliverables for each level of the Organization, which together will contribute to 82 outputs in 30 programme areas. These outputs define Secretariat responsibility and accountability, and together with the actions of Member States and other partners, will contribute to the achievement of measurable health outcomes in each programmatic area over the six-year period of the general programme of work. These outcomes, in turn, will ultimately contribute to eight impact goals, which have measurable targets for improvements in the health of populations. 26. An Organization-wide risk management framework and risk register has been developed for the Board and will be considered by the Programme, Budget and Administration Committee and Board in May 2013.1 A Compliance, Risk Management and Ethics Unit has been established in the Office of the Director-General, and recruitment of staff for the unit is under way. This new unit will take responsibility for maintaining and monitoring the Organization-wide risk management framework.
Evaluation 27. Steps to strengthen evaluation in WHO have resulted in the adoption of an evaluation policy by the Executive Board in 2012, and development of a supplementary WHO Evaluation Handbook providing guidelines on the conduct of evaluations in compliance with the policy, and increased capacity for internal audit and evaluation with recruitment of additional staff. The Global Network on Evaluation, comprising representatives from the three levels of the Organization, has been established to foster a culture of evaluation, strengthen capacity and improve quality control mechanisms. An Organization-wide evaluation plan is in development, and a searchable database of WHO evaluations will support a mechanism for tracking the implementation of evaluation recommendations. The planned increased capacity for internal audit and evaluation, to be achieved through the recruitment of additional staff in 2013 and 2014, will also strengthen the central evaluation function. 28. The first stage of the external evaluation of WHO reform was presented to the Sixty-fifth World Health Assembly and the modalities for a second stage have been developed. The recommendations of the first stage evaluation will be implemented in the context of the reform implementation (as outlined in Annex 2). The Executive Board has established an Evaluation Management Group, comprising the Officers of the Executive Board, to provide oversight of the second stage of the external evaluation, the results of which will be reported to the Executive Board in January 2014. The objective of the
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Document EB133/10.
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second stage of the evaluation is to assess the WHO reform implementation strategy and the Organization’s preparedness to implement the reform process. 29. In December 2012, the United Nations Joint Inspection Unit published two reports: on decentralization in WHO; and a review of the management and administration of WHO. The reports were discussed by the Executive Board at its 132nd session, and the recommendations have been incorporated in this reform implementation plan (see Annex 3). 30. WHO is also being assessed by the Multilateral Organization Performance Assessment Network (MOPAN) in 2013. The assessment involves headquarters, the regional offices, and six country offices in: Ethiopia, Guatemala, Indonesia, Mozambique, Pakistan and Viet Nam. It will examine four strategic dimensions – strategic, operational, relationship and knowledge management – in order to assess organizational effectiveness. For the first time, the assessment will consider WHO’s contribution to country level results (including progress towards the MDGs). This is the fourth MOPAN assessment of WHO, and results will become available towards the end of 2013, providing an independent assessment of organizational performance.
Communication 31. Communication capacity and effectiveness has been significantly strengthened with the establishment of a central WHO communications team, together with expansion of communication training for staff, and significant growth in the use of social media. These new communication approaches have provided a particularly effective means for rapid communication, with more than 700 000 people following WHO on Twitter. 32. A global perception survey was conducted in 2012, providing information on the views on the Organization of 3500 external stakeholders and WHO staff. The results have been published on the WHO web site,1 and will inform the development of a WHO global communications strategy. The survey will be repeated every two years and will also provide information to assess progress in several aspects of WHO reform.
Status of WHO reform outputs 33. Annex 1 provides details on progress in implementation of specific outputs and key deliverables in each of the 12 elements of reform, using the following terms: Output status To commence Ongoing Completed Continuous Partially complete Meaning Planned activities have not yet started Planned activities have commenced but are not yet completed Planned activities are completed and output delivered Planned activities have commenced and have been mainstreamed into the work of WHO Planned activities have commenced but were not completed within the original planned deadline
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http://www.who.int/about/who_reform/change_at_who/who_perception_survey/en/index.html.
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34. Of the 51 outputs currently included in the implementation plan, 5 were scheduled to be completed or mainstreamed by 2012, 23 by end 2013, 14 by end 2014 and 9 by end 2015. By end March 2013, 12 (24%) outputs had been completed or mainstreamed into the work of WHO. Table: Status of outputs in the reform implementation plan (as at end March 2013) Output status Completed Continuous Partially completed Ongoing To commence Total Count 3 8 1 33 6 51
ACTION BY THE HEALTH ASSEMBLY 35. The Health Assembly is invited to note this report.
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ANNEX 1 WHO REFORM HIGH-LEVEL IMPLEMENTATION PLAN AND REPORT
1. This high-level implementation plan and report reflects the current status of the different reform proposals, and will continue to be regularly updated for review by the governing bodies. Four-monthly progress reports will be presented to the Independent Expert Oversight Advisory Committee for review. The implementation plan and report has also been modified to incorporate the recommendations of the first stage evaluation and of the United Nations Joint Inspection Unit in Annexes 2 and 3, respectively. The high-level implementation plan and report provide details of outcomes and outcome indicators, outputs, key deliverables, and budgets at the output level. A more detailed comprehensive implementation plan and report describing the expected outcomes and outputs, with details of activities, costs, responsibilities, milestones and indicators will be available on the WHO reform web site.1 Areas of WHO reform 1. Programmatic reform 2. Governance reform Elements of WHO reform 1.1 Programmatic priorities 2.1 Oversight by the governing bodies 2.2 Harmonization and alignment of the governing bodies2 2.3 Decision-making by the governing bodies 2.4 Streamlined national reporting3 2.5 Engagement with stakeholders 3.1 Support to Member States 3.2 Human resources 3.3 Finance and resource allocation 3.4 Accountability and transparency 3.5 Evaluation 3.6 Communication 4.1 Change management
3. Management reform
4. Change management
Assumptions, risks and dependencies 2. Successful implementation of reform proposals will be facilitated by clarifying the assumptions on which the proposals are developed, managing and mitigating potential risks that could jeopardize achievement, and identifying interdependencies between different reform proposals. 3. Risk assessment is based on the WHO risk management framework comprising: identification and categorization of external risks; risk assessment and prioritization; mitigation; implementation of risk mitigation; monitoring and review of the risk. The external risks described in the table below are
1 2
See http://www.who.int/about/who_reform/en/index.html.
Reform areas 2.2 Scheduling and alignment of the governing bodies and 2.3 Harmonization of governing bodies have been merged to better reflect the discussion and decisions of the governing bodies. The reform area 2.4.4 Streamline national reporting in accordance with Articles 61–65 of the WHO Constitution, using modern tools have been elevated to a separate area of reform 2.4 reflecting the expansion of key deliverables. 3
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Annex 1
of particular relevance to WHO reform, and of the highest priority in terms of management and mitigation. 4. Many of the proposed reforms are interlinked and interdependent. Identification of dependencies is important for risk management and performance management; as progress in one area of reform can significantly enhance or limit achievement in others. The dependencies shown in the following table highlight the most critical relationships. Reform area Programmatic reform 1.1 Programmatic priorities The work of WHO has a significant impact on health outcomes at the global, regional and national level Catastrophic global political, economic or epidemiological event (e.g. outbreak) The ability to address programmatic priorities more effectively is dependent on all other aspects of governance and managerial reform Key assumptions Risk Dependencies
Governance reform 2.1 Oversight Strengthened oversight by the governing bodies will contribute to greater organizational effectiveness Increasing harmonization and alignment between regional and global governing bodies will facilitate consensusbuilding on key decisions and strengthen the governing bodies The current burden of work for the governing bodies is excessive, weakening decisionmaking processes, and limiting the engagement of some resource-poor Member States Streamlined national reporting will improve bases for national and global decision-making The current landscape of global health is complex and cluttered, and particularly difficult to manage for low-resource countries Lack of agreement on distinctive oversight roles of different governing bodies and Director-General Inconsistency in positions taken by Member States at regional and global governing bodies 2.3 Decision-making 2.4. Streamlined national reporting 3.4 Accountability 3.5 Evaluation 2.3 Decision-making
2.2 Harmonization and alignment
2.3 Decision-making
Inability to reach consensus on shorter and more strategic agendas for governing body meetings
2.1 Oversight 2.2 Harmonization and alignment 3.4 Accountability
2.4. Streamlined national reporting
Complexity and cost of improving reporting and communications Failure to manage major conflicts of interest
2.1 Oversight 3.6 Communications
2.5 Engagement
3.1 Support to Member States 3.4 Accountability
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Reform area Management reform 3.1 Support to Member States
Key assumptions
Risk
Dependencies
WHO needs to change from an organization that delivers separate outputs through technical programmes, to become an interdependent network of offices, delivering effective support to Member States WHO is a knowledgebased organization, and depends on a highly skilled, flexible and motivated staff Greater predictability, flexibility, sustainability and transparency in financing will enable better delivery on priorities Transparency and accountability generate trust and confidence, which will strengthen financing, and generate opportunities for greater efficiency and effectiveness
Inability to reach a shared understanding of the comparative advantages of different organizations working in global health
3.2 3.3 3.4 3.5
Human resources Finance Accountability Evaluation
3.2 Human resources
Inadequate human resource reforms in the United Nations common system Prolonged global economic crisis
3.1 Support to Member States 3.3 Finance
3.3 Finance
1.1 Programmatic priorities 3.1 Support to Member States 3.2 Human resources 3.4 Accountability 3.5 Evaluation 3.2 Human resources 3.3 Finance
3.4 Accountability
Inadequate alignment of internal accountability mechanism
3.5 Evaluation
A culture of evaluation is Failure to link evaluation 3.4 Accountability essential to reform findings to organizational learning Rapid technological advances and increased access to information necessitate radical changes in the way WHO communicates with the public Failure to address the inequitable access to information and the Internet 2.4 National reporting 3.1 Support to Member States
3.6 Communication
Change management 4.1 Change management Organizational reform requires a planned approach to managing change Lack of financing 3.1 Support to Member States
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Annex 1
Performance management and reporting 5. The three objectives of WHO reform set out in paragraph 2 of this report reflect the desired “impact” of reform in the recently adopted results chain for WHO. Progress towards these objectives will be measured in the following ways: Indicator of WHO reform objectives Progress towards health impact indicators adopted in the twelfth general programme of work Means of verification Interim assessment in 2016 based on (a) second stage evaluation and (b) biennial WHO performance assessment reports Final assessment in 2020 based on evaluation of the twelfth general programme of work Second and subsequent WHO global perception surveys Interim assessment in 2016 based on second stage evaluation and second WHO global perception survey Final assessment in 2020 based on evaluation of the twelfth general programme of work Biennial WHO performance assessment reports
Percentage of Member States and other stakeholder representatives evaluating WHO’s effectiveness and performance as excellent or good Qualitative assessment of coherence in global health
Organizational performance; consolidated assessment of delivery of planned outputs
6. Progress in implementing the reforms, delivering the outputs, and achieving the desired outcomes requires a monitoring framework and mechanism in order to routinely assess progress against this implementation plan; identify bottlenecks and take appropriate remedial action; and validate achievements. 7. Based on the monitoring mechanism, regular progress reports will be produced and presented to the Independent Expert Oversight Advisory Committee for validation. These reports will form the basis of regular reports to the governing bodies. 8. The first stage of the independent evaluation of WHO requested by Member States and the reports of the United Nations Joint Inspection Unit on administration and decentralization in WHO have informed this implementation plan and report. The second stage of the independent evaluation will contribute to this process by assessing the WHO reform implementation strategy and the Organization’s preparedness to implement the reform process.
Managing change 9. Effective communication and engagement with internal and external stakeholders is a critical function in managing the changes inherent in reform, and a communication strategy is therefore a key component of the change management process. Generating awareness and understanding, building commitment, and enabling participation helps to create an environment within which change is welcomed rather than resisted. 12
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10. Key elements of the communication and engagement strategy include a stakeholder analysis, an engagement and communications plan, and a reform implementation plan. The communication and engagement strategy does not encompass the formal governance processes on WHO reform of consultation and documentation; these elements are managed in accordance with normal WHO procedures. 11. No new structures are required for implementation of WHO reforms, other than those specifically established as an output of reform, such as the Compliance, Risk Management and Ethics (CRE) Office. Existing departments, structures and offices that have the mandate and responsibility for a specific area of reform will take work forward in that area. 12. The Director-General, Deputy Director-General and the regional directors, as the Global Policy Group, are responsible for providing direction and oversight for the Organization, and accountability to Member States. The Deputy Director-General leads change management, and forms ad hoc teams as required to develop specific reform proposals. 13. Assistant Directors-General and directors of programme management are responsible for overseeing and reporting on implementation of WHO reforms within their cluster or region. Their work is coordinated through meetings of Assistant Directors-General and meetings of deputy regional directors/directors of programme management. 14. Department directors and heads of WHO Offices in countries, territories and areas, as heads of budget centres in WHO, are responsible for implementation of reforms within their area of responsibility and accountability. 15. A reform support team in the Office of the Director-General supports the Director-General, Deputy Director-General, the Global Policy Group and implementing offices, by facilitating the development of the implementation plan and monitoring framework, updating the plan and monitoring framework, and producing reports on progress.
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1.1
PROGRAMMATIC REFORM: PRIORITIES
16. Explicit priority setting is at the heart of WHO reform; the Organization has evolved and grown over the years and now finds itself overcommitted and overextended. Priority setting is neither strategic nor focused. The ultimate expression of WHO’s priorities for a particular biennium appears in the biennial programme budget. That budget is informed by the strategic direction contained in a general programme of work which, in turn, is influenced by the objectives and functions set out in the WHO Constitution. Development of the twelfth general programme of work (2014–2019) and the proposed programme budgets for this period are therefore the primary means of expressing reform of priority setting in WHO. Outcome 1.1 WHO’s priorities defined and addressed in a systematic, transparent, and focused manner and financed in alignment with agreed priorities Outcome indicators Outcome indicators adopted in the general programme of work Budget 2012–2013 (US$ thousand) Baseline Target 2015
Outputs 1.1.1 Vision and priorities for global health for 2014–2019, with defined impacts and outcomes, presented as the draft twelfth general programme of work for endorsement by Member States at the Sixty-sixth World Health Assembly
Target date
Status
2013
Ongoing
160
Key deliverables: • Member State meeting develops consensus on criteria for priority setting and programmatic categories of work for WHO February 2012 • Revised draft twelfth general programme of work following review by regional committees in 2012 January 2013 • Revised draft twelfth general programme of work following review by the Executive Board at its 132nd May 2013 session 1.1.2 Scope of work for WHO for 2014–2015, with defined outputs linked to outcomes, presented as the proposed programme budget 2014–2015, for approval by Member States at the Sixty-sixth World Health Assembly
Completed Completed
Completed
2013
Ongoing
–
Key deliverables: • Consensus on key programmatic areas for the work of WHO February 2012 • Revised draft of proposed programme budget 2014–2015, following review by regional committees, presented for consideration by the Executive Board at its 132nd session January 2013 • Revised draft of the proposed programme budget 2014–2015, following review by the Executive Board at its 132nd session, presented for consideration by the Sixty-sixth World Health Assembly May 2013 14
Completed
Completed
Ongoing
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2.1
GOVERNANCE REFORM: OVERSIGHT
17. The World Health Organization exercises oversight through its governing bodies; the World Health Assembly, Executive Board, regional committees, and relevant subcommittees established by each of these bodies. The Executive Board and its Programme, Budget and Administration Committee play a particularly important role, and have therefore been the focus of reforms to strengthen oversight of the Organization. Outcome 2.1 Strengthened oversight by governing bodies Outcome indicators Percentage of Member State representatives satisfied with WHO’s governance Baseline Target 2015 Progressive improvement
Outputs 2.1.1 Strengthened Programme, Budget and Administration Committee with expanded role to include oversight of monitoring and evaluation of programmatic and financial implementation at the three levels of the Organization Key deliverables: • Revised terms of reference for the Programme, Budget and Administration Committee • Reports by the Programme, Budget and Administration Committee to the Executive Board reflect the Committee’s expanded role 2.1.2 Increased strategic, executive and oversight role for the Executive Board
Target date
Status
Budget 2012–2013 (US$ thousand)
2013
Continuous
–
January 2012
Completed
January 2012 2013
Continuous Continuous –
Key deliverables: • Report by the Board to the World Health Assembly reflects the Board’s increased strategic, executive and oversight role From May 2013 2.1.3 Increased oversight role for regional committees and subsidiary bodies Key deliverables: 2013
Continuous Continuous –
• Reports by regional committees to the Board reflect the From January committees’ increased oversight role 2013 Continuous Notes: The outcome indicator will be assessed through the WHO global perception survey, which is conducted on a biennial basis. Output indicators will be based on qualitative assessments of the reports by the Programme, Budget and Administration Committee, Executive Board, and regional committees.
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2.2
GOVERNANCE REFORM: HARMONIZATION AND ALIGNMENT
18. The governing bodies do not function in isolation of one another; their interconnectedness is described in the WHO Constitution. In order to function effectively and coherently, a rational schedule of meetings is required, with alignment of relevant agenda items to facilitate consensus and appropriate decision-making at each level. Outcome 2.2 Harmonization and alignment of governance processes Outcome indicators Alignment of agendas of meetings of WHO governing bodies on relevant issues Harmonized rules of procedure of global and regional governing bodies Baseline Target 2015 Progressive alignment 100% harmonized Budget 2012–2013 (US$ thousand) –
4 regions*
Outputs 2.2.1 Rational schedule for governing body meetings Key deliverables:
Target date 2013 January 2013 2012
Status Completed Completed Continuous
• Decision on schedule for governing bodies meetings 2.2.2 Increase linkages between the regional committees and the global governing bodies Key deliverables: • Regional committees comment and provide input to all global strategies, policies and legal instruments such as conventions, regulations and codes • The Health Assembly refers specific items to the regional committees in order to benefit from diverse regional perspectives • Regional committees adapt and implement global strategies as appropriate • Chairpersons of the regional committees routinely submit a summary report of the committees’ deliberations to the Board 2.2.3 Harmonized practices across the regional committees in relation to the nomination of regional directors, the review of credentials, and participation of observers Key deliverables: • Reports by regional committees to the Board reflect the committees’ increased oversight role • Appointed credentials committees or the task of reviewing credentials entrusted to the Officers of the regional committee
–
From May 2012
Continuous
From May 2012 From May 2012
Continuous Continuous
From May 2012
Continuous
2012
Partially completed
–
2012
Completed Partially completed*
2012
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Outputs • Ensure that there are relevant rules within the rules of procedure that enable regional committees to invite observers to attend their sessions, including as appropriate, Member States from other regions, intergovernmental and nongovernmental organizations
Target date
Status
Budget 2012–2013 (US$ thousand)
2012
Partially completed*
* See document EB132/5 Add.3: except for the Regional Committee for Africa and the Regional Committee for South-East Asia (which have the item on their regional committees agenda for 2013), all the other regional committees have harmonized their practice as requested by the Health Assembly with regard to the review of credentials of delegates and the participation of observers in the work of the committees.
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2.3
GOVERNANCE REFORM: STRATEGIC DECISION-MAKING
19. In discussing reforms of governance processes, Member States have identified several important steps to enhance strategic decision-making by the governing bodies. These include: aligning the agendas of the governing bodies with the agreed priorities of the Organization as reflected in the general programme of work and the programme budget; introducing greater discipline into the debates on agenda items; standardizing the approach to resolutions; improving the Secretariat support to Member States in preparing for meetings of the governing bodies by providing documents in time, and providing briefings for Member States; and strengthening and simplifying national reporting. Outcome 2.3 Enhanced strategic decision-making by governing bodies Outcome indicators Extent of the alignment of the governing bodies’ agendas with the general programme of work and the programme budget, and their harmonization Baseline Target 2015 Progressive improvement 100%
Not applicable 60%*
• Provision of governing body documents in all official languages within the deadline
Outputs 2.3.1 The governing bodies vet resolutions, and limit reporting requirements and timelines Key deliverables: • Executive Board to limit number of draft resolutions based on assessment of strategic value, financial and administrative implications, and reporting requirements and timelines 2.3.2 Improved methods of work of the Board and World Health Assembly including standardized approaches to resolutions/decisions Key deliverables: • Debates to become more disciplined to discourage lengthy national reports and focus on the substance of the item • “Traffic light” system and enforcement by chairmen of time limits • Officers of the Board use criteria, including those used for priority setting in the draft general programme of work, in reviewing items for inclusion on the Board’s agenda • Board to consider amending its Rules of Procedure in order to manage the late submission of draft resolutions
Target date 2013
Status Continuous
Budget 2012–2013 (US$ thousand) –
2013
Continuous
2013
Ongoing
–
From 2011 Continuous
Continuous Continuous
2013 Continuous
Continuous Ongoing
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Outputs • Governing bodies make better use of the Chairman’s summaries, reported in the official record, with the understanding that they do not replace formal resolutions • Capacity building and training for new Board Members and Officers • Options for criteria for inclusion, exclusion or deferral of items on the Executive Board provisional agenda • Options proposed on possible changes needed in the rules of procedure of the governing bodies in order to limit the number of agenda items and resolutions 2.3.3 Strengthened support to Member States in preparation for and participation in the work of the governing bodies in collaboration with regional offices, with particular regard to the timely provision of quality documentation in all official languages Key deliverables: • Handbook on procedural issues for briefing of Executive Board chairmen and chairmen of committees of the Health Assembly • Mission briefings prior to governing body meetings • Improve electronic access to governing body meetings and documentation on a registered basis • Conduct a study, including options on the feasibility of holding meetings of the Executive Board and World Health Assembly with minimal use of paper documents *Baseline 132nd Executive Board, January 2013.
Target date
Status
Budget 2012–2013 (US$ thousand)
2013 2013 2013
Continuous Ongoing Ongoing
2013
Ongoing
2014
Ongoing
100
2012 Continuous From 2013
Partially completed Ongoing Ongoing
January 2014
Ongoing
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2.4
GOVERNANCE REFORM: STREAMLINED NATIONAL REPORTING
20. Reporting of information from Member States to WHO is fundamental to the work of the Organization. Member States have therefore requested the Secretariat to propose options on how to modernize, improve and streamline reporting based on a detailed analysis on the current practice of reporting, with its strengths, weaknesses and costs. This will address the three dimensions of health data, health policy and the resolutions and decisions of the governing bodies. Furthermore first steps will be taken towards the establishment of an extranet platform for formal communication between all three levels of the Secretariat and Member States that is accessible across the whole Secretariat and to the focal points of the Member States. Outcome 2.4 Streamlined reporting of and communication with Member States Outcome indicators Proportion of Member States reporting on minimal health data set, national laws, policies and implementation of Assembly resolutions Number of Member States regularly using the extranet platform Baseline 0 0 Target 2015 TBD TBD
Outputs 2.4.1 A streamlined national reporting system for health data; health policies and law; and the implementation of governing body decisions Key deliverables: • Proposals on streamlining national reporting and communication with Member States including relevant financial information • Definition of a minimal set of health data and indicators as well as a recommended additional set in the context of the results of a detailed analysis on the current practice of reporting • A reporting mechanism on national health policy and laws • A realistic reporting mechanism on the implementation of governing body resolutions and decisions • A single planned annual questionnaire, which covers regular required reporting, and a reduction in the number of other questionnaires sent out • A harmonized platform for all reporting, and a webbased repository where all required and relevant reports by Member States are posted and available for sharing among Member States 2.4.2 A platform for communication with Member States Key deliverables: • Develop and pilot an extranet platform for formal communication between all three levels of the Secretariat and Member States 20
Target date
Status
Budget 2012–2013 (US$ thousand)
2014
Ongoing
130
January 2014
Ongoing
January 2014 January 2014 January 2014
On going Ongoing Ongoing
January 2014
Ongoing
January 2014 2014
Ongoing Ongoing 50
January 2014
Ongoing
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2.5
GOVERNANCE REFORM: ENGAGEMENT
21. The growing number of organizations working in health creates a need for clearer definitions of responsibility, better rules of engagement, and opportunities for multistakeholder dialogue on global health issues, with the aim of aligning priorities and accelerating progress towards national, regional and global health goals. Member States have emphasized that engagement with other stakeholders should be guided by the following: (i) the intergovernmental nature of WHO’s decision-making remains paramount; (ii) the development of norms, standards, policies and strategies, which lies at the heart of WHO’s work, must continue to be based on the systematic use of evidence and protected from influence by any form of vested interest; (iii) any new initiative must have clear benefits and add value in terms of enriching policy or increasing national capacity from a public health perspective; (iv) building on existing mechanisms should take precedence over creating new forums, meetings or structures, with a clear analysis provided of how any additional costs can lead to better outcomes.1 Outcome 2.5 Strengthened effective engagement with other stakeholders Outcome indicators Percentage of countries where WHO is perceived as providing the main support to government/partner coordination for health Baseline 80% Target 2015 85%
Outputs 2.5.1 Engage and, where appropriate, lead and coordinate across the United Nations system and with other international agencies on issues that impact health
Target date
Status
Budget 2012–2013 (US$ thousand)
2015
Ongoing Ongoing
–
Key deliverables: 2015 • Health positioned strategically in the post-2015 agenda • Follow up on the United Nations High-level Meeting on the Prevention and Control of Non-communicable Diseases Continuous • Agenda for universal health coverage 2013 • Implementing the provisions of International Health 2015 Regulations (IHR 2005) • Increased access to essential, high quality and affordable medical products 2015 • Social, economic and environmental determinants of 2015 health addressed 2.5.2 Principles, policies and operational procedures for engagement with non-State actors 2014
Ongoing Ongoing Ongoing Ongoing Ongoing Ongoing 80
1
See decision EBSS2(2).
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Outputs Key deliverables: • Draft policy paper on WHO’s engagement with nongovernmental organizations prepared for consideration by the Executive Board at its 132nd session • Draft principles and operational procedures for engagement of non-State actors based on consultations with Member States for the 133rd session of the Board • Policy for engagement with nongovernmental organizations based on consultative process with Member States and NGOs • Policy on WHO’s relations with private commercial entities based on consultative process with Member States and private commercial entities. 2.5.3 Increased Member State involvement with and oversight of partnerships Key deliverables:
Target date
Status
Budget 2012–2013 (US$ thousand)
January 2013
Completed
May 2013
Ongoing
January 2014
To commence
January 2014 2015
To commence To commence 50
• Report prepared on WHO’s hosting arrangements of health partnerships and proposals for harmonizing work with hosted partnerships for consideration by the Executive Board at its 132nd session January 2013 January 2014 • Framework for review of hosted partnerships From January • Review of hosted partnerships by governing bodies 2015 January 2014 • Study on the true cost of hosting partnerships 2.5.4 Strengthened coherence in global health matters Key deliverables: • Report on global health governance for consideration by the Executive Board at its 132nd session and 133rd session • Exploration of options for a framework to guide interaction between all stakeholders active in health1 2015 Completed To commence To commence To commence Ongoing –
May 2013 2015
Ongoing To commence
1
See decision EBSS2(2), subparagraph (2)(i).
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3.1
MANAGERIAL REFORM: SUPPORT TO MEMBER STATES
22. The purpose of this element of reform is to ensure that the work of the Secretariat is organized and delivered in ways that meet the changing needs of Member States. This includes making the most effective use of the decentralized structure of the Organization; defining the roles of the different levels in ways that reduce duplication; and developing management systems that facilitate access to knowledge and expertise across technical and organizational boundaries. Outcome 3.1 Effective technical and policy support for all Member States Outcome indicators Number of country cooperation strategies that are up to date and aligned with national health policies strategies and plans Number of qualified candidates in the heads of WHO Offices roster Baseline x (2013) 219 Target 2015 129 (2015) 300
Outputs 3.1.1 Increased alignment of profile of WHO country presence with country needs and priorities Key deliverables: • Renewed or developed country cooperation strategies in all countries, based on revised framework to align with country needs and priorities • Staffing and resource plans for each country office aligned with the country cooperation strategies 3.1.2 Strengthened country offices Key deliverables:
Target date 2015
Status To commence
Budget 2012–2013 (US$ thousand) 200
2015 2015 2015
To commence To commence Continuous 593
• Roster of qualified candidates for competitive selection of heads of WHO Offices in countries, areas and territories • Enhanced induction for heads of WHO Offices, to include training on health diplomacy, managerial skills and accountability 3.1.3 Promote alignment, synergy and collaboration across the Organization Key deliverables: • WHO taskforce on roles and responsibilities of different levels of the Organization • Strengthened capacity and functions of country support units in headquarters and regional offices, in line with the Joint Inspection Unit recommendations • Review of the organizational structure to enhance management and operational effectiveness, in line with the Joint Inspection Unit recommendations From 2012 Continuous
From 2012 2014
Continuous Ongoing 450
May 2013
Completed
2013
To commence
2014
To commence
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Outputs 3.1.4 Improved knowledge management Key deliverables: • Public searchable database of WHO knowledge resources and products • WHO information management policy and strategy 3.1.5 Strengthened technical excellence
Target date 2015
Status Ongoing
Budget 2012–2013 (US$ thousand) 730
2015 2015 2014 2013 2014
Ongoing To commence To commence To commence To commence 200
• Establishment of a taskforce to strengthen technical excellence • Development of a strategy for strengthening technical excellence
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3.2
MANAGERIAL REFORM: HUMAN RESOURCES
23. As a knowledge-based organization, WHO relies on a highly skilled, flexible and motivated staff. WHO’s ability to maintain such a workforce is hampered by organizational policies and practices that are frequently outdated, and by short-term project type financing which is not aligned with the longer term programmatic nature of much of WHO’s work. Reform of human resources is based on an Organization-wide human resources strategy, which will deliver streamlined recruitment and selection processes, simplify staff contracts, strengthen performance management and accountability, increase mobility across WHO, and enhance competencies through learning and development. Outcome 3.2 Staffing matched to needs at all levels of the Organization Outcome indicators Percentage of recruitment processes completed within 180 days Baseline 65% (2013) Target 2015 90% (2015)
Outputs 3.2.1 Human resources strategy that encompasses a model for strategic workforce planning and career development Key deliverables:
Target date
Status
Budget 2012–2013 (US$ thousand)
2013 2013
Ongoing Ongoing
229
• Revised WHO human resources strategy • Proposed changes to Staff Rules, based on a draft appointment policy to support a flexible workforce, for consideration by the Executive Board at its 132nd session • Human resources plan including for each major office staffing norms and baselines 3.2.2 Streamlined processes recruitment and selection
January 2013 2014 2014
Completed To commence Ongoing 150
Key deliverables: • Harmonized recruitment policy and practice across all major offices • Generic job descriptions for key categories of staff including; administrative officers, epidemiologists, health technical coordinators, and emergency health communicators • Global rosters of “prequalified” staff in the aforementioned categories based on generic vacancy notices and competitive selection • Measures to enhance gender balance and report on progress to the governing bodies meetings
2013
Ongoing
2013
Ongoing
From 2013 2014
To commence To commence
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Outputs 3.2.3 Mobility and rotation framework Key deliverables: • Global mobility and rotation scheme based on experiences with regional schemes and on global workforce planning 3.2.4 Enhanced staff learning and development Key deliverables: • Global eLearning platform incorporating learning management system (LMS), and based on blended learning approach
Target date 2013
Status Ongoing
Budget 2012–2013 (US$ thousand) 70
From 2013 2013
Ongoing Ongoing 481
• Management development programme 3.2.5 Improved performance management Key deliverables: • New performance development and management system and tool • Policies on (a) rewards and recognition and (b) improving performance 3.2.6 Enhanced administration of justice Key deliverables:
2013 2013 2013
Ongoing Ongoing Ongoing 278
2013 2013 2014 2013 2014
Ongoing To commence To commence To commence To commence 50
• Study on WHO administration of justice • Revised system of administration of justice
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3.3
MANAGERIAL REFORM: FINANCE
24. From the outset of WHO’s reform, two key issues have framed the discussion concerning the financing of WHO: how best to align the priorities agreed by WHO’s governing bodies with the monies available to finance them; and how to ensure greater predictability and stability of financing to promote more realistic results-based planning, effective resource management, and increased transparency and accountability. Although improved financing underpins the optimal execution of WHO’s work, particularly at the country level, it is also recognized that enhanced organizational performance is a means to improve WHO’s financing. Reform of WHO’s financing has therefore focused on; steps to increase transparency, predictability and flexibility of financing; strengthening results-based planning and budgeting; better coordination of resource mobilization; cost recovery of administration and management; and transparency in resource allocation. Outcome 3.3 Financing and resource allocation aligned with priorities Outcome indicators Baseline Percentage of programme budget by category and major office 55% funded at the beginning of biennium (2013) Alignment of income and expenditure with approved programme budget by category and major office Not fully aligned Target 2015 At least 70% (2015) 100% aligned Budget 2012–2013 (US$ thousand) 1230
Outputs 3.3.1 Increased transparency, flexibility of WHO’s financing Key deliverables: predictability and
Target date 2013
Status Ongoing
• Extraordinary meeting of the Programme, Budget and Administration Committee to discuss financing of WHO December 2012 Adoption of the general programme of work and the programme budget by the Health Assembly to facilitate May 2013 alignment of resources with priorities Financing dialogue to encourage predictability of June–December financing, and reduced earmarking of funds 2013 Web-based portal for real-time tracking and reporting of resource flows and results June 2013 Exploration of the possibility of supplements to assessed contributions on a voluntary basis with interested countries 2013 budgeting 2013 2012 2013 2013 Ongoing Completed Ongoing Ongoing 652 Completed
• • • •
Ongoing Ongoing Ongoing
Ongoing
3.3.2 Results-based planning and mechanism based on new results chain Key deliverables:
• New results chain • Methodology for a standardized costing of outputs • Methodology for assessing the contribution of outputs to outcomes, and of outcomes to impact
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Outputs 3.3.3 Sequenced planning to reflect country needs Key deliverables:
Target date 2015 2013 2016–2017 2015 resource 2013
Status To commence To commence
Budget 2012–2013 (US$ thousand) –
• Revised corporate planning process • Draft proposed programme budget developed on the basis of the new process 3.3.4 Improved mobilization Organization-wide
To commence Ongoing 457
Key deliverables: • WHO task force on resource mobilization and management to propose policies on resource management
• Organization-wide resource mobilization plan 3.3.5 Improved financing of administration and management costs Key deliverables:
May 2013 2013 2014
Ongoing Ongoing Ongoing 394
• Study of costs of administration and management in WHO • Revised approach to financing of administration and management costs in WHO 3.3.6 New resource allocation mechanism Key deliverables: • Principles of transparent allocation • Application of principles of allocation programme budget for 2014–2015 March 2013 May 2014 2014 May 2013 to the 2014 To commence Completed Ongoing Ongoing Ongoing –
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3.4
MANAGERIAL REFORM: ACCOUNTABILITY AND TRANSPARENCY
25. Member States expect greater accountability for results and resources, with stronger performance assessment, and increased transparency. As a result, improving accountability and transparency is a fundamental element of almost all the reform proposals. In addition to strengthening organizational capacity in audit and oversight, specific areas of improved accountability and transparency include: development of an approach to results-based planning based on country needs; an improved internal control framework supported by a Compliance, Risk Management and Ethics (CRE) Office; development of an Organization-wide approach to risk management; adoption of an information disclosure policy; and strengthened management of conflicts of interest. Outcome 3.4 Managerial accountability, transparency and risk management Outcome indicators Proportion of corporate risks with response plans approved and implemented Baseline Not applicable Target 2015 100% (2015)
Outputs 3.4.1 Improved accountability and internal control framework Key deliverables: • Standard operating procedures for administrative processes; travel, human resources, finance and procurement • Performance and compliance monitoring based on standard metrics and dashboard • Established Compliance, Risk Management and Ethics (CRE) Office • Standardized delegations of authority and performance compacts for senior staff • Comprehensive, Organization-wide independent evaluation of the Global Management System • Long-term strategy for the functions and operations of the Global Service Centre 3.4.2 Improved risk management framework Key deliverables: • Risk management framework with oversight by the Compliance, Risk Management and Ethics (CRE) Office • Organizational-wide risk register
Target date 2015
Status Ongoing
Budget 2012–2013 (US$ thousand) 1844
2013 2013 2013 2013 2015 2014 2013
Ongoing Ongoing Ongoing To commence To commence To commence Continuous Budgeted under 3.4.1 – CRE office
2013 2013
Continuous Continuous
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Outputs 3.4.3 Information disclosure policy Key deliverables: • Draft policy on information disclosure, based on best practice in international organizations, for consideration by governing bodies • Revised document management systems and information retention policies to support information disclosure policy 3.4.4 Increased effectiveness in management of conflicts of interest Key deliverables:
Target date 2013
Status Ongoing
Budget 2012–2013 (US$ thousand) –
2013
Ongoing
2013 2013 2012 2013
Ongoing Ongoing Completed To commence Budgeted under 3.4.1 – CRE office 2734 –
• Audit of declaration of interest policy • Revised declaration of interest policy and practice based on audit recommendations • Established Ethics Office
2013 3.4.5 Increased capacity of audit and oversight Key deliverables: 2012 2012 2012
Ongoing Completed Completed Completed
• Recruitment of additional staff for internal audit • Recruitment of additional staff for investigations
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3.5
MANAGERIAL REFORM: EVALUATION
26. Evaluation is a crucial function, and carried out at all levels of WHO, reinforcing accountability to key stakeholders, and promoting institutional and individual learning. Member States have emphasized the need to develop a “culture of evaluation” in WHO, leading to the development and implementation of an evaluation policy with oversight by the governing bodies. In addition they requested an independent evaluation of the work of WHO, to be carried out in several stages,1 and also requested the United Nations Joint Inspection Unit to update two earlier reports on decentralization in WHO, and management and administration in WHO.2 Outcome 3.5 Strengthened culture of evaluation Outcome indicators WHO programmes are systematically evaluated in accordance with the criteria and quality requirements of the WHO policy. Regular reporting of Organization-wide evaluation workplans and progress on implementation of evaluation findings and results Baseline Target 2015
N/A
100%
Outputs 3.5.1 Evaluation policy including a mechanism for oversight of evaluation by governing bodies Key deliverables:
Target date 2013
Status Ongoing
Budget 2012–2013 (US$ thousand) 921
• Adoption of WHO evaluation policy by the governing bodies
• Recruitment of additional staff for evaluation • Annual workplan for evaluation presented to the From January governing bodies
2012 2013
Completed Ongoing Continuous Ongoing Ongoing
• Web-based inventory of WHO evaluations • Operational Global Network on Evaluation to promote evaluation culture and strengthen capacity across WHO • Annual report on evaluation activities covering enhanced accountability and lessons learnt presented to governing bodies 3.5.2 Conduct an independent evaluation of WHO Key deliverables: • First stage of the independent evaluation consisting of a review of existing information with a focus on financing challenges for the Organization, staffing issues, and internal governance of WHO by Member States
2013 2013 2013
2014 2014
Continuous Ongoing 500
2012
Completed
1 2
See document EB132/5 Add.7. See document EB132/5 Add 6.
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Outputs • Paper on the specific modalities of the second stage evaluation for consideration by the Executive Board at its 132nd session • Report of the second stage of the external evaluation for review by the governing bodies 3.5.3 Joint Inspection Unit to update its reports (a) Decentralization in WHO, and (b) Review of management and administration of WHO
Target date
Status
Budget 2012–2013 (US$ thousand)
January 2013 January 2014
Completed Ongoing
2013
Completed
120
Key deliverables: • Joint Inspection Unit reports on (a) Decentralization in WHO, and (b) Review of management and December 2012 administration of WHO • Incorporate Joint Inspection Unit recommendations in reform implementation plan January 2013
Completed Completed
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3.6
MANAGERIAL REFORM: COMMUNICATION
27. Several factors have contributed to the need to reform WHO’s work in communications: rapid changes in information technologies; the changing landscape of organizations engaged in global health; a growing demand from the public for more information on health and on the work of WHO; and the emergence of new health challenges. Reform of communications in WHO seeks to address these issues by increasing internal communications capacity; improving coordination between the different levels of WHO; developing and utilizing cost-effective communications platforms such as social media; and regularly measuring public understanding of the work of the Organization. Outcome 3.6 Improved strategic communications Outcome indicators Percentage of Member States and other stakeholder representatives evaluating WHO’s performance as excellent or good Baseline 77% (2013) Target 2015 85% (2015)
Outputs 3.6.1 Increased communications capacity Key deliverables:
Target date 2013 From 2012 2013 2013 2012 2013
Status Ongoing Continuous Ongoing Ongoing Completed To commence
Budget 2012–2013 (US$ thousand) 850
• Communication training for different categories of staff • Emergency communications network of pretrained communicators to deploy in emergency situations 3.6.2 Strengthened communications coordination Key deliverables:
400
• Centralized communications team in headquarters • WHO communications strategy • Global communications forum for WHO communications staff held every biennium, and virtual coordination meetings every quarter • Internal communications strategy 3.6.3 Cost-effective communications platforms Key deliverables: • Social media platforms in use, in headquarters and regions • Developed video platform • Upgraded WHO web site with improved searchability and usability • Information technology as regular item on agenda of Global Policy Group and annual report to Programme, Budget and Administration Committee
2013 2013 2014
To commence To commence Ongoing 600
From 2011 2013 2013
Continuous Continuous To commence
From 2014
To commence
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Outputs 3.6.4 Improved public and stakeholder understanding of the work of WHO Key deliverables:
Target date 2015 From 2012 2014 2014
Status Continuous Continuous To commence To commence
Budget 2012–2013 (US$ thousand) 150
• Biennial global stakeholder perception survey 3.6.5 Strengthen publication policy and strategy Key deliverables: • Evaluation of WHO publishing policy and practice
50
34
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4.1
CHANGE MANAGEMENT
28. Implementation of these reforms will demonstrate best practice in management of change, with: (a) a clear articulation of the purpose, scope and measures of success of reform; (b) comprehensive planning to achieve these results; (c) a monitoring framework to measure, assess and report on progress; (d) a communications strategy for engagement with Member States, other external stakeholders, and staff, to maintain awareness, trust and commitment; and (e) an organizational framework to manage change. Outcome 4.1 WHO reform implementation coordinated, monitored and evaluated Outcome indicators Percentage of outputs in the WHO implementation plan being completed or on track Baseline 25% (2013) Target 2015 100% (2015) Budget 2012–2013 (US$ thousand) –
Outputs 4.1.1 Implementation plan for WHO reform Key deliverables: • High-level implementation plan for presentation to the Executive Board at its 132nd session • Comprehensive costed implementation plan available on WHO web site, updated based on decisions of the governing bodies 4.1.2 Monitoring and reporting framework for WHO reform
Target date 2013
Status Ongoing
January 2013
Completed
January 2013 2013
Completed Ongoing Ongoing –
Key deliverables: • High-level implementation and monitoring framework May 2012 • Four-monthly reports on implementation for review and validation by the Independent Expert Oversight From February Advisory Committee 2013 • Regular reports to governing bodies From May 2012 4.1.3 Communication and engagement strategy on WHO reform for Member States, other external stakeholders and staff Key deliverables:
Ongoing Ongoing
From 2011 From 2011 From 2012 From 2011 From 2011 From May 2011 2011
Ongoing Continuous Ongoing Ongoing Ongoing Ongoing Completed
140
• WHO reform web site and Intranet site • Newsletter on WHO reform; Change@WHO (3 issues/year)
• Briefings and consultations on WHO reform for Member States and staff 4.1.4 Change management support and organizational structure Key deliverables:
2800
• Reform support team • WHO taskforce on managerial reform
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WHO reform budget for the biennium 2012–2013 (excluding 13% programme support costs) and mapping to 2014–2015 Reform area Programmatic reform 1.1 Programmatic priorities Governance reform 2.1 Oversight 2.2 Harmonization and alignment 2.3 Decision-making 2.4 Streamlined national reporting 2.5 Engagement Management reform 3.1 Support to Member States 3.2 Human resources 3.3 Finance 3.4 Accountability 3.5 Evaluation 3.6 Communication Change management 4.1 Change management Total 2 940 17 843 6.1 2 173 1 258 2 733 4 578 1 541 2 050 6.1 6.4 6.4 6.2 6.2 6.5 – – 100 180 130 6.1 6.1 6.1 6.1 6.1 160 6.3 Anticipated costs (US$ thousand)1 2012–2013 Budget line2 2014–2015
Not included in the original Programme budget 2012–2013 The costs of reform in 2014–2015 have been planned and budgeted within the proposed programme budget 2014–2015. 2
1
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ANNEX 2 INCLUSION OF RECOMMENDATIONS OF THE FIRST STAGE OF THE EXTERNAL EVALUATION OF WHO
The Executive Board, at its special session on reform in November 2011, decided on an independent evaluation of the WHO reform proposals informing WHO’s reform as the first of a two-stage process.1 The first stage of the evaluation focused on whether the WHO reform proposals had identified a sufficient range of issues that needed to be dealt with in the reform process and made a series of recommendations that have been integrated and mapped to the reform implementation plan as follows: Recommendation Related element of the WHO reform implementation plan 2.2.2
1
Interlinkages among governing bodies at headquarters and regional offices have to be carefully created, as these would have a far-reaching impact on organizational coherence and would provide the Organization with a strategic focus. The accountability and responsibility structures for the three layers of governance, i.e., country offices, regional offices and global head office would need to be redesigned, keeping in view, the new programmatic approach, resource allocation mechanism and country focus on programme planning and delivery. A robust results-based management system and an effective performance management and development system could provide the requisite links. Country focus seems to be a running theme in the reform proposal, starting from programme formulation to resource allocation to programme delivery. A detailed strategy interlinking various aspects of proposed changes along with structural and procedural support needs to be formulated. A regular feedback mechanism is a must for providing assurance about the activities of the Organization. WHO needs to have an evaluation policy with clear deliverables, for conducting programme evaluations at regular intervals. Such wide-ranging changes require acceptance at various levels. An advocacy plan, to explain the implications of the change strategy, identification of change agents and a detailed change management plan would be required to implement the plan of action, after the approval is received from the appropriate authority. The existing internal procedures would require fine-tuning and adjustments for implementing the proposed changes, this would be especially important in implementing areas covered under “managerial reforms”.
2
3.1.3; 3.3.2
3
3.1.
4
3.5
5
4.1
6
4.1
1
See decision EBSS2(3).
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Recommendation
Related element of the WHO reform implementation plan 4.1.1; 4.1.2
7
It is understood that the reform proposal is still a work in progress, as various components of the proposal are at various stages of consideration. However, it is of paramount importance that desired outputs, outcomes and impact are identified, indicators to measure these are designed and a monitoring and feedback mechanism is put in place. The Organization is proposing a comprehensive reform programme, which involves action on a large number of fronts. It is recommended that a prioritization plan may be prepared to allow a smooth and gradual shift. This plan could also distinguish between the elements of changes proposed on the basis of level of approvals required. The implementation strategy should indicate resource requirements in financial, human, time and technical terms. Consultations with non-Member State donors may be considered to understand their concerns. This feedback might be important for preparing a realistic strategy. The success of the proposal would also be dependent on carrying out of changes in human resources policies. Given the fact that human resources policies do have inbuilt rigidities, WHO may have to resort to innovative solutions. It is recommended that best practices in similarly placed organizations may be considered. The success of any change strategy is directly correlated to understanding of its gains by the stakeholders. It is suggested that a regular communication should be maintained with all concerned on the progress of the reform proposal, which would help in creating the right environment for implementation. The proposed reform proposal has highly interdependent components, the success of the process would require that this interdependence is recognized and woven in the implementation strategy.
8
4.1.1.
9 10
4.1.1 3.3.1
11
3.2
12
4.1.3
13
4.1.1; 4.1.2
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ANNEX 3 INCLUSION OF RECOMMENDATIONS OF THE UNITED NATIONS JOINT INSPECTION UNIT ON ADMINISTRATION AND DECENTRALIZATION IN WHO
In line with the request of the Executive Board, at its special session on reform in November 2011, the United Nations Joint Inspection Unit conducted and updated reviews of (a) Decentralization of Organizations within the United Nations System – Part III: the World Health Organization; and (b) Review of management and administration in the World Health Organization.1 The recommendations of the Joint Inspection Unit have been integrated and mapped to the reform implementation plan as follows: Recommendation Related element of the WHO reform implementation plan 3.1.3
ADMINISTRATION 1 The Director-General should review the current headquarters organizational structure to enhance management and operational effectiveness in line with the changes to be approved in the ongoing reform process. 2 In the course of the ongoing management reform, the Director-General should review the number of ADG positions, formulate their job descriptions and inform the Executive Board about measures to enhance the transparency of their selection and appointment process. 3 The Director-General should ensure that further development of the Global Management System be undertaken on the basis of a comprehensive, Organization-wide independent evaluation of the design, operational experiences and lessons learned. 4 The Director-General should elaborate a long-term strategy for the functions and operation of the Global Service Centre, including its governance and financing. 5 The Director-General should commission an external evaluation of the preparation of publications in WHO. 6 The Director-General should take measures to strengthen the central content management and ownership of the WHO intranet and ensure that the staff have better knowledge and access to use available professional information existing in the Organization. 7 The Director-General should elaborate a concrete action plan to ensure better monitoring and a more consistent implementation of human resources policies across the Organization 8 The Director-General should present a contractual model that adequately reflects the changing staffing needs and takes into account the existing financing modalities 9 The Director-General in consultation with Regional Directors should elaborate and promote an Organization-wide mobility policy across all three levels of the organization with concrete targets and a set of indicators to be monitored. 10 The Director-General together with the Regional Directors concerned should elaborate an action plan with targets and indicators to improve gender balance and report on its implementation to the Executive Board as part of regular human resources reporting.
3.2.2
3.4.1
3.4.1 3.6.5 3.6.2
3.2.1
3.2.1 3.2.4
3.2
1
See decision EBSS2(3).
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Recommendation 11 The Executive Board should recommend that Member States support the DirectorGeneral’s efforts aimed at increasing the predictability of financing, including through providing more flexible and multi-year voluntary contributions. 12 The Director-General should establish an appropriate formal mechanism for the resource allocation process to improve transparency and participation of different players of the Organization. 13 The Director-General should ensure that the compliance and control mechanisms at different levels be integrated into a coherent and comprehensive internal control framework
3.3.1
3.3.6
3.4.1
14 The Director-General should ensure that a long-term policy on building management be Not part of reform, elaborated and its implementation supported by organization-wide standards and will be reported guidance through Capital Master Plan 15 The World Health Assembly should review the long-term policy on building management and to provide the necessary funding for its implementation 16 The Director-General should include the global information technology programmes in the agenda of the Global Policy Group to ensure that the necessary support and resources are provided. 3.6.3
17 The Director-General should initiate a UNEG peer review on the evaluation function of JIU is currently WHO so as to benefit from the established best practices in the United Nations system undertaking a review and to fully align the evaluation function of WHO with the UNEG norms and standards in the United Nations and present this peer review to the Executive Board no later than 2014. Related element of the WHO reform DECENTRALIZATION implementation plan 1 The Executive Board should complete, in the context of the current WHO reform process, a comprehensive review of the governance process at regional level and put forward concrete proposals to improve the functioning of Regional Committees and subcommittees and finalize the harmonization of their rules of procedure for the consideration of Regional Committees. 2 The Director-General, in consultation with the Assistant Directors-General and Regional Directors, should monitor the set-up and functioning of networks and annual meetings by technical and administrative areas of work at the three levels of the Organization. 3 The Director-General and Regional Directors, in consultation with Member States, should agree on criteria for a minimum and robust country presence. Criteria and procedures should also be developed to open and close sub-offices subject to changing needs. 4 The Director-General and Regional Directors should take action as appropriate to reposition the country support units/functions at headquarters and regions more strategically, enhance their capacity and leverage their role in harmonization and decision-making. 5 The Director-General, in consultation with the Global Policy Group, should revise the existing categories, grades and delegation of authority of heads of country offices in line with the size, capacity and operational needs of the country offices. 6 The Director-General and Regional Directors should include in their programme budgets and work plans specific objectives, activities and indicators relating to the promotion of intercountry and interregional cooperation and ensure that adequate funding is foreseen for their implementation. 2.3.1
3.1.3
3.1.1
3.1.3
3.1.1
3.1.3
= 40
=
=
REGIONAL COMMITTEE Sixty-sixth Session SEARO, New Delhi, India 10–13 September 2013
Provisional Agenda item 3.3 SEA/RC66/5 Inf.Doc.2 22 July 2013
WHO reform and Programme Budget matters: WHO reform: financing dialogue and Programme Budget 2016–2017
The attached document (A66/48) on “WHO reform: Financing of WHO” was submitted to the Sixty-sixth World Health Assembly in May 2013.
SIXTY-SIXTH WORLD HEALTH ASSEMBLY Provisional agenda item 11
A66/48 13 May 2013
WHO reform Financing of WHO Overview 1. Improving the transparency, alignment, and predictability of WHO’s financing is at the centre of WHO’s reform. In December 2012, an extraordinary meeting of the Programme, Budget and Administration Committee of the Executive Board agreed on five proposals designed to advance this aim. These were subsequently endorsed by the Executive Board at its 132nd session in January 2013.1 2. Subsequently, a number of Member States have asked for clarification on the operationalization and implementation of these proposals. The purpose of this paper is to provide information on the following: (i) the implications for the 2014–2015 programme budget resolution and for WHO’s Financial Regulations and Financial Rules of the World Health Assembly’s approval of the proposed programme budget in its entirety; (ii) (iii) the form and format of the financing dialogue; the strategic allocation of WHO’s resources; and
(iv) the role of WHO’s governing bodies in the different phases of the financing cycle of WHO’s programme budget.
Approval of WHO’s entire programme budget 3. WHO is financed by a mix of assessed contributions provided by Member States, and voluntary contributions provided by both State and non-State actors. In 2003, WHO embarked on a results-based programming and budget system, with deliverables based on funds from both assessed contributions and voluntary contributions. Currently, however, the World Health Assembly approves only the proportion of the programme budget financed from assessed contributions (i.e. approximately 25%).
1 A detailed analysis of WHO’s financing situation, challenges, and description of proposals examined by the Second extraordinary meeting of the Programme, Budget and Administration Committee on financing and EB132 can be found in document EBPBAC/EXO2/2 and document EB132/3.
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4. In so doing, the collective oversight of the World Health Assembly over nearly 80% of the total budget of the Organization and the ability to hold the Secretariat accountable for the totality of available resources towards the implementation of WHO’s agreed programme, priorities, and expected deliverables, is constrained. 5. The move towards approving the budget in its entirety is a radical departure from the way WHO currently does business. Deliverables in the programme budget will now be the key drivers of the work of the Organization and its resource mobilization efforts, and will facilitate enhanced budgetary discipline. 6. In addition to setting limits on assessed contributions, approval will set realistic — as opposed to aspirational — limits on voluntary contributions. It will also demonstrate greater ownership by Member States over WHO’s resource requirements by reflecting greater commitment to align contributions against the budget’s programmatic priorities, while assisting the Director-General in assuring the financing of the whole of WHO’s programme budget. Moreover, it would facilitate WHO’s ability to employ the programme budget as a central instrument for human and financial resource planning, and the effective management of potential financial risks to WHO.
The 2014–2015 proposed programme budget resolution and amendments to WHO’s Financial Regulations and Financial Rules 7. In order for the Health Assembly to approve the WHO entire proposed programme budget, a number of changes are required in both the programme budget resolution and WHO’s Financial Regulations and Financial Rules. In the programme budget resolution for the financial period 2012–2013, Member States appropriated the amount of assessed contributions across 13 budget envelopes. The term “appropriation” was relevant in this context as it applied specifically to the distribution of assessed contributions. In the context of approval of the entire budget, voluntary contributions cannot be “appropriated” in the same manner, as these are funds that are not yet assured. 8. Rather, while recognizing that the legal and financial obligation of Member States is limited to the assessed contribution part of WHO’s total budget, the 2014–2015 proposed programme budget resolution will request the Health Assembly to: • Approve WHO’s two-year programme of work and performance measures; agree on the total resources required to deliver that programme; • Allocate the total budget to WHO’s six categories of work; • Determine that the programme will be financed through a mix of assessed contributions and voluntary contributions; and • Encourage Member States and other contributors to support, on a voluntary basis, the financing of the voluntary contribution part of the programme budget. 9. To align WHO’s Financial Regulations and Financial Rules with the programme budget resolution outlined above, the amendments to WHO’s Financial Regulations and Financial Rules clarify that the Director-General is authorized to raise and spend available resources in accordance with the approved budget, and that the financial obligation of a Member State following budget approval will continue to be limited to the assessed contribution.
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A structured and transparent financing dialogue 10. The proposed financing dialogue aims to increase the predictability and transparency of WHO’s financing before the implementation of the biennial budget begins. It is a transparent mechanism to allow contributors to enhance the alignment of resources with outputs agreed by Member States, as outlined in the programme budget. It is intended to contribute to the full funding of WHO’s programme budget for 2014–2015.1
Structure of financing dialogue and participation in financing dialogue meetings 11. The financing dialogue will occur after the Health Assembly approves WHO’s programme budget and is marked by two dedicated meetings, tentatively scheduled for 24 June 2013 and 25–26 November 2013. All Member States will be invited to participate in the meetings. In addition, non-State partners who contribute more than US$ 1 million to WHO will be invited (with the exception of private sector commercial enterprises). Participation will be either in-person or via a webstream. The Chairman of the Programme, Budget and Administration Committee will facilitate the discussions of the meetings of the financing dialogue. It is intended that both meetings will encourage dialogue among participants on how best to ensure the financing of the Organization.
First meeting: Launch session of the financing dialogue 12. The first financing discussion has the objective of providing participants with information on the funding needs of the Organization. The meeting will review the planned work of the programme budget for 2014–2015 and provide additional information on what funding is already available for it. This first meeting will also provide participants additional information related to the structure of the second meeting of the financing dialogue, and the methods to monitor progress in contributions to the Organization during the interim period.
Second meeting of the financing dialogue 13. The second meeting of the financing dialogue has the objective of increasing the predictability and alignment of WHO’s financing. The agenda of the meeting will include programmatic detailing of what WHO intends to achieve and where, and will showcase the work of the different levels and different parts of the Organization. The second meeting will highlight financing commitments made to date and identify funding shortfalls in relation to the programme budget. Additional information arising from WHO’s operational planning process will also be provided. 14. It is proposed that, during the second meeting of the financing dialogue, the Director-General will provide a provisional indication of the distribution of flexible monies available to the Organization towards the full funding of each category of work and major office at the beginning of the biennium, based on a detailed analysis of alignment of available resources with the programme budget. 15. The second meeting will enable Member States and non-State contributors to WHO to discuss information provided by the Secretariat in relation to programmatic activities and associated costs. The meeting will also feature a dialogue among Member States and non-State contributors to WHO, to 1
The financing dialogue may not necessarily include discussions concerning the emergencies component of the proposed programme budget for 2014–2015.
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examine existing resource deficits with the aim of identifying joint solutions towards the full funding of WHO’s programme budget. The aim is to formulate a concrete approach to address remaining shortfalls. This will inform the development of an income and financing plan for review and guidance by WHO’s governing bodies in 2014 (see the section on the role of WHO’s governing bodies).
Interim period between meetings of the financing dialogue 16. The period in between the two meetings will comprise discussions between potential contributors and the Secretariat, with a view to articulating commitments in financing for presentation to the November 2013meeting of the financing dialogue. These discussions will build on established WHO channels and mechanisms, and will be based on a clear picture of the Organization’s funding needs. WHO’s operational planning process to take place during this period will also inform the discussions of the second financing dialogue, as described. The Sixty-sixth World Health Assembly DECIDES: To establish a financing dialogue, convened by the Director-General and facilitated by the Chairman of the Programme, Budget and Administration Committee, on the financing of the programme budget, with the first financing dialogue on the proposed programme budget 2014-2015 to take place in 2013, in accordance with the modalities described in this paper.
Strategic allocation of WHO’s resources 17. Historically, allocation of resources in WHO has been a challenging endeavour. The different models employed throughout the Organization’s existence have met with varying degrees of success. 18. In view of experience to date, it is recognized that an Organizational approach to resource allocation must aim to ensure a ‘fair allocation’ of resources to WHO’s major offices, accommodate all WHO’s financial resources, both assessed contributions and voluntary contributions, and address primary concerns of what the assessed contributions will be used for and when the allocation of the assessed contribution per Regional Office will be known. 19. The 2014–2015 programme budget is a transitional budget; the allocation has been informed by Member States’ expectation of a realistic budget based on past trends of income and expenditures as well as agreed organizational deliverables reflecting programmatic shifts in emphasis grounded in health priorities. As a transitional budget, it is important that the Secretariat report regularly to WHO’s governing bodies on income and expenditure for their oversight and guidance on course correction, if appropriate. 20. It is recognized that assessed contributions are the most flexible resources available to the Organization and need to be used strategically. It is also recognized, however, that a divergence that is too drastic from previous allocation may create serious risks for existing, long-term programmatic and staffing commitments. 21. With the shift towards a realistic limit on the programme budget, a new WHO resource allocation methodology is required. WHO needs a transparent, well-coordinated resource mobilization mechanism, with fair allocation of resources that are used and managed effectively and produce desired results. It is intended that resource allocation be rooted in the principles of transparency, equity and support of countries in greatest need, while following a clear definition of resource needs reflecting WHO priorities. Such allocation will be grounded in a robust bottom-up planning process 4
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and realistic bottom-up costing of outputs based on clear roles and responsibilities across the three levels of WHO. In addition, due consideration will continue to be given to performance, the core functions of the Organization, and the areas within WHO that work is best and most effectively performed. The new allocation mechanism will be developed and used for the programme budget to be proposed for 2016–2017.
Role of WHO’s governing bodies in the full funding of WHO’s programme budget 22. The oversight role of WHO’s governing bodies in relation to the financing of WHO’s programme budget can be viewed in the context of the three discernible phases of WHO’s financing cycle:1 priority-setting and programme budget development; the financing dialogue period; and subsequent targeted, coordinated Organization-wide resource mobilization (Figure). 23. In the first phase, priorities for the Organization will be approved by the governing bodies, beginning with the regional committees, through the January session of the Executive Board, and ending with the World Health Assembly’s approval of the programme budget in the year prior to budget implementation. 24. The second phase, which begins once the Health Assembly has approved the programme budget, brings Member States together with WHO’s non-State contributors in a joint and transparent financing dialogue to align resources to the programme budget and ensure greater predictability at the beginning of budget implementation. 25. In relation to the financing dialogue specifically, the Programme, Budget and Administration Committee and the January session of the Executive Boardof the first year of the biennium will consider and provide guidance to the Director-General on the outcome of the financing dialogue to be presented as part of a broader Organizational income, financing and resource mobilization plan. WHO’s governing bodies will also review the Director-General’s use of the different sources of monies available to the Organization towards full funding of each category of work and major office at the beginning of the biennium. 26. The third phase, coordinated Organization-wide resource mobilization, will proceed throughout the course of biennial budget implementation. This phase is aimed at targeting areas requiring further funding pursuant to the financing dialogue. The Secretariat will continue resource mobilization efforts during the programme budget cycle in order to address such shortfalls, as part of the ongoing engagement with partners. A coordinated, Organization-wide resource mobilization plan of action will be developed to be implemented under the leadership of the Director-General and the Regional Directors for review by WHO’s governing bodies. 27. During this third phase, and further to the recommendations of the Executive Board in January, the World Health Assembly in May of the first year of the biennium will review and provide guidance to the Director-General relating to income assured and received, areas within the programme budget still requiring resources, and initial expenditures related to budget implementation. An evaluation of the financing dialogue and resource mobilization experiences will be presented to the Health Assembly in 2014 for Member State review and guidance on any corrective action, where appropriate, in advance of proceeding with the financing process for the proposed programme budget 2016–2017.
1
As noted in EBPBAC/EXO2/2.
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28. The information presented to WHO’s governing bodies in the second year of the biennium will be extended to cover income received, assured and outstanding, funding shortfalls, expenditures and the initial results from one year of implementation. The governing bodies will be invited to provide guidance on the Director-General’s proposals relating to any reprogramming of resources or activities deemed necessary, in view of the progress towards programme budget implementation, new mandates received and World Health Assembly resolutions with associated financial implications or emerging public health needs. Figure: Role of WHO’s governing bodies towards the full funding of WHO’s programme budget Priority setting and development of PB14─15
WHA66 approval of PB14─15
PHASE 1
Financing Dialogue
PHASE 2 First session of Financing Dialogue June 2013 Second session of Financing Dialogue November 2013 Biennial budget implementation 2014─2015 and coordinated Organization‐wide resource mobilization
PHASE 3
PBAC/EB134 January 2014
PBAC/WHA67/EB May2014 • Review recommendations of EB134 Review income assured and received, areas within the programme budget still requiring resources, and initial expenditures related to budget implementation Guidance to Director‐General towards full funding of PB14‐15
PBAC/EB136 January 2015 • Review income received, assured and outstanding, funding shortfalls, expenditures and initial results from one year of budget implementation • Guidance to Director‐General and recommendations to the Sixty‐eighth World Health Assembly towards full funding of PB14‐15, including on the Director‐General’s proposals relating to any reprogramming of resources or activities deemed necessary • Examination of draft PB16‐17 and guidance provided to the Director‐General
PBAC/WHA68/EB May 2015 • Review income received, assured and outstanding, funding shortfalls, expenditures and initial results from one year of budget implementation • Review of recommendations of EB136 and guidance to the Director‐General towards full funding of PB14‐15, including decisions on the Director‐ General’s proposals relating to any reprogramming of resources or activities deemed necessary • Examination and approval of PB16‐17
• Review outcome of financing dialogue
• Guidance of Director‐General
• and recommendations to the Sixty‐seventh World Health Assembly regarding income and financing plan and the Director‐ General’s distribution of flexible resources •
• Review and evaluate financing dialogue and resource mobilization experiences— lessons learnt and guidance on corrective action
=
=
=
6
REGIONAL COMMITTEE Sixty-sixth Session SEARO, New Delhi, India 10–13 September 2013
Provisional Agenda item 3.3 SEA/RC66/5 Inf.Doc.3 22 July 2013
WHO reform and Programme Budget matters: WHO reform: financing dialogue and Programme Budget 2016–2017 In response to World Health Assembly Decision WHA66(8), the Director-General convened the Launch of WHO’s Financing Dialogue on 24 June 2013. The attached document is a report of the launch of WHO’s financing dialogue .
Report of the Launch of WHO’s Financing Dialogue 24 June 2013 1. In response to World Health Assembly DecisionWHA66(8), the Director-General on 24 June convened the Launch of WHO’s Financing Dialogue. Two hundred and fifty-six participants from 87 Member States, six other United Nations agencies and 14 non-State partner organizations, participated in the meeting in person or via webcast 1. 2. The meeting was chaired by Dr Dirk Cuypers, Chairman of the Programme, Budget and Adminstration Committee of the Executive Board. The meeting started with general statements by participants, followed by dedicated sessions on programme, budget and financing aspects and next steps. Ms Maria Luisa Escorel de Moraes of Brazil, Mr Saud Faisal Alsaati of the Kingdom of Saudi Arabia and Dr Anders Nordstrom of Sweden moderated the sessions. Dr Zsuzsanna Jakab, Director, WHO Regional Office for Europe and Dr Mohammed Jama, Assistant Director-General, General Management introduced the topics on behalf of the Secretariat 2. 3. The Financing Dialogue seeks to facilitate a dialogue both with and among Member States and other funders and is underpinned by the following key principles: 3.1. Alignment: Member States and other funders to commit to allocating funding in a way that is fully aligned with the approved Programme Budget. 3.2. Predictability & Flexibility: Member States and other funders to commit to striving for increased predictability and flexibility of their funding. 3.3. Transparency: Member States and other funders to commit to making public their funding allocations (firm pledges as well as provisional figures), to allow for a shared understanding of available income against budget category, programme and major office. 4. The participants re-emphasized the unique role of WHO in advancing the global health agenda and the need for WHO to have the necessary capacity, skills, competencies and the financial resources to pursue its work plan as articulated in the Programme Budget 2014-2015. 5. The decision to embark upon the Financing Dialogue was strongly supported by meeting participants, with several noting that it will facilitate their future funding decisions. There was a broad acknowledgement that it will be a learning process and there were invitations by Member States and other funders to continue the dialogue and exchange of views. Participants were invited to provide feedback on the meeting via an on-line survey and this feedback will help to inform both the work that will take place over the next six months and the design of follow-up meeting to be held in November.
1 2
List of Participants attached Meeting Agenda attached
6. The meeting resulted in specific commitments on the following: 6.1. Alignment: The commitment to respect the priorities set by the World Health Assembly was strongly re-affirmed, with participants who expect to continue to provide funds that are earmarked for a particular location, programme or category, committing that this earmarking would be aligned to the priorities agreed by Member States and presented in the Programme Budget. WHO shall not take on the implementation of projects which are not in line with the priorities in the Programme Budget. 6.2. Predictability: The value in Member States and other funders increasing the predictability of their funding, for, by example, making public in advance their provisional commitments and moving toward multi-year commitments was noted, though several participants highlighted internal constraints that would prevent them from doing so. A number of Member States provided general indications of the amount and shape of their funding for 2014-15 and committed to confirming their contributions by November. Others committed to be ready to share at least indicative information by November. 6.3. Flexibility: Several Member States and other funders expressed their commitment to increase the flexibility of their funding, for example by moving the level of earmarking from project to programme level, or from programme level to category level. Some participants encouraged the Secretariat to explore incentives for contributors to provide more flexible funding. 6.4. Broadening the contributors base: Ten contributors provide more than 60% of WHO’s funding, with the top 20 donors providing more than 80% of WHO’s funding. The vulnerability inherent in this situation was highlighted and the importance of broadening the donor base, in the first instance among Member States, was underscored. One Member State announced that it had provided a supplement to assessed contributions on a voluntary basis. 6.5. Transparency: Meeting participants endorsed a prototype of a web portal WHO is developing in response to Member State calls for increased transparency and accountability around WHO financing. The portal will provide access to real-time results and programmatic, budgetary and financial and monitoring information. It could also allow for tracking of pipeline funding. It was widely acknowledged that the web portal will be a key tool in supporting the Finance Dialogue principles and it was noted that the portal would also help facilitate policy coherence within Member States. 6.6. Continuing the discussion: The discussion shall continue at the Regional Committees, to allow full understanding of this work so that member states can fulfill their responsibility also for the financing of the organization. It was also suggested that a specific discussion, complementary to bilateral discussions, should take place with partners providing core voluntary contributions.
7. In her closing remarks the Director-General paid tribute to Member States for the constructive dialogue, and their commitment to the principles of alignment, transparency, predictability, flexibility and broadening of the contributors base. Based on feedback received during the course of the meeting, she highlighted several actions the Secretariat will be taking that will feed into planning for the follow-up Financing Dialogue meeting in November. 7.1. The web portal will be further developed based on feedback received, with the goal of having it operational in October. There was recognition that this would remain a work in progress for some time, including relating to the level of access to/openness of the web portal. 7.2. Operational planning, a bottom-up process reflecting country-level priorities, is underway. It will establish costed outputs to complement the higher level information provided at the meeting. 7.3. WHO will conduct bilateral follow-up with Member States and other funders as requested, to assist in funding decisions and will work with Member States and other funders to share this information ahead of the November meeting. 7.4. The report of this meeting will be provided to Regional Committees and a synthesis of the Regional Committee discussions will be made available ahead of the November meeting. 7.5. WHO will respond to Member State calls for a more coordinated approach to resource mobilization and income planning across all levels of the Organization as well as a plan for the work beyond November. 7.6. WHO will work to broaden the contributors base, starting with Member States, and will continue to explore additional opportunities to increase income, including through “voluntary” assessed contributions, as has been suggest ed by some Member States. 7.7. At the November meeting of the financing dialogue, the Director-General will give an indication of the strategic use of assessed contributions to ensure core programs are operational.
REGIONAL COMMITTEE
Provisional Agenda item 3.3
Sixty-sixth Session SEARO, New Delhi, India 10–13 September 2013
SEA/RC66/5 Inf.Doc.4 4 September 2013
WHO reform and Programme Budget matters: WHO reform: financing dialogue and Programme Budget 2016–2017 The attached document is a concept note on Preparation of the Proposed Programme Budget 2016–2017, developed by WHO headquarters for discussions at the regional committee meetings. The document describes the key steps and process for development of the Programme Budget 2016–2017. The document is submitted to the Sixty-sixth Session of the Regional Committee for review and comments.
Preparation of the Proposed programme budget 2016–2017
Context 1. The Twelfth General Programme of Work, 2014–2019 and the Programme budget 2014–2015 constituted a first step in the continuing process of implementing programmatic and managerial reforms at WHO. The Twelfth General Programme of Work establishes the leadership priorities, categories of work and expected results for the Organization. The Programme budget 2014 –2015 further elaborates this by identifying the outputs to be achieved and delineating the roles, functions and deliverables of each level of the Organization. 2. Despite marking a significant step forward, the Programme budget 2014–2015 is a transitional budget. Further improvements are needed. Two areas in particular need to be addressed in the development process for the Proposed programme budget 2016–2017: (a) bottom-up planning based on country priorities; and (b) a standardized approach to costing outputs. Dealing with these two points represents a paradigm shift in terms of the planning and budgeting of the Organization. 3. The present document provides an update on interim measures taken to improve these areas of weakness during the operational planning of the Programme budget 2014–2015; it also gives an outline of issues requiring further attention in the preparation of the Proposed programme budget 2016–2017.
Operational planning for the Programme budget 2014–2015 4. Since the approval by the Health Assembly in May of the Programme budget 2014–2015,1 a coordinated operational planning process has been initiated to ensure that all three levels of the Organization are aligned to produce the results and deliverables outlined in the Programme budget 2014–2015. 5. The first step has been to align operational planning for the biennium 2014–2015 with country priorities. To this end, each region has launched a process of country consultations in order to identify a focused set of priority areas for WHO technical cooperation. These priority areas, including specific results and deliverables, are informed by the leadership priorities and expected results outlined in the Twelfth General Programme of Work and the Programme budget 2014–2015, as well as by the national health policy, strategies and investment priorities. 6. The priorities for WHO technical cooperation indicated by countries are being consolidated and discussed through the global category and programme networks to ensure coherence across all levels of the Organization and alignment with the priorities and results outlined in the Twelfth General Programme of Work and the Programme budget 2014–2015. Based on requests received for technical cooperation, as well as the identification of global and regional priority work, each budget centre develops its individual workplans together with its resource requirements in terms of staffing and activities. 7. Following an Organization-wide review, the draft workplans and resource requirements will be summarized and presented at the November meeting of the financing dialogue; an analysis will also be provided of the income available for the Programme budget 2014–2015 together with any financing gaps.
1
See resolution WHA66.2.
PB16–17 Concept Note Final
Lessons learnt 8. During the current operational planning process, progress has been made in tackling the issues identified. However, a number of lessons have been learnt that should inform the development process of the Proposed programme budget 2016–2017. (i) The “country priorities” are mentioned in several instances, but are not consistently defined; nor has a common approach to identifying them been adopted across the Organization. In many cases, the WHO country cooperation strategies lack the necessary detail for defining the biennial work programme. In addition, they are not always up-to-date and are not necessarily consistent with current national health priorities. (ii) The lack of a comprehensive and common approach to country prioritization often means that scarce resources are spread too thinly, and are allocated without strategic focus. WHO’s cooperation with countries often involves the provision of small grants to health ministries. In many cases, clear deliverables and tangible results are not well articulated. Accountability and financial management systems tend to be less than optimal. (iii) Even when the country prioritization process is conducted effectively, the priorities for technical cooperation are often not in line with the budget allocations as approved in the programme budget. This occurs because the detailed consultations at country level are undertaken after the approval of the budget. (iv) The country prioritization process takes place in parallel with planning at regional offices and headquarters and does not sufficiently influence the prioritization of regional and global deliverables such as norms, standards and guidelines, which should ideally be informed by the country needs. (v) The Organization does employ some forms of standard costing – in particular in relation to staff costs – but the lack of a standardized approach to the planning and costing of outputs and deliverables across all levels means that it is difficult to compare and assess their costs across the three levels of the Organization. (vi) The current budgeting system separates technical delivery costs from those associated with administration and management. As a result, administration and management costs are seen as either “divorced from” or “additional to” the costs for technical delivery and their nature is not well understood. The standardized costing of outputs and deliverables should include both the costs directly attributable to the outputs and those that contribute indirectly, such as programme coordination, administrative, building, security, leadership and governance costs.
Timeline and sequencing 9. The issues identified above need to be addressed in the process for developing the Proposed programme budget 2016–2017. In particular, the consultations with countries to identify a focused set of priority areas for WHO technical cooperation based on leadership priorities and expected results outlined in the Twelfth General Programme of Work – as well as on the national health policy, strategies and investment priorities – need to take place at beginning of the process rather than towards the end as is currently the case. This would require a number of steps to be taken before the regional committees in 2014:
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PB16–17 Concept Note Final
(i) the organization of country consultations to identify priority areas for technical cooperation, including specific results and deliverables; (ii) the review of country technical cooperation priorities together with the identification of regional and global results and deliverables, which are themselves informed by priorities for country technical cooperation as well as by global and regional needs; and (iii) the completion of budget development, based on a standardized approach to costing outputs and deliverables. 10. The result of this process would be the draft Proposed programme budget 2016–2017, which would be presented at the regional committees in 2014. 11. The regional committees are invited to share experiences of the operational planning process for the Programme budget 2014–2015, and to comment on the issues raised in this paper. Based on the regional committees’ comments, a more detailed description of the process for development of the Proposed programme budget 2016–2017 will be presented to the Executive Board at its 134th session in January 2014.
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REGIONAL COMMITTEE Sixty-sixth Session SEARO, New Delhi, India 10–13 September 2013
Provisional Agenda item 3.3 SEA/RC66/5 Inf.Doc.5 5 September 2013
WHO reform and Programme Budget matters: WHO reform: financing dialogue and Programme Budget 2016–2017 The attached document contains frequently asked questions (FAQs) related to WHO’s financing dialogue, developed by WHO headquarters for the information of the regional committees.
WHO’s Financing Dialogue Frequently Asked Questions: For 2013 Regional Committees Prepared by the Financing Dialogue Global Project Team
Q) Why is WHO having a financing dialogue? A) A key element of WHO reform, the Financing Dialogue with member states and key non-state contributors is designed to ensure that WHO is well-equipped to address the increasingly complex challenges of the health of populations in the 21st century. The dialogue aims to ensure a match between WHO’s results and deliverables as agreed in the US$3.977 b 2014-2015 Programme Budget and the resources available to finance them, with the ultimate objective of enhancing the quality and effectiveness of WHO’s work. It aims to achieve full funding of the Programme Budget. The Dialogue was launched at a meeting on 24 June 2013. A second Financing Dialogue meeting will be held on 25-26 November. Q) Who attended the 24 June Launch of WHO’s Financing Dialogue? A) All member states and non-state actors contributing more than $1 million (excluding the commercial private sector) were invited to the meeting. Two hundred and fifty-six participants from 87 member states, six other UN agencies and 14 non-state partner organizations attended the meeting in person or via webcast. Q) What were the key outcomes of the June meeting? A) The meeting re-affirmed the principles of alignment, transparency, predictability, flexibility and broadening the donor base, in the first instance among member states. The secretariat and member states committed to take action between the June and November meetings to ensure that we reach our shared goal of predictable funding aligned with the priorities defined by Member States. Specific commitments made relating to the following principles included: (i) Alignment: The commitment to respect the priorities set by the World Health Assembly was strongly re-affirmed, with participants who expect to provide earmarked funds committing that this earmarking would be aligned to these priorities and presented in the Programme Budget. (ii) Predictability: A number of Member States provided general indications of the amount and shape of their funding for 2014-2015 and committed to confirming their contributions by November. Others committed to be ready to share at least indicative information by November. (iii) Flexibility: Several participants expressed their commitment to increase the flexibility of their funding, with some encouraging the Secretariat to explore incentives for contributors to provide more flexible funding. (iv) Broadening the contributors base: Twenty donors provide more than 80% of WHO’s funding. The vulnerability inherent in this situation was highlighted and the importance of broadening the donor base, in the first instance among Member States, was underscored.
(v) Transparency: Meeting participants endorsed a prototype of a web portal WHO is developing in response to Member State calls for increased transparency and accountability around WHO financing. The portal will provide access to real-time results and programmatic, budgetary and financial and monitoring information. (vi) Continuing the discussion: Participants committed to continuing the discussion, in WHO Regional Committees and bilateral discussions, in the lead-up to the second Financing Dialogue meeting in November. Q) What has happened since the June meeting? A) WHO in August sent Circular Letters to all Geneva-based missions offering bilateral meetings to discuss how commitments of the June meeting can begin to be operationalized. The DirectorGeneral wrote similar letters to Heads of Development agencies. Follow-up to these letters is being coordinated between HQ and the regions and is focusing on (i) member states that provide voluntary contributions, (ii) BRICS and G20 members who don’t fall into this category and (iii) smaller MS with the potential to provide/increase voluntary contributions. Financing discussions at Regional Committees and at Geneva-based mission briefings are also taking place, with a view to helping member states operationalize the general commitments made in June. Operational planning, a bottom-up process that responds to country-level priorities, is wellunderway. It is establishing further detailed budgets at output level to complement the high-level information contained in the Programme Budget that member states approved at the World Health Assembly. The Secretariat has also launched an income planning process. Q) What are the objectives of the bilateral meetings? A) Meetings will be designed to: (i) understand opportunities and challenges that may exist to contributors increasing the predictability, alignment, flexibility and/or transparency of their funding to WHO, (ii) explore actions needed to influence the amount/predictability/ alignment/flexibility/and/or transparency of funding for 2014-2015, and (iii) identify next steps in identifying details of 2014-2015 funding and what might be possible to have ready to share, also with others, ahead of the November meeting. Q) What are the objectives of the November Financing Dialogue meeting? A) The objectives of the November meeting are (i) to enable contributors to express financing commitments/intentions for 2014-2015 in advance of, or at, the meeting, (ii) to identify areas of underfunding in view of expressed financing commitments/intentions and (iii) to identify solutions to address areas of underfunding. Q) What budget and financing information will be available for the November meeting? A) 2014-2015 budget information will be available down to output level, complementing the higher-level budget information by category, programme and major office presented in the Programme Budget. Distribution of 2014-2015 income received to date will be presented at category, programme and major office level, providing a clear picture of funding gaps by category, programme and major office.
Q) When will invitations for the November meeting be issued and when will meeting materials be available? A) 14 October is the target date for invitations to the November meeting to be issued, together with the meeting agenda. Meeting materials (including a synthesis report of the Financing Dialogue discussions at the Regional Committees and the link to the live web portal which will provide participants with updated 2014-2015 income and gaps information) will be posted on the Financing Dialogue website two weeks before the meeting. Q) How should participants to the November meeting prepare for the meeting? A) It is hoped that member state and other contributors to WHO are using the time between the June and November Financing Dialogue meetings to gather the information they need (from WHO and internally) to be able either ahead of, or at, the meeting to share information regarding the amount and specificity of their 2014-2015 funding. For some contributors it may not be possible to provide firm funding commitments: in these cases, contributors will be encouraged to provide funding projections. Having information on firm and projected funding will in turn facilitate an understanding of areas of underfunding and allow for the identification of possible actions that could be taken to ensure a fully-funded 2014-2015 Programme Budget. Q) What happens if the 2014-15 Programme Budget is not fully funded by 31 December 2013? A) Following the November Financing Dialogue meeting, the Secretariat will launch a coordinated resource mobilization plan to raise the remaining funds required to fully finance the Programme Budget. The Director-General will report to WHO Governing Bodies on the progress of the plan. Q) Where can I get more information? A) Questions can be sent to financedialogue@who.int or can be directed to any member of the Financing Dialogue global project team. Team members are listed on the PRP intranet site .