REGIONAL COMMITTEE Provisional Agenda item 7.2 Seventy-third Session SEA/RC73/6 Rev. 1 (Virtual) Thailand 9–10 September 2020 6 September 2020 Programme Budget 2020–2021: Implementation Consistent with WHO’s accountability framework, this Working Paper provides an update on implementation of the Programme Budget 2020–2021 in the South-East Asia Region for the first semester of the current biennium (January–June 2020). The Programme Budget 2020–2021 was approved by the Seventy-second World Health Assembly in May 2019 vide resolution WHA72.1. It aims to turn the bold vision of the Thirteenth General Programme of Work (GPW13) 2019–2023 into reality: by delivering impact for people at the country level. It is the first Programme Budget developed under GPW13 and a vital element in ensuring implementation of the strategy set forth in GPW13. The vision of GPW-13 – impact for people at the country level – is also the overarching objective of the Programme Budget 2020–2021. This Working Paper includes the progress made on: (i) financing and implementing the Programme Budget 2020–2021; (ii) development of the Thirteenth General Programme of Work Results Framework, including the new approach for Programme Budget monitoring using the Output scorecard; and (iii) the ongoing review of the Programme Budget considering the COVID-19 pandemic situation. The total approved Programme Budget 2020–2021 for the Organization amounts to US$ 5840.4 million, comprising US$ 3768.7 million for the Base segment, US$ 863 million for the Polio eradication segment, US$ 208.7 million for the Special Programmes segment and US$ 1000 million for the Emergency Operations and Appeals segment (i.e. OCR segment). The Base Budget of 2020–2021 is 11% higher than that of 2018–2019. The approved Programme Budget 2020–2021 for the WHO South-East Asia Region is US$ 446.6 million, comprising US$ 388.5 million for the Base segment (inclusive of polio transition), US$ 12.1 million for the Polio eradication segment and US$ 46 million for the Emergency Operations and Appeals segment. The Base Budget for the SEA Region has increased by approximately 35% (US$ 99.7 million) vis-à-vis 2018–2019, mostly due to the transition of key polio activities into essential public health functions. As on 30 June 2020, the approved Programme Budget was funded at 59% (US$ 264.2 million/US$ 446.6 million); and implementation (expenditure) was 20% against the approved Budget and 35% against total distributed resources. The COVID-19 pandemic has adversely affected the planned implementation of the approved Programme Budget 2020–2021. The Secretariat is undertaking a review to assess the impact and identify necessary reprogramming and repurposing of workplans considering the evolving situation, and new ways of working in the light of the ‘new’ reality. The Secretariat remains committed to implement the approved Programme Budget 2020–2021 with Member States and partners, while continuing to support efforts to respond and mitigate the effects of COVID-19. This Working Paper was presented to the Thirteenth Meeting of the Subcommittee on Policy and Programme Development and Management (SPPDM) for its review and recommendations. The Subcommittee on Policy and Programme Development and Management reviewed this report, and made the following recommendations to the Seventy- third Session of the WHO Regional Committee for South-East Asia: Actions by Member States (1) Maintain essential health services and programmes while ensuring an effective response to the COVID-19 pandemic. (2) Strengthen systems to ensure regular monitoring of implementation at the country level. (3) Continue participating in the implementation of the GPW13 Results Framework jointly with the WHO Secretariat. Actions by WHO (1) Continue working with Member States and other partners to strengthen national capacity to track progress towards the Thirteenth General Programme of Work targets and the health-related Sustainable Development Goals. (2) Continue to mobilize resources to fully fund the Programme Budget 2020–2021 and efforts to minimize adverse impact of the COVID-19 pandemic on programme implementation. (3) Update and consult Member States on the development of the Programme Budget 2022–2023 at the Regional Committee Session. The updated implementation data, as of 31 August 2020, is attached as Annexes 1A, 2A, 3A and 4A. SEA/RC73/6 Rev. 1 Introduction 1. This Working Paper presents an update on implementation of the Programme Budget (PB) 2020–2021 in the WHO South-East Asia Region in the first semester of 2020–2021. The paper considers the challenges being faced in implementing the approved Programme Budget while responding to the unprecedented COVID-19 pandemic. 2. Programme Budget 2020–2021 was approved by the Seventy-second World Health Assembly in May 2019 vide resolution WHA72.1. It aims to turn the bold vision of the Thirteenth General Programme of Work (GPW13) 2019–2023 into reality: by delivering impact for people at the country level. It is the first Programme Budget developed under GPW13 and, therefore, is an instrument vital for the operationalization of the strategy and achievement of the results and targets set forth in the General Programme of Work. Current situation, response and challenges A. Programme implementation and new results framework 3. WHO is fully committed to implement Programme Budget 2020–2021 while responding to the COVID-19 pandemic. However, implementation of the Programme Budget 2020–2021 has been affected since the beginning of the biennium due to the unprecedented impact and scale of response required for the COVID-19 pandemic at global, regional and national levels. While the focus has been on supporting Member States in responding to COVID-19, the Organization has continued to implement other critical activities with particular attention accorded to essential health services and programmes to protect public health gains. Regional and country office teams have implemented new ways of working via the use of online platforms and tools for continued engagement with and support to countries drawing on experts and networks at the country, regional and global levels. 4. The Organization has initiated a review of workplans to identify their necessary reprogramming and repurposing, considering the priorities and needs in the light of the evolving situation. The main objective of the exercise is to assess the impact and identify mitigation actions, including new ways of working, to ensure that commitments are honoured considering the new reality. This review is work-in-process considering the current situation, and subsequent reviews may be carried out depending on the needs. The Secretariat is also carrying out an analysis of the potential impact of the halt in funding from the United States of America on implementation of the Programme Budget 2020–2021 to identify the major gaps and mitigation measures. Overall funding from the United States in 2018–2019 was US$ 922 million, accounting for about 16% of total funding to WHO; in the SEA Region it was 17% (or US$ 63.8 million) of total funds available for the biennium. 5. While approving the Programme Budget 2020–2021 in May 2019, the Seventy-second World Health Assembly requested the WHO Director-General to continue developing the results framework of the Thirteenth General Programme of Work 2019–2023, in consultation with Member states, and to present it to the Executive Board at its 146th Session in February 2020. SEA/RC73/6 Rev. 1 Page 2 6. The Secretariat presented an update on the Thirteenth General Programme of Work results framework to the 146th session of the Executive Board, including a summary of the methods for measuring the 46 outcome indicators, the indices for the “Triple Billion” goals (UHC index, health emergency protection index and healthier population index), and the healthy life expectancy (HALE) measure – used as an overarching measurement of the General Programme of Work. This update also included progress on the development of the new Output scorecard approach to measure what the Secretariat delivers and how this contributes to the achievement of outcomes and impacts. The Output scorecard is an innovative approach aimed at improving accountability and performance of the Organization. 7. The updated results framework, including methods and tools to track progress, were presented to the Second Global Consultation (on 16–17 April 2020) held virtually, and a paper with the final draft results framework was prepared for the Seventy-third World Health Assembly (see World Health Assembly document A73/16 attached as Information Document SEA/SPPDM- Meet/2.2 INF. DOC. 1). The WHO results framework has been refined with inputs from Member States at regional and global consultations, as well as pilot-testing conducted in countries. In the Region, Bangladesh, Bhutan, India, Maldives, Nepal, Sri Lanka, Thailand and Timor-Leste participated actively in such pilot-testing. 8. The SEA Regional Office conducted a piloting of the new Output Scorecard approach from 27 April to 1 May 2020 and provided inputs for improvements. This new approach is expected to be rolled out in November 2020 and used for the mid-term monitoring of the Programme Budget 2020–2021. This new approach will replace previous outputs and Top Task monitoring done by budget centres. 9. The Secretariat will continue working with Member States and other partners to strengthen national capacity to track progress towards the Thirteenth General Programme of Work targets and the health-related Sustainable Development Goals (SDGs). A one-stop database of official country data to track progress towards the health-related SDGs and Triple Billion Targets will be launched in July 2020 by the Secretariat. These analyses will generate further opportunities for all three levels to align planning, implementation and measurement of impact achieved at the country level. B. Financial implementation 10. The total approved Programme Budget 2020–2021 for the Organization amounts to US$ 5840.4 million. The Base Budget of 2020–2021 is 11% higher than that of 2018–2019. Table 1 presents the composition of the Programme Budget 2020–2021, distributed resources and implementation. SEA/RC73/6 Rev. 1 Page 3 Table 1: Global Programme Budget 2020–2021, distributed resources and implementation by segment (in US$ million) Segment Approved Programme Budget Distributed resources Resources as % of approved Budget Implementation (expenditure) Implementation as % of approved Budget Implementation as % of distributed resources Base programmes 3 768.7 1 994.8 53% 660.5 18% 33% Polio eradication 863.0 377.8 44% 142.2 16% 38% Emergency operations and appeals 1 000.0 1 332.4 133% 497.8 50% 37% Special programmes1 208.7 130.4 63% 24.1 12% 18% Total 5 840.4 3 835.4 66% 1 324.6 23% 35% 11. Distributed resources across different segments range from 44% for the Polio eradication segment to 133% for Emergency Operations and Appeals segment, mostly due to resources mobilized to support the COVID-19 pandemic response. Implementation rate to approved Budget across different segments ranges from 12% for Special Programmes to 50% for Emergency Operations and Appeals segment. 12. Annexure 1 presents a summary view of the approved Programme Budget, resources distributed and implementation across all Major Offices. All Major Offices, except the Regional Office for the Americas, have their approved Budget funded by over 50%. The SEA Region is at third place among the regions in terms of Programme Budget funding and implementation of distributed resources. Annexure 1A presents updated figures of the above as on 31 August 2020. Regional perspective 13. The total approved Programme Budget for the WHO South-East Asia Region is US$ 446.6 million. Base Budget for the SEA Region has increased by 35% approximately (US$ 99.7 million) vis-à-vis 2018–2019, mostly due to the transition of key polio activities into essential public health functions. Table 2 below presents the approved regional Programme Budget 2020–2021 by Strategic Priorities and Segments, distributed resources and implementation. 1 Includes Research Development and Research Training in Human Reproduction; Research and Training in Tropical Disease Research (TDR); and Pandemic Influenza Preparedness (PIP) SEA/RC73/6 Rev. 1 Page 4 Table 2: Programme Budget 2020–2021: Approved Budget, distributed resources, implementation and utilization by Strategic Priorities and Segments (in US$ million) GPW13 – Strategic Priorities/Segments Ap pr ov ed P B D is tr ib ut ed re so ur ce s % D is tr ib ut ed re so ur ce s vs ap pr ov ed P B Im pl em en ta tio n (e xp en di tu re ) U til iz at io n (e xp en di tu re + en cu m br an ce s) Ba la nc e av ai la bl e % U til iz at io n vs ap pr ov ed P B % U til iz at io n vs re so ur ce s % Im pl em en ta tio n vs a pp ro ve d PB % Im pl em en ta tio n vs r es ou rc es 1. One billion more people benefiting from universal health coverage 160.7 91.9 57% 32.4 49.0 42.9 30% 53% 20% 35% 2. One billion more people better protected from health emergencies 107.8 29.2 27% 13.3 16.9 12.3 16% 58% 12% 46% 3. One billion more people enjoying better health and well-being 30.8 16.6 54% 4.7 6.0 10.6 19% 36% 15% 28% 4. More effective and efficient WHO providing better support to countries 89.2 37.8 42% 16.2 22.2 15.6 25% 59% 18% 43% Total Base Programmes 388.5 175.5 45% 66.6 94.1 81.4 24% 54% 17% 38% 10. Polio eradication 12.1 5.3 44% 2.9 3.1 2.2 26% 59% 24% 54% 13. Emergency Operations and Appeals 46.0 72.5 158% 20.7 29.0 43.5 63% 40% 45% 29% Total approved PB 446.6 253.3 57% 90.2 126.2 127.1 28% 50% 20% 36% 14. Special Programmes 0.0 5.0 N/A 0.9 1.3 3.7 N/A 27% N/A 19% Grand total 446.6 258.3 N/A 91.1 127.5 130.8 N/A 49% N/A 35% 14. Although the Programme Budget has an overall higher level of funding at this stage compared with the previous biennium, funding by Strategic Priorities and Segments is uneven. Distributed resources across different segments range from 44% of the approved Budget for Polio eradication segment to 158% for Emergency Operations and Appeals segment. This variation is mostly due to resources mobilized and distributed for the COVID-19 pandemic response. Base segment funding stands at 45% of the approved Budget. Among the three Strategic Priorities (SP), SP-2 or Health Emergencies remains the least funded at merely 27% of its approved Budget. 15. The total distributed resources for the Region currently are US$ 258.3 million and implementation (expenditure) is US$ 91.1 million, which amounts to 35% of the distributed resources. Utilization (expenditure plus encumbrances) is US$ 127.5 million, which amounts to 49% of the distributed resources. 16. The distributed resources amount to 57% of the approved Programme Budget and its implementation and utilization are 20% and 28%, respectively. Of the total distributed resources, US$ 74.5 million (29%) are flexible funds and US$ 183.8 million (71%) are Voluntary Contributions. Flexible funds allocations for the biennium are usually received in two tranches of 50% each. The first tranche was received at the start of the biennium and the second tranche is expected by November 2020. Voluntary contributions flow during the biennium as per donor agreements. SEA/RC73/6 Rev. 1 Page 5 17. The top priorities of the Thirteenth General Programme of Work agreed with that of countries for WHO’s support and the Regional Flagship Priority Programmes continued to guide the allocation of resources available to respond to such priorities. In line with the “Vision” of the Regional Director and regional focus on driving impact at the country level, 81% of the Region’s total financial resources have been distributed to WHO country offices. This percentage has increased with 87% of the COVID-19 response funds directed to countries. 18. The implementation (expenditure) of distributed resources was 33% (US$ 29.9 million) in staff costs and 67% (US$ 61.2 million) for activities. 19. The SEA Region has received resources to the tune of US$ 56.1 million for COVID-19 response. This includes funds allocated by WHO headquarters and those mobilized at regional and country levels. The top three donors for the SEA Region, contributing almost 60% of all COVID-19 funds received to date, are: Japan (US$ 21.5 million, or 38%), DFID (US$ 6.6 million, or 12%) and USAID (US$ 5.6 million, or 10%). As on 30 June 2020, overall implementation against distributed resources for COVID-19 resources stands at 33% and utilization at 44%. Annexure 4 provides the implementation status of COVID-19 funds by country. Annexure 4A presents updated figures of the above as on 31 August 2020 20. As on 30 June 2020, 87% of COVID-19 funds have been distributed to countries. The distribution of COVID-19 funds is being done in line with the following criteria: (i) alignment with national priorities as reflected in costed national action plans/country preparedness and response plans to COVID-19; (ii) country’s risk and vulnerability to COVID-19 and their progression to/ resolution of different transmission scenarios; (iii) implementation mechanisms and processes in place for response; and (iv) synergy for available resources (in country and from other sources). 21. In addition to the approved Programme Budget, the Secretariat uses allocated Programme Budgets to manage the flow of funds during the biennium to regional and country office workplans as per programmatic needs. The Programme Budget allocations are dynamic and are constantly revised. The current allocated Programme Budget stands at US$ 485.1 million (reflecting a total increase over the Approved Budget of US$ 38.5 million: US$ 30.9 million for COVID-19 response and US$ 7.6 million for Special Programmes – US$ 4 million for Research Development and Research Training in Human Reproduction and US$ 3.6 million for Pandemic Influenza Preparedness). Annexure 3 presents the status of implementation by countries for reference of respective Member States of this Region and the Regional Office as a whole. Annexure 2 presents implementation figures classified by Outcomes under the Base Segment. Annexure 2A and 3A present updated figures of the above as on 31 August 2020 SEA/RC73/6 Rev. 1 Page 6 22. Figure 1 below shows a comparison with the approved Budget, distributed resources and implementation at the same point of time in the previous biennium. As displayed, there is an increase in approved Programme Budget (by 19%), distributed resources (by 31%) and implementation (by 28%) in the current biennium. Furthermore, implementation in the current biennium is higher in absolute terms by US$ 19.6 million vis-à-vis 2018–2019. In percentage terms, implementation against distributed resources is the same in both bienniums and implementation against approved Budget is higher in the current biennium by one percentage point. All this confirms that the Budget increase for 2020–2021 was based on realistic planning. Figure 1: Comparison of Budget, funding and implementation with the previous biennium (in US$ million) * Programme Budget 2020–2021 includes OCR as part of the approved Budget while the last biennium of 2018–2019 did not. To make figures comparable between the two bienniums, allocated Budget of US$ 31.1 million for OCR has been added to the approved Programme Budget for 2018–2019. 23. Figure 2 depicts the impact of the largescale emergency operations, which included international procurement of emergency supplies and other technical and logistics in response to the COVID-19 pandemic on the planned implementation of the Programme Budget. As it can be appreciated, the Region had a better start than the last biennium in terms of utilization rate during the first three months of 2020. However, the impact of closures/lockdowns in countries and restrictions on international travel were felt thereafter as the countries of the Region focused on containing the spread of COVID-19. Despite this situation, it is encouraging to see that at the end of June 2020 the Region is at the same level as it was at the end of the first semester in 2018– 2019. This shows the capacity of the Region to implement the additional resources being mobilized and, as the restrictions are lifted in countries, the Region can regain its full momentum to implement other planned activities in addition to the continued response required for COVID-19. SEA/RC73/6 Rev. 1 Page 7 Figure 2: Comparison of utilization rate with previous biennium 24. Figure 3 below presents the total expenditure by “expenditure type”. The main components of the total expenditure of US$ 91.1 million are “Staff and other Personnel Costs” (33%), “Contractual Services” (28%), “Transfers and grants to Counterparts” (19%), “General Operating Expenses” (11%), and the balance 9% for other activities. Figure 3: Programme Budget 2020–2021 expenses by expenditure type Financing of the Programme Budget 25. The full financing of the Programme Budget requires a combination of the right levels of financing from flexible funds (comprising Assessed Contributions, Programme Support Cost and Core Voluntary Contributions) and Voluntary Contributions. 26. The total funds available to the Region are US$ 264.2 million, of which 71% is from Voluntary Contributions and 29% from flexible funds as shown in Table 3 below. It is worth noting that 30% (US$ 56.1 million) of the Voluntary Contributions are funds mobilized for COVID-19 response. 0% 5% 10% 15% 20% 25% 30% Feb Mar Apr May Jun Utilization rate against Allocated PB 2018-2019 2020-2021 SEA/RC73/6 Rev. 1 Page 8 Table 3: Financing of Programme Budget 2020–2021 by funding source (in US$ million) Funding source Funds available Voluntary Contributions (VC) 187.2 Flexible funds 77.0 Grand total * 264.2 * Includes undistributed resources to the tune of US$ 5.9 million. 27. Table 4 shows the contribution of the top 10 donors during the first six months of the biennium. Their contribution accounts for 74% of the total Voluntary Contributions. Table 4: Top 10 donors for the SEA Region, Programme Budget 2020–2021 (in US$ million) Donor name Funds available GAVI Alliance 47.7 Japan 21.5 Department for International Development (DFID), United Kingdom 14.4 United States Agency for International Development (USAID) 13.5 India 10.3 United Nations Office for Project Services (UNOPS) 6.8 United Nations Population Fund (UNFPA) 6.1 Centers for Disease Control and Prevention (CDC), United States of America 6.0 Bill & Melinda Gates Foundation 6.0 Department of Foreign Affairs and Trade (DFAT), Australia 5.7 Others 49.2 Total 187.2 The way forward 28. To continue with efforts to fully fund Programme Budget 2020–2021, including implementation of the new WHO Strategic Resource Mobilization Framework that seeks to increase the quality of financing to align resources with the priorities that have been agreed upon with Member States. 29. To continue to take steps to minimize the adverse impact of COVID-19 on implementation of the approved Programme Budget 2020–2021 and reprogram workplans as necessary. 30. To continue engaging with Member States in the implementation of the Thirteenth General Programme of Work results framework and conduct the mid-term assessment of the Programme Budget 2020–2021 applying the new approaches and tools developed. SEA/RC73/6 Rev. 1 Page 9 Annexure 1 Global Programme Budget 2020–2021 Financing and Implementation by Major Offices (in US$ million, as on 30 June 2020) Major Office Approved PB Distributed resources % resources to approved PB Implementation (expenditure) % impl. to approved PB % impl. to Resources Africa 1 519.2 773.7 51% 322.8 21% 42% Americas 228.9 112.8 49% 35.8 16% 32% Eastern Mediterranean 1 050.7 864.1 82% 283.6 27% 33% Europe 384.7 239.3 62% 89.1 23% 37% Headquarters 1 874.6 1 405.9 75% 446.7 24% 32% South-East Asia 446.6 258.3 58% 91.1 20% 35% Western Pacific 335.7 181.3 54% 55.4 16% 31% Grand total 5 840.4 3 835.4 66% 1 324.6 23% 35% (See updated Annex 1A with figures as on 31 August 2020) SEA/RC73/6 Rev. 1 Page 10 Annexure 2 Base Programme Budget 2020–2021, its distributed resources and expenditure by outcomes (as on 30 June 2020) Strategic Priority/Outcome Approved Programme Budget Distributed resources Resources as % of approved Budget Implementation (expenditure) Implementation as % of approved Budget Implementation as % of resources 1. One billion more people benefiting from universal health coverage 1.1. Improved access to quality essential health services 129.8 81.7 63% 28.7 22% 35% 1.2. Reduced number of people suffering financial hardships 7.7 2.3 30% 0.8 11% 35% 1.3. Improved access to essential medicines, vaccines, diagnostics and devices for primary health care 23.2 7.9 34% 2.9 13% 37% Subtotal 1 160.7 91.9 57% 32.4 20% 35% 2. One billion more people better protected from health emergencies 2.1. Countries prepared for health emergencies 15.3 3.3 22% 1.5 10% 46% 2.2. Epidemics and pandemics prevented 80.1 23.8 30% 10.4 13% 44% 2.3. Health emergencies rapidly detected and responded to 12.4 2.1 17% 1.4 11% 66% Subtotal 2 107.8 29.2 27% 13.3 12% 46% 3. One billion more people enjoying better health and well-being 3.1. Determinants of health addressed 11.8 8.5 72% 2.0 17% 24% 3.2. Risk factors reduced through multisectoral action 15.4 6.6 43% 2.1 13% 31% 3.3. Healthy settings and Health in All Policies promoted 3.6 1.5 40% 0.6 18% 44% Subtotal 3 30.8 16.6 54% 4.7 15% 28% SEA/RC73/6 Rev. 1 Page 11 Strategic Priority/Outcome Approved Programme Budget Distributed resources Resources as % of approved Budget Implementation (expenditure) Implementation as % of approved Budget Implementation as % of resources 4. More effective and efficient WHO providing better support to countries 4.1. Strengthened country capacity in data and innovation 21.6 9.4 43% 3.1 14% 33% 4.2. Strengthened leadership, governance and advocacy for health 32.2 12.3 38% 5.4 17% 44% 4.3. Financial, human, and administrative resources managed in an efficient, effective, results- oriented and transparent manner 35.4 16.1 46% 7.7 22% 48% Subtotal 4 89.2 37.8 42% 16.2 18% 43% Grand total 388.5 175.5 45% 66.6 17% 38% (See updated Annex 2A with figures as on 31 August 2020) SEA/RC73/6 Rev. 1 Page 12 Annexure 3 Programme Budget 2020–2021: Budget, distributed resources and implementation by country (in US$ million, as on 30 June 2020) Bu dg et C en tr e Al lo ca te d PB D is tr ib ut ed re so ur ce s % D is tr ib ut ed re so ur ce s vs al lo ca te d PB Im pl em en ta tio n (e xp en di tu re ) U til iz at io n (e xp en di tu re + en cu m br an ce ) Ba la nc e av ai la bl e % U til iz at io n vs al lo ca te d PB % U til iz at io n vs di st ri bu te d re so ur ce s % Im pl em en ta tio n vs a llo ca te d PB % Im pl em en ta tio n vs d is tr ib ut ed re so ur ce s SE_BAN 50.2 37.6 75% 13.3 17.4 20.3 35% 46% 27% 35% SE_BHU 7.0 3.8 55% 1.1 1.5 2.3 22% 40% 16% 29% SE_IND 106.5 50.6 48% 25.4 35.1 15.5 33% 69% 24% 50% SE_INO 41.0 27.6 67% 8.9 10.4 17.2 25% 38% 22% 32% SE_KRD 20.8 15.0 72% 1.2 2.3 12.8 11% 15% 6% 8% SE_MAV 7.1 4.4 61% 1.3 3.0 1.4 42% 68% 18% 29% SE_MMR 42.6 26.6 62% 9.1 15.5 11.0 36% 58% 21% 34% SE_NEP 28.0 13.4 48% 3.8 5.7 7.7 20% 43% 13% 28% SE_SRL 10.2 5.8 57% 2.1 2.8 3.0 28% 48% 21% 37% SE_THA 22.0 13.6 62% 5.5 7.1 6.5 32% 52% 25% 40% SE_TLS 13.6 10.4 77% 2.6 3.5 6.9 26% 34% 19% 25% CO reserves 20.2 0.0 0% 0.0 0.0 0.0 0% 0% 0% 0% CO total 369.3 209.0 57% 74.2 104.4 104.6 28% 50% 20% 36% RO total 115.8 49.3 43% 16.9 23.1 26.1 20% 47% 15% 34% Grand total 485.1 258.3 53% 91.1 127.5 130.7 26% 49% 19% 35% (See updated Annex 3A with figures as on 31 August 2020) SEA/RC73/6 Rev. 1 Page 13 Annexure 4 COVID-19 funds: Distributed resources, utilization and implementation by country (in US$, as on 30 June 2020) Budget Centre Distributed resources Implementation (expenditure) Utilization (exp. + enc.) Balance available % Utilization to resources % Impl. to resources BAN 9 404 545 1 450 444 1 940 001 7 464 544 21% 15% BHU 816 204 618 993 675 417 140 787 83% 76% IND 6 284,779 5,127,429 6,177,387 107,392 98% 82% INO 12 222 255 4 437 276 4 821 623 7 400 632 39% 36% KRD 941 120 2 345 25 796 915 324 3% 0% MAV 2 143 982 567 118 1 791 323 352 659 84% 26% MMR 2 179 161 1 024 004 1 503 163 675 998 69% 47% NEP 1 958 574 526 676 1 127 085 831 489 58% 27% SRL 1 840 266 756 662 913 883 926 383 50% 41% THA 8 758 366 2 750 172 4 043 458 4 714 908 46% 31% TLS 2 234 982 498 238 828 621 1 406 361 37% 22% CO total 48 784 234 17 759 358 23 847 756 24 936 478 49% 36% SE/WHE 7 330 149 482 740 861 553 6 468 596 12% 7% Grand total 56 114 383 18 242 098 24 709 310 31 405 074 44% 33% (See updated Annex 4A with figures as on 31 August 2020) SEA/RC73/6 Rev. 1 Page 14 Annexure 1A Global Programme Budget 2020–2021 (All segments) Financing and implementation by Major Offices (in US$ million, as on 31 August 2020) Major Office Approved PB Distributed resources % resources to approved PB Implementation (expenditure) % impl. to approved PB % impl. to Resources Africa 1 519.2 944.8 62% 435.8 29% 46% Americas 228.9 142.9 62% 58.0 25% 41% Eastern Mediterranean 1 050.7 1 037.6 99% 417.4 40% 40% Europe 384.7 295.7 77% 134.7 35% 46% Headquarters 1 874.6 1 490.3 79% 558.4 30% 37% South East Asia 446.6 291.7 65% 130.5 29% 45% Western Pacific 335.7 213.7 64% 82.2 24% 38% Grand Total 5 840.4 4 416.7 76% 1 817.1 31% 41% SEA/RC73/6 Rev. 1 Page 15 Annexure 2A SEAR Base Programme Budget 2020–2021, distributed resources and implementation by GPW13 Strategic Priorities and Outcomes (in US$ million, as on 31 August 2020) Strategic Priority / Outcome Approved Programme Budget Distributed Resources Resources as % of Approved Budget Implementation (expenditure) Implementation as % of approved Budget Implementation as % of resources 1. One billion more people benefiting from universal health coverage 1.1. Improved access to quality essential health services 129.8 84.6 65% 37.3 29% 44% 1.2. Reduced number of people suffering financial hardships 7.7 2.7 36% 1.1 15% 41% 1.3. Improved access to essential medicines, vaccines, diagnostics and devices for primary health care 23.2 8.2 35% 4.0 17% 49% Subtotal 1 160.7 95.5 59% 42.4 26% 44% 2. One billion more people better protected from health emergencies 2.1. Countries prepared for health emergencies 15.3 3.1 20% 1.7 11% 57% 2.2. Epidemics and pandemics prevented 80.1 30.8 39% 13.8 17% 45% 2.3. Health emergencies rapidly detected and responded to 12.4 2.1 17% 1.3 10% 61% Subtotal 2 107.8 36.0 33% 16.8 16% 47% 3. One billion more people enjoying better health and well-being 3.1. Determinants of health addressed 11.8 8.3 71% 3.0 25% 36% 3.2. Risk factors reduced through multisectoral action 15.4 6.6 43% 3.0 19% 46% 3.3. Healthy settings and Health in All Policies promoted 3.6 1.5 42% 0.8 24% 57% Subtotal 3 30.8 16.4 53% 6.8 22% 42% 4. More effective and efficient WHO providing better support to countries 4.1. Strengthened country capacity in data and innovation 21.6 9.7 45% 4.6 21% 47% 4.2. Strengthened leadership, governance and advocacy for health 32.2 12.6 39% 7.1 22% 57% 4.3. Financial, human, and administrative resources managed in an efficient, effective, results-oriented and transparent manner 35.4 16.1 46% 10.3 29% 63% Subtotal 4 89.2 38.4 43% 22.0 25% 57% Grand Total 388.5 186.3 48% 88.0 23% 47% SEA/RC73/6 Rev. 1 Page 16 Annexure 3A SEAR Programme Budget 2020–2021 (All segments): Budget, distributed resources and implementation by country (in US$ million, as on 31 August 2020) Bu dg et C en tr e Al lo ca te d PB D is tr ib ut ed Re so ur ce s % D is tr ib ut ed re so ur ce s vs al lo ca te d PB Im pl em en ta tio n (e xp en di tu re ) U til iz at io n (e xp en di tu re + en cu m br an ce ) Ba la nc e A va ila bl e % U til iz at io n vs al lo ca te d PB % U til iz at io n vs di st ri bu te d re so ur ce s % Im pl em en ta tio n vs a llo ca te d PB % Im pl em en ta tio n vs d is tr ib ut ed re so ur ce s SE_BAN 58.8 42.7 73% 18.5 23.0 19.7 39% 54% 31% 43% SE_BHU 7.9 4.7 59% 2.3 3.0 1.7 38% 64% 29% 49% SE_IND 117.7 69.7 59% 38.9 55.8 13.9 47% 80% 33% 56% SE_INO 44.8 27.4 61% 10.6 12.9 14.5 29% 47% 24% 39% SE_KRD 20.8 15.5 74% 1.6 3.9 11.6 19% 25% 8% 10% SE_MAV 9.0 6.3 69% 2.8 3.9 2.3 44% 63% 31% 45% SE_MMR 43.8 28.4 65% 12.9 18.4 10.0 42% 65% 30% 46% SE_NEP 29.9 15.5 52% 5.5 7.7 7.8 26% 50% 18% 36% SE_SRL 11.2 7.5 67% 3.2 4.4 3.0 40% 59% 29% 43% SE_THA 22.4 14.1 63% 6.9 8.5 5.7 38% 60% 31% 49% SE_TLS 14.4 11.4 79% 3.6 5.1 6.3 36% 45% 25% 32% CO Reserves 35.4 N/A N/A N/A N/A N/A N/A N/A N/A N/A CO Total 416.1 243.1 58% 107.0 146.8 96.3 35% 60% 26% 44% RO Total 119.0 48.6 41% 23.5 29.3 19.3 25% 60% 20% 48% Grand total 535.1 291.7 55% 130.5 176.1 115.6 33% 60% 24% 45% SEA/RC73/6 Rev. 1 Page 17 Annexure 4A COVID-19 funds: Distributed resources, utilization and implementation by country (in US$ million, as on 31 August 2020) Budget Centre Operational budget Distributed resources % Resources to operational budget Implementation (expenditure) Utilization (Exp.+Enc.) Balance available % Utilization to resources % Impl. to resources SE_BAN 19.89 13.40 67% 3.05 3.81 9.59 28% 23% SE_BHU 5.38 1.68 31% 1.36 1.67 0.02 99% 81% SE_IND 35.00 17.68 51% 12.26 14.46 3.21 82% 69% SE_INO 27.00 12.22 45% 4.53 4.98 7.24 41% 37% SE_KRD 7.91 0.94 12% 0.02 0.83 0.11 89% 2% SE_MAV 9.98 3.96 40% 1.60 2.23 1.73 56% 40% SE_MMR 9.22 3.66 40% 1.69 2.12 1.54 58% 46% SE_NEP 15.00 3.73 25% 1.30 2.19 1.54 59% 35% SE_SRL 6.43 3.50 54% 1.16 1.53 1.97 44% 33% SE_THA 12.55 9.15 73% 3.64 4.82 4.33 53% 40% SE_TLS 11.00 2.91 26% 0.90 1.38 1.53 47% 31% CO Total 159.37 72.84 46% 31.51 40.03 32.81 55% 43% SE/WHE 15.63 5.22 33% 1.30 1.72 3.50 33% 25% Grand total 175.00 78.06 45% 32.80 41.75 36.31 53% 42%
REGIONAL COMMITTEE Provisional Agenda item 7.2 Seventy-third Session SEA/RC73/6 Inf. Doc. 1 (Virtual) Thailand 9–10 September 2020 28 July 2020 Programme Budget 2020–2021: Implementation The ‘WHO results framework: an update’ for the Programme Budget 2020–2021, prepared for the Seventy-third World Health Assembly in May 2020, is attached herewith as an Information Document to the main Working Paper SEA/RC73/6, titled ‘Programme Budget 2020–2021: Implementation’. SEVENTY-THIRD WORLD HEALTH ASSEMBLY A73/16 Provisional agenda item 18.1 6 May 2020 Programme budget 2020–2021 WHO results framework: an update Report by the Director-General 1. In resolution WHA72.1 of 24 May 2019, the Seventy-second World Health Assembly approved the Programme budget 2020–2021 and requested the Director-General, inter alia, to continue developing the results framework of the Thirteenth General Programme of Work, 2019–2023, in consultation with Member States, including through the regional committees, and to present the results framework to the Executive Board at its 146th session. 2. This report follows on from document EB146/28 Rev.1, presented to the Executive Board in January 2020. It provides an update on stepwise progress towards the finalization and implementation of the measurement of the results framework for the Thirteenth General Programme of Work, 2019–2023, undertaken in close consultation with Member States. 3. The Thirteenth General Programme of Work, 2019–2023 focuses on measurable impacts on people’s health at the country level. To implement this measurement system, a results framework is in place to track the joint efforts of the Secretariat, Member States and partners to meet the triple billion targets and achieve the health-related Sustainable Development Goals, as well as to measure the Secretariat’s contribution to that process. 4. The results framework is accompanied by a system for measuring impact – the Thirteenth General Programme of Work, 2019–2023 WHO Impact Framework,1 a scorecard for output measurement; and qualitative case studies. Together, they provide a holistic view of WHO’s overall impact. The WHO impact measurement structure is based on the Sustainable Development Goals and consists of the top-level healthy life expectancy indicator; the triple billion targets and related indices; and 46 outcome indicators. Reporting Period 5. The time frame for the reporting of the results framework is 2019–2023 and spans three separate programme budget periods: the end of the 2018–2019 biennium, the 2020–2021 biennium (for which the programme budget was approved in May 2019) and the 2022–2023 biennium. 1 See document A72/5. A73/16 2 Consultation Process and Pilot Testing for the Impact Measurement 6. As recommended by Member States, a stepwise process was established to finalize the results framework, involving a series of consultations, technical reviews and feedback processes, to ensure that the results framework reflects technical inputs and recommendations from Member States, technical experts and partners. The framework has been subject to in-depth review, recommendations made were incorporated at every stage and pilot exercises have been undertaken. It was presented to Member States and discussed at all six WHO regional committees from August to October 2019. 7. A first technical global consultation on the Thirteenth General Programme of Work, 2019–2023 results framework was held in October 2019. Twenty countries took part, represented by health ministries and national statistical offices, with stakeholder experts and staff from all three levels of WHO. At the consultation, discussions covered impact measurement, methods of calculating progress towards the triple billion targets, review of the 46 outcome indicators and their application to programmes, the healthy life expectancy indicator, data availability and mechanisms to strengthen that availability. All recommendations made were incorporated into the framework. The output scorecard was discussed across all three levels of WHO, followed by briefings for Member States. In November 2019, the WHO Regional Office for South East Asia hosted a consultation of all Member States of the Region on application of the impact measurement system. Regular briefings were held for permanent missions. An updated version of the report on methods for 13th General Programme of Work (GPW 13) impact measurement (the “methods report”) and of the database were made available online in January 2020.1 8. Additional Member States have joined the pilot exercise and a total of 33 countries are currently at various stages of piloting the impact measurement system, including a number that have completed the exercise and have submitted recommendations which have been incorporated into the methods report and related tools. A second global technical consultation was held on 17–18 April 2020 with participation from nearly 30 Member States. The impact measurement piloted in 33 countries and the output scorecard in the regional offices and several country offices revealed that the results framework was useful, feasible to implement in countries and based on a methodology that was agreed upon by Member States. A key message that emerged was that tracking of progress will need better and more timely data. That, in turn, will require improved data systems and processes across all three levels of the Organization as well as support to strengthen data and health information systems in countries. 9. The review process and pilot implementation of the impact measurement system have been aligned across all three levels of the Organization. Feedback and recommendations received were incorporated into updated documentation that has been posted online. A summary report from the pilot exercise is available online. Recommendations made and questions raised during the discussion at the 146th session of the Executive Board 10. Regarding the impact measurement system, during the discussion at the 146th session of the Executive Board, Member States called on WHO to focus on the Sustainable Development Goals, and to reduce the reporting burden on countries; to address data gaps as a matter of high priority, and work with countries with the greatest need to improve their data and health information system capacity; WHO should become the central repository for data, and the Secretariat should strictly follow WHO 1 Thirteenth General Programme of Work, 2019–2023 (https://www.who.int/about/what-we-do/thirteenth-general- programme-of-work-2019---2023, accessed 14 April 2020). A73/16 3 data principles and data sharing guidelines; the Organization should work to foster collaboration across entities and partners beyond health ministries, such as national statistics offices and general registry offices; it should finalize the impact measurement system, so that countries can employ the system to track implementation of the Thirteenth General Programme of Work, 2019–2023, and improve their programmes and policies. 11. In respect of the output scorecard, WHO should test the system in country offices, and finalize the leading indicators for the results dimension; pilot-test and consider an independent validation mechanism; seek agreement from Member States and use the scorecard for the mid-term review to be undertaken in 2020, and submit a report to the Seventy-fourth World Health Assembly in May 2021. The following paragraphs contain a brief description of the impact measurement system and output scorecard. THIRTEENTH GENERAL PROGRAMME OF WORK, 2019-2023, RESULTS MEASUREMENT Outcome indicators 12. The outcome indicators are intended to provide a flexible approach in which Member States select their own priorities. Countries will track progress using the associated outcome indicators. Of the 46 outcome indicators, 39 are Sustainable Development Goal indicators. The seven non-Sustainable Development Goal indicators, which were approved in World Health Assembly resolutions and have been selected for the Thirteenth General Programme of Work, 2019–2023 cover antimicrobial resistance (antibiotic consumption); polio; risk factors for noncommunicable diseases (obesity; blood pressure; trans-fatty acids); and emergency related factors (vaccination for emergencies, essential health services for vulnerable populations). Data availability for all indicators may vary across the countries and not all countries may have recent primary data, providing disaggregation to enable equity and gender analysis. The Secretariat will continue to support Member States to address these gaps and strengthen health information systems and analytical capabilities to generate reliable, timely, affordable, country-owned and accessible data to track health-related Sustainable Development Goals and triple billion targets. A detailed database, metadata and tools are available on the webpage of the Thirteenth General Programme of Work, 2019–2023.1 Universal health coverage index 13. A combined measure of health service coverage (Sustainable Development Goal 3.8.1) and financial hardship (Sustainable Development Goal 3.8.2) will be used to monitor progress towards the Thirteenth General Programme of Work, 2019–2023 milestones. Health service coverage in the population will continue to be measured using the service coverage index that has been approved by the Inter-agency and Expert Group on Sustainable Development Goal indicators and its underlying indicators. The methodology to create the index, related to indicator 3.8.1 of the Sustainable Development Goals, is well documented.2 Financial hardship due to spending on health occurs when a household has to devote a large share of its capacity to pay to health services out of its own pocket (catastrophic payments), or when the costs of health services push a household below the poverty line 1 Thirteenth General Programme of Work, 2019–2023 (https://www.who.int/about/what-we-do/thirteenth-general- programme-of-work-2019---2023, accessed 14 April 2020). 2 See the metadata repository of the United Nations Statistics Division (https://unstats.un.org/sdgs/metadata/files/Metadata-03-08-01.pdf, accessed 28 April 2020). A73/16 4 (impoverishing payments). The methodology to estimate financial hardship related to indicator 3.8.2 of the Sustainable Development Goals is also approved by the Inter-agency and Expert Group on Sustainable Development Goal indicators and documented. 14. Tracking people with access to health services without financial hardship (universal health coverage billion) will continue to be measured through the combination of these two Sustainable Development Goal indicators: access to services and financial protection. Two numbers will be produced at country level: the number of people benefiting from service coverage and the number of people who suffer from catastrophic health spending. The billion will be determined using a combined measure that estimates the number of additional people with service coverage and without financial hardship. Progress will be visualized as a snapshot for a baseline year to allow an assessment of whether countries are moving in the right direction. The method for the calculation of the universal health coverage billion was developed by a working group in the Secretariat. Member States were consulted in the process of finalizing the methodology. 15. Member States, the Secretariat, United Nations partners and the Inter-agency and Expert Group on Sustainable Development Goal indicators all recognize that the current measure of health service coverage focuses on “crude” coverage and does not capture “effective” coverage, that is, whether people who need health services are receiving services of sufficient quality to produce the desired health gain. The Secretariat has begun work on an updated measurement for effective service coverage that categorizes tracer indicators by type of care (promotion, prevention, treatment, rehabilitation and palliation) and by age group (life course). This is intended to capture the quality of services and the health gains by the type of care. The Secretariat will continue consultations with Member States, experts and United Nations partners and pilot the updated measurement in countries that have expressed interest. Health emergencies protection index 16. The health emergencies protection index is consistent with Sustainable Development Goals 3.d and 3.d.1 (International Health Regulations (2005) capacity and health emergency preparedness), and with the 2016 Review Committee report on the Role of the International Health Regulations (2005) in the Ebola outbreak and response. The health emergencies billion will be measured using the health emergencies protection index, which consists of three tracer indicators, derived from the outcome indicators, that capture capacity to prepare for, to prevent, and to detect and respond to health emergencies. 17. The prepare indicator measures a country’s preparedness for emergencies. It encapsulates the level to which a country is ready to identify and respond to a range of emergency situations. It allows countries to be stratified into five levels of preparedness, enabling prioritization of where preparedness efforts are most needed. Progress will be measured by the cumulative population moving from one level of preparedness to a higher level – thus encouraging improvements to be made for all Member States. 18. The prevent indicator measures efforts to prevent health emergencies via vaccination coverage. Reaching high vaccination coverage in at-risk groups for vaccine-preventable infectious pathogens is key to tackling preventable epidemic diseases and pandemics, leading to the control and elimination of high-threat infectious hazards. 19. For the detect and respond indicator, countries will be assessed on timeliness of detection, notification and response to public health emergencies. Timeliness is a critical aspect of improving public health impact in order to protect lives, measuring the speed with which Member States are able to react to public health events. This is a new measure that will help establish data systems and A73/16 5 milestones to measure the impact of surveillance and response efforts. The objective is to encourage Member States to respond quickly to major public health emergencies. 20. Refinements to the methodology and steps to improve data availability for the health emergencies protection index, especially for the detect and respond indicator, were made throughout 2019. The method for the calculation of the one billion people protected from health emergencies was developed by a working group in the Secretariat and experts. Member States were consulted in the process of finalizing the methodology. 21. The coronavirus disease (COVID-19) pandemic throws into stark relief the need to measure preparedness, prevention and detection, and countries’ response to health emergencies. It also shows the need to support countries to strengthen data and health information systems for preparedness, prevention, and detection and response. The COVID-19 pandemic also illustrates the dynamic relationship between health emergencies, universal health coverage, and healthier populations, as well as with other Sustainable Development Goals. Healthier population index 22. The healthier population index focuses on measuring the impact of multisectoral interventions that are influenced by policy, advocacy and regulatory approaches stewarded by the health and health-related sectors. A set of priority indicators for use in this index have been selected from the Thirteenth General Programme of Work, 2019–2023 outcome indicators. Sixteen indicators will be used to measure the healthier population billion derived from the Sustainable Development Goals and World Health Assembly resolutions (Sustainable Development Goals 3.a.1, tobacco use; 3.5.2, alcohol; 3.6.1, road injuries and deaths; 2.2.1, stunting; 2.2.2, wasting; 2.2.2, overweight; 11.6.2, mean particulates (PM2.5); 7.1.2, clean fuels; 6.1.1, safely managed water; 6.2.1, safely managed sanitation; 4.2.1, developmentally on track; 5.2.1, partner violence for women; 16.2.1, violence against children; 3.4.2, suicide attempts and deaths; and resolution WHA66.10 (2013), obesity and trans-fats). 23. These indicators were chosen based on the following criteria: they have a significant impact on population health; they are a motivation for change; they are a measure of risk (such as tobacco and alcohol use); they are measures of prevalence; and they require multisectoral action. The method for the calculation of the healthier population billion target was developed by a working group in the Secretariat. Member States were consulted in the process of finalizing the methodology. The method is purposely kept straightforward in keeping with the use of Sustainable Development Goals within the Thirteenth General Programme of Work, 2019–2023. The healthier lives indicator uses a simple unweighted approach and counts the number of people whose lives are newly healthier as measured by the net change in one or more of the underlying indicators. Healthy life expectancy 24. The healthy life expectancy indicator provides a summary measure of average levels of population health. It quantifies the expected remaining years of life in good health at a particular age. That indicator has been selected because it can be used to monitor the overall progress made in achieving the triple billion targets and because of its alignment with Sustainable Development Goal 3 (ensure healthy lives and promote well-being for all at all ages). It will be used for the Thirteenth General Programme of Work, 2019–2023 baseline reporting and monitoring in future years for each Member State. Healthy life expectancy estimates will be calculated at the country level and disaggregated by sex, allowing inequality monitoring. A73/16 6 25. WHO regularly reports on healthy life expectancy through its global health estimates, using an accepted standard methodology that is WHO GATHER1 compliant. The Organization is developing standard guidance, and tools and technical assistance for Member States to apply standardized methods to measuring and reporting on healthy life expectancy. WHO will support countries to strengthen underlying data on overall mortality and cause-specific morbidity. Output Measurement 26. The Secretariat is making a significant shift in its approach to measuring its accountability for results. The output scorecard, with its full set of six dimensions with their attributes, criteria and scoring scale, is presented in detail in Annex 5 of document EB146/28 Rev.1. The output scorecard elaborates the leading indicators by which the “results leading to impact” dimension will be measured. This approach is a major step forward in strengthening how performance is measured in WHO. 27. The output scorecard methodology represents an important change in WHO that will require understanding and buy-in by the staff who will apply it. The methodology will therefore be piloted across the three levels of the Organization, and the Secretariat will continue internal consultations and evaluation, before the methodology is first applied for reporting for the 2020–2021 biennium mid-term review. The output scorecard, including the leading indicators, will be finalized on the basis of these consultations and pilot testing at headquarters, regional and country offices. Member States will have the opportunity to observe the pilot tests and provide input to the measurement system to ensure that the Secretariat’s reporting addresses the most important questions of accountability. Methods and technical tools 28. As mentioned above, all information on methods and technical tools (the methods report, metadata and the database for all indicators, including outcome indicators, triple billion targets and healthy life expectancy indicator) are available online, along with baselines and targets.2 The methods report also includes suggested approaches to data disaggregation for the outcome indicators and the triple billion indices in order to make inequality monitoring possible, and thus determine who is being left behind. The global estimates that will be produced will follow the WHO GATHER guidelines. 29. Other public health priorities for which additional indicators are being considered include service coverage for severe mental disorders, care dependency in older adults, cervical cancer screening, childhood cancers, physical activity and palliative care. The Secretariat will continue to engage with Member States and experts over the course of 2020–2023 in defining the indicators for these areas, exploring ways of strengthening data sources and finalizing methodology through a series of technical consultations. Baselines and milestones will be established once these steps have been completed. The indicators that are agreed on will then be presented to the Executive Board for inclusion in the next General Programme of Work. 1 Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) (http://gather-statement.org/, accessed 14 April 2020). 2 Thirteenth General Programme of Work, 2019–2023 (https://www.who.int/about/what-we-do/thirteenth-general- programme-of-work-2019---2023, accessed 14 April 2020). A73/16 7 Reporting results 30. The results report to Member States will be prepared annually, based on the Thirteenth General Programme of Work, 2019–2023 results framework, which will progressively include all aspects of the new reporting structure, including reporting on the output scorecard, the outcomes and the triple billion targets. The results report for the 2020–2021 biennium will contain a scorecard for each of the outputs and the performance of output delivery at each of the levels of the Organization. It will include both quantitative reports on the indicators and indices and qualitative reports that explain progress, risks, challenges and lessons learned, as well as case studies that illustrate the impacts resulting from WHO’s work in countries and from its normative functions. 31. At the end of the Thirteenth General Programme of Work period, the Secretariat will prepare a comprehensive report summarizing progress made towards the 2023 targets, the triple billion targets and the Secretariat’s contribution as measured through the output scorecard and the qualitative case studies over the 2019–2023 period. 32. Selective country and topical qualitative case studies will showcase the Organization’s impact by sharing experiences on successes and lessons learned, including failures, strengthening its role as a learning organization. Case studies at the country, regional or global levels may be included, and clear country results will be demonstrated, as well as the impact of WHO’s work on the lives of people. Delivering impact 33. Impact measurement for the Thirteenth General Programme of Work, 2019–2023 is linked to delivering impact at the country level and making a difference to the lives of those we serve. The Secretariat will work across all three levels of the Organization to take stock continuously of the triple billion targets, track progress on the agreed targets and solve problems in support of Member States on priority areas as appropriate. Assessments of baselines and forecasting of future trends will build on past achievements, help identify challenges and approaches to overcoming barriers, and suggest successful interventions that can be replicated and scaled. Strengthening Country Data, Analytics and Heath Information Systems 34. Member States recommended that WHO establish a central repository for health data, provide support to countries in strengthening their public health data collection and storage, increase capacity and alignment for data management at all three levels and, upon request, help to strengthen country capacity for data and health information systems and provide timely, reliable and actionable data to drive impact. 35. Given the recent developments in global health, with an increased focus on monitoring and accountability, as well as advances in population health measurement and during emergencies, WHO is accelerating efforts to assist Member States to ensure that maximal gains in population health are achieved through policies and programmes informed by data, analytics, interpretation, and reporting. 36. The Secretariat is fully committed to delivering impact to billions of people around the world, backed by the highest standards of health data. There are however significant data gaps in the existing health-related Sustainable Development Goals data availability in many parts of the world, and those need to be addressed as a matter of priority. WHO will ensure countries with the greatest needs are given priority in producing reliable, timely, affordable, country-owned, accessible and disaggregated data, as appropriate. A73/16 8 37. WHO is accelerating efforts among global partners to improve data collection and health information systems and analytical capacity in countries by establishing data standards, identifying health data gaps and developing data collection platforms and tools, and reporting trajectories against the health-related Sustainable Development Goals and triple billion targets to ensure no one is left behind. 38. The Secretariat has begun working with ministries of health, national statistics offices and registrar generals’ offices to improve civil registration and vital statistics and causes of death reporting. The aim is also to strengthen capacity through training and technical assistance, promoting sustainable, integrated, and innovative digital solutions for data collection platforms for surveys, administrative records, routine health services, censuses, and to build local capacity in data analytics, reporting and use. 39. WHO will continue to serve as the steward of Member States’ reported data in accordance with the WHO data principles and data sharing policies. Estimates produced will be in compliance with the WHO GATHER guidelines. A long-lasting benefit of this measurement approach will be to identify and fill gaps in measurement systems at the country level and to support countries in applying these to the monitoring and improvement of public health impact. This will also strengthen the evidence base for policy and implementation decisions. ACTION BY THE HEALTH ASSEMBLY 40. The Health Assembly is invited to note the Thirteenth General Programme of Work, 2019–2023 results framework and measurement report. = = =