WORLD
HEALTH
ORGANIZATION
REGIONAL OFFICE FOR THE WESTERN PACIFIC BUREAU REGIONAL DU PACIFIQUE OCCIDENTAL REGIONAL COMMITI'EE Forty-sixth session Manila 11-15 September 1995 Provisional agenda item 9.3 WPRJRC46/6
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ORGANISATION MONDIALE DELASANli
21 July 1995 ORIGINAL: ENGLISH
REGIONAL ALLOCATIONS
The reorientation of allocations was discussed by the Forty-eighth World Health Assembly and by the Executive Board at its ninety-sixth session. The Executive Board decided that this subject should be on the agenda of the 1995 sessions of the regional committees, and that they should consider the determination of the allocations in line with the major functions of the Organization and the priorities of its programmes. This document presents the issues involved to the Regional Committee, which may wish to prepare a resolution providing the basis for the Region's position in respect of distribution of resources from the regular budget.
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1. INTRODUCTION
In the context of discussion of the proposed programme budget for 1996-1997, the Executive Board at its ninety-sixth session discussed an information document prepared by the Director-General on the distribution of regular budget funds to the different levels of the Organization, taking into account functions at each level. The Executive Board then decided to place the issue on the agenda of the 1995 sessions of the regional committees to solicit their views before it discussed the subject further. An extract from the report presented by the Director-General to the Executive Board in May 1995 (EB96/8) is reproduced in Part I of this document for the attention of the Regional Committee. In Part II, general information on budget allocation is presented.
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PART I EXTRACT FROM: REGIONAL ALLOCATIONSREPORT BY THE DIRECTOR-GENERAL (EB96/8)
"At the ninety-fifth session of the Executive Board, in January 1995, in the context of discussion on the proposed programme budget for 1996-1997, the Director-General proposed to prepare an information document for the Executive Board on the distribution of regular budget funds to the different levels of the Organization, taking into account functions at each level. He noted that this issue was clearly linked to the renewal of the health-for-all strategy, and redefinition of WHO's policy and mission. Earlier, at their sessions in 1994, the Regional Committee for the Eastern Mediterranean and the Regional Committee for Europe had considered aspects of this matter. The former recommended an increase in the regional share of the total
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regular budget; the latter requested a review of methods of allocation and actual distribution of resources from the regular budget.
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Allocation of the resources of the regular budget has been a constant preoccupation of WHO since its foundation. Debate has on various occasions centred on allocation to substantive programmes, to technical cooperation, and to headquarters, regional offices and countries. The basic criterion is the allocation of resources in line with the major functions of the Organization and the priorities of its programme. Regarding the methods used for establishing allocations, various other technical criteria have been referred to over the years. In general, however, such criteria have been subordinate to, rather than determinants of, the decision on sharing of the total amounts available. Decisions on allocations between programmes, or between regions or countries, have been reached following a process of debate and consensus-building among the membership, based on considerations on priorities at the time. Nevertheless, some concerns have been expressed that, although the matter of priority-setting for substantive programmes is being addressed in the current reform processes, the share of the budget between headquarters and the six individual regional budgets has not been reviewed recently. As will be noted from the following table, the share has remained about the same for the past decade, the small variations being due primarily to the impact of different inflation and exchange rate changes.
Regular budget Region 1975 % 15.60 9.31 10.41 5.71 10.47 7.87 59.42 40.58 100.00 1980-1981 % 15.94 8.77 10.53 5.58 9.28 7.72 57.82 42.18 100.00 1984-1985 %
1990-1991 % 18.31 9.95 12.34 5.83 10.31 8.89 65.63 34.37 100.00
1994-1995 % 18.77 9.71 12.03 5.96 10.40 8.70 65.57 34.43 100.00
Africa The Americas South-East Asia' Europe Eastern Mediterranean Western Pacific Sub-total Global and interregional Total
18.13 9.77 11.79 6.76 10.35 8.87 65.67 34.33 100.00
, Mongolia. originally a part of the South-East Asia Region, officially joined the Western Pacific Region on 4 May 1995 with its country allocation. For the purposes of fair comparison over the time periods illustrated. Mongolia has been shown under South· East Asia Region. The figures are those of the approved budget. The ratio may have changed during implementation.
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The major shift in regional allocations from 1980 was primarily as a consequence of resolution WHA29.48, which requested that "allocations of the regular programme budget reach the level of at least 60% in real terms towards technical cooperation and provision of services by 1980". The extent of technical cooperation activities under the regular budget has not been precisely recorded. This work is undertaken in many programmes at all three levels of WHO - global, regional and country - and may well currently account for over three-quarters of the regular budget. Reorientation of allocations was also a subject of debate at the Forty-eighth World Health Assembly. The Assembly adopted resolution WHA48.26, which
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requests the Board and Director-General to initiate a process of transfer of resources to priority health programmes in countries."
PART II GENERAL INFORMATION
The issue of how resources are allocated is a complex one, especially when regular budget resources are decreasing in real terms. The following factors may be considered when establishing a method of reorientation of the allocations between headquarters and the regions, and between the regions: I. The Western Pacific Region is responsible for the largest population of any region (28% of
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the world) but has the lowest per capita regular budget input (Table I). The Region has a popUlation of 1.584 billion, however, the financial allocation, at US$O.05 per capita, is the lowest in WHO. The Eastern Mediterranean Region has the lowest population among the regions at 424 million, with a per capita allocation of US$0.20, second only to the African Region's US$O.27 per capita allocation for a population of 568 million.
WPRlRC46/6 pageS Table 1. Population, regional allo~ation and per ~apita allo~ationl
(I)
(2)
(3)
Region
Population 1993 ('000) 567980 751 683 1 379780 864 178 423934 1 584494 5572 049
%
Regular budget regional allocation 1994-1995 US$154310 79794 95948 48987 85518 74531 USS 539088
Per capita allocation %
(2)/(1)
Africa The Americas South-East Asia Europe Eastern Mediterranean Western Pacific TOTAL
10.19 13.49 24.76 15.51 7.61 28.44 100.00
28.62 14.80 17.80 9.09 15.86 13.83 100.00
US$ 0.27 0.11 0.07 0.06 0.20 0.05 USS 0.10
2.
Over the last 25 years, the Western Pacific Region has experienced the greatest increase in
membership (125%) and is second only to the European Region in terms of increase in number of members (Table 2). The number of Member States in the Western Pacific Region rose from 12 countries in 1970 to 27 in 1995, an increase of 15 countries (including Mongolia), compared to the increase of 19 countries in the European Region. Table 2. WHO Member States from 1970 to 1995
Region Africa The Americas South-East Asia Europe Eastern Mediterranean Western Pacific TOTAL
19701971 33 26 8 31 19 12 129
19741975 38 28 10 31 21 14 142
19801981 44 31 10 32 22 15 154
19821983 44 32 II 32 22 17 158
19841985 44 34 II 32 22 20 163
19901991 45 35 I1 34 22 22 169
19921993 46 35 II
19941995 46 35 10 50 22 27 190
New Members % 1970-1995 I3
39 35 25 61 16 125 47
9 2 19 3 15 61
50 22 23 187
2
Tables I and 2 include Mongolia under the Western Pacific Region.
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3.
Three countries of the South-East Asia Region (Bangladesh, India and Indonesia) when
combined have a total population of 1.2 billion, which is comparable to that of China (Table 3). The Country Planning Figure (CPF) of each ofthese three countries alone exceeds China's CPF of US$6.8 million. Their combined CPF of US$37.6 million exceeds China's CPF of US$6.8 million by more than five times. Further, their combined CPF of US$37.6 million is more than 50% of the entire regular budget for the Western Pacific Region.
Table 3. Comparison of country planning figures and populations of large countries in the South-East Asia and Western Pacific Regions
Population in 1993 (OOO's) South-East Asia A.
1996-1997* Country Planning Figure (USS)
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Bangladesh India Indonesia Total
122210 896567 194617 1213 394
10570300 IS 723100 11 354000 37647400
Western Pacific B. China 1205181 99% 6809000 18%
Comparison (%) - (B/A)
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*without cost increase.
4.
The Western Pacific Region has seven countries categorized as Least Developed Countries
(LDCs) and an increasing number of new Member States, especially Pacific island countries. These countries have very special needs, as does Cambodia, a country which needs special support for its
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recovery from strife and war.
The Region also contains countries which have health indicators
comparable to those of LDCs, even though they are not officialy recognized as belonging to this category. 5. The Western Pacific Region's record of 100% implementation and absorption capacity Other regions are known to have surrendered
indicates maximum implementation of funds.
significant portions of their allocation as unused surplus funds.
CONCLUSIONS
Although the health situation in most countries of the Region has improved over the past few years, there are still urgent health issues to be addressed such as the eradication of poliomyelitis, the control of tuberculosis, malaria and leprosy, and reduction of the unacceptably high maternal and infant mortality rates in some countries. In addition, the increasing importance of noncommunicable diseases and diseases related to lifestyles is becoming apparent in many countries and areas. This is not the time to reduce efforts or budgetary allocations. For the 15 new members since 1970, the WHO Western Pacific Regional Office has allocated US$14.0 million for 1996-1997, based on the country planning figures for the 1994-1995 biennium. If China and Cambodia (which rejoined in 1972 and 1991) are added, this figure becomes US$23.6 million (see Annex). Under the present situation, the proportion of the budget available to countries of the Region is reduced each time a new Member State joins the Region. Thus, while the proportions of the funds allocated to the various regions have altered very little over in recent years, there have been significant shifts in allocations for countries within the Region. This is also true for some other regions. A strong case therefore exists for the Western Pacific Region not only to maintain its overall share of WHO funds but in fact to increase its share substantially. The Regional Committee may wish to consider the above facts in making its recommendations on this subject.
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ANNEX
WESTERN PACIFIC REGION LIST OF MEMBER STATES JOINING THE REGION
1970 -1995 Date of admission CPF 1994-1995
I. Fiji 2. Tonga 3. Papua New Guinea 4. Vanuatu 5. Solomon Islands 6. Cook Islands 7. Kiribati 8. Brunei Darussalam 9. Marshall Islands 10. Federated States of Micronesia
01 January 1972 14 August 1975 29 April 1976 07 March 1983 04 April 1983 09 May 1984 26 July 1984 25 March 1985 05 June 1991 14 August 1991 07 May 1993 04 May 1994 09 May 1994 09 March 1995 04 May 1995
1469000 1453800 3066900 1443000 1657900 487000 786000 99600 257600 698000
II. Tuvalu 12. Niue
50000
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13. Nauru 14. Palau 15. Mongolia Sub-total
145900 2359300 13974000
C.Quntries. that l(!.te.r reiQined: China (1972) Cambodia (1991) TOTAL 8487700 1 100000
23561700
In addition to the above, Tokelau has had associate membership since 8 May 1991. The total of country planning figures for the Western Pacific Region (including Mongolia) in 1994-1995 is US$39 744 900.