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Financing WHO Reform: Challenges & Proposals

Explore WHO's financial reform, Gates Foundation influence, funding models, and proposed strategies for a healthier future. Engage in consultations and reflect on Member States' input for financial reforms. Dive into crucial areas endorsed by the World Health Assembly to enhance the WHO's effectiveness. Address challenges, recommendations, and the influence of private foundations in global health. Stay informed and involved for a brighter global health landscape.

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Financing WHO Reform: Challenges & Proposals

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  1. Geneva – 13th ofOctober 2011 – The reformoftheWHO The financing of the WHO: Current status and proposals for engagement Dr. Remco van de Pas Wemos, The Netherlands Medicus Mundi International network Democratising Global Health coalition

  2. Content • Rationale of the WHO reform • Current status of financing of the WHO • Assessment of WHOs performance • The role of the Bill and Melinda Gates foundation • Proposals for engagement

  3. Trend financing WHO Last decade • 2 main streams: Core budget and voluntary conytributions • Budget increased from $1.6b (98-99) to $ 4.2b (08-09) • Extrabudgetary budget from 48.8% to 77.3% same period • Initiated via decentralisation and autonomy of resource mobilisation to departments and regional offices • Extrabudgetary funding (VC) skews global health priorities, 60% funding infectious diseases, 3.9% NCD’s.

  4. 2010: Future of financing for WHO • Initiated in budget discussionsduring EB and WHA 2009: • Alligningprioritiesbygoverningbodieswithavailablefunding • Greaterpredictabilityandstability of funding • MS consultation Jan. 2010 onward. Report for EB 2011: • 1. More flexibleandun-markedfunding • 2. MS urgedtoincreaseassessedcontributions • 3. WidenWHO’s resource base via a replenishment model • 4. Effective and corporate approach to resource mobilization

  5. 2011: WHO reform for a healthy future • Financing part WHO managerial reform paper (Sep. ‘11) • VC are expectedtoremain the main source of income • Imbalancebetweentechnicalworkandnormativework • Needreplenishment model + innovativefinancing model • Increasing full and highly flexible income to 40% • Revised corporate resource mobilization strategy: expand or strengthen the donor base.

  6. Reflection by Member States on proposals for financial reforms Consultation Geneva 15 Sep. 2011 and WHO-EURO : • More details requiered; financial health and root causes • Increase budget to 70% predictable fund over –ambitious • VC must be alligned with WHO’s priorities • Replenishiment model: predictabililty? Donor-driven? • Innovative sources of funding: Costs and CoI? • Corporate approach “appropriate for WHO”? • WHA does not distinguish flexible and earmarked funds • Not consistent demanding program support cost donors

  7. A64/7 Proposed budget 2012-2013

  8. A64/7 Proposed budget 2012-2013

  9. A64/7 Proposed budget 2012-2013

  10. DFID – Multilateral AID review – March 2011 WHO’s challenge

  11. DFID – Multilateral AID review – March 2011 WHO’s challenges

  12. DFID’s approach to WHO funding Recommendations: • Focus on it’s comparative advantage, including at the country level. • Improve reporting of resultsand impact of interventions • Improve its cost-effectiveness and better manage poorly performing project. These fields will be closely monitored and within 2 years DFID will decide to increase or decrease its funding.

  13. Five areas of core business endorsed by 64th World Health Assemby • Health systems and institutions: PHC as per Alma-Ata • Health and development: Normative function • Health security: Strenghtening the IHR • Evidence on health trends and determinants for Policy • Convening for better health: Coherence, inclusiveness, concensus and partnerships

  14. Two big elephants in the room 2. The unproportional, non-mandated influence of the Bill and Mellinda Gates foundation. “This will be the Decade of Vaccines”, “We have a bias towards funding technology based solutions”. • Second largest funder for the WHO • Private foundations share 21% of the budget (2009) Articles: McCoy ea, The Bill and Melinda’s Foundation grant making programme for global health. Lancet. 2009. May 09 Stuckler et all. Global health philanthropy and institutional relationships: how should conflicts of interest be addressed PLoS Med. 2011 Apr;8(4):e1001020. Epub 2011 Apr 12.

  15. Proposals for engagement

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