Wednesday, June 22, 2011

Switzerland: WHO Funding- Facts and Problems

The WHO is funded through two sources. First, the member states fund the WHO through mandatory contributions. The amount that each of the 193 member states are required to contribute correlates with the country’s wealth and population. The second source of funding is voluntary contributions from either member states or NGOs. These contributions, termed extra-budgetary funding, are earmarked for specific diseases or countries. They fund specifically targeted programs that are set by the donors’ priorities. Within the last decade, the portion of the budget received from voluntary contribution has risen from 48.8% to 77.3%. The WHO, therefore, has full control over only 20% of its budget.

It is unsustainable to have nearly 80% of the budget come from voluntary donations and this earmarked funding skews public health priorities. For example, approximately 60% of WHO’s budget is directed towards infectious diseases while only 3.9% on non-communicable diseases and 2.4% on injuries. Yet, non-communicable diseases and injuries make up a much larger percentage of the global burden of disease (62% and 17%, respectively).

Additionally, the WHO had a $300-million deficit in 2010. At this year’s World Health Assembly, the member states corrected this budget deficit for the following two years by reducing the budget from a requested $4.8 billion to $3.96 billion. The immediate effect of this decrease in budget was laying off 300 of the 2,4000 individuals who work at the Geneva Headquarters. Part of the budget deficit can be attributed to the decline of the US dollar in relation to the Swiss franc. The dollar is the currency in which the WHO receives its contributions, while the Swiss franc is used to pay staff and other costs at its headquarters.

The decline in the budget is surprising given that funding for global health has ballooned over the past decade. Investment by all donors (including governments and foundations) in global health has increased from $5.6 billion in 1990 to $26.8 billion in 2010.

One solution to the budget problems at the WHO is to set higher member state contributions. The member states should focus on working together to set unbiased global health priorities and should avoid making voluntary contributions that are specifically earmarked for a certain country or disease. If the WHA cannot take decisive actions to fix the problem of reducing the earmarked funding, then perhaps the WHO should consider charging overhead costs for each earmarked funds in order to supplement its core budget.

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