‘More Talk’ on WHO Replenishment Fund Ahead of May’s Health Assembly
US representative Loyce Pace (left) and Denmark’s Erik Brøgger Rasmussen

A major overhaul of the World Health Organization’s (WHO) finances is chugging ahead after member states at Monday’s Executive Board meeting agreed that the reform proposals – including the mooted replenishment fund to bolster the global body’s core finances – will be taken to the World Health Assembly in May.

However, some member states expressed concern about the body’s financial priorities, accountability and reporting.

Madagascar, on behalf of the 47 African member states, once again called for a greater budget allocation for regions and country offices, while Russia called on the WHO to pay more attention to corruption and fraud as these were “more common than sexual misconduct”.

Meanwhile, Denmark’s Erik Brøgger Rasmussen, speaking on behalf of his country, Estonia, Finland, Iceland, Norway and Sweden, supported the decision to increase assessed contributions to the WHO.

The proposals to improve governance strike “the right balance between the respective roles and responsibilities of member states and the secretariat”, added Rasmussen, but added that the countries looked forward to “improvements in transparency, efficiency and accountability”. 

He added that while the replenishment mechanism “has potential”, this should be “further explored” including through in-depth consultations between the Secretariat and member states in the run-up to the World Health Assembly.

The UK and US supported the idea of a replenishment fund but stressed this should be voluntary, while China stressed that it should ensure that the WHO had access to flexible funding.

Germany commended the Secretariat for its “substantial progress” in resolutions, adding that the current programme budget “shows the weaknesses of how WHO was financed”. 

It added that “the replenishment mechanism, as an additional voluntary pillar of WHO funding, will lead to a more sustainable, transparent and above all, predictable financing”.

WHO Director-General Dr Tedros Adhanom Ghebreyesus and Raul Thomas, WHO Assistant Director-General for Business Operations.

Increase in members’ fees

“The gradual increase in assessed contributions will be an important step to further strengthen WHO.”
Australia expressed commitment to “working with fellow member states and the Secretariat to implement reforms that are tangible, cost-effective and have measurable impact to achieve more efficient use of resources”, and also supported “sustainably financing the organisation, particularly through increased assessed contributions”.

Japan, however, cautioned that all economies had been affected by the COVID-19 pandemic, and that it would need to be able to justify any increases in assessed contributions to its citizens.

In response to member states’ concerns, the WHO’s Secretariat reported that more budgetary information would be loaded onto the member states’ password-protected portal once certain security issues had been resolved.

Raul Thomas, Assistant Director-General for Business Operations, said that there would also be reportbacks to the Programme, Budget and Administration Committee (PBAC), the EB and the World Health Assembly – but that with 59 proposed reforms on the table, “the major challenge is going to be resources”.

In response to Africa’s ask, Thomas said that country allocation had increased from 39% in the 2018/19 biennium to 50% in the proposed 2024/ 25 biennium – with a 4% increase since  the last biennium. 

“We are making strides in this respect. What we really need to also focus on is the financing of the budget,” stressed Thomas. “Increasing a ceiling alone will not address our problems.”

Shortly before the EB, the influential PBAC proposed that the WHO Secretariat should explore details about a replenishment mechanism for continued consideration by Member States, consulting members about the timeframe, and base segment of the programme budget to be used in a replenishment mechanism.

Dr Bruce Aylward, the Director-General’s special advisor, said that the Secretariat had “heard loud and clear” member states’ suggestions on the replenishment mechanism.

“We’re delighted to do this in consultation with the member states. It’s a big new direction for the organisation, and we are committed to having intercessional sessions with you to work out some of the detail,” he added.

“We’ve heard the importance of ensuring those [funds] are unearmarked contributions, that they are directed in the right manner, etc and we look forward to further discussing those with you.”

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