As the 63rd World Health Assembly (WHA) opens on May 17, 2010, WHO member countries will meet to consider matters of great moment including such topics as ‘counterfeit medical products’, pandemic influenza preparedness (sharing of influenza viruses and access to vaccines and other benefits) and the Report of the WHO Expert Working Group on R&D Financing. Perhaps unnoticed in the litany of WHO briefing documents is a 24 page information document produced by the WHO secretariat on Voluntary contributions by fund and by donor for the financial period 2008–2009. This informative document is essential in terms of understanding the the politics and power dynamics of the World Health Organization (WHO).
A63/INF.DOC./4 disaggregates all voluntary contributions to WHO by individual donor including Member States and private donors noting that
[v]oluntary contributions – core include two types of income: funds received to support the Programme budget as a whole, considered fully or highly flexible; and funds that are earmarked for purposes within the Programme budget, considered designated, or medium flexible. Fully flexible funds are recorded in the Core voluntary contributions account. Highly flexible funds, earmarked only at the level of strategic objective, are also generally recorded in the Core voluntary contributions account. Designated funds, to a greater or lesser degree earmarked at the level of Organization-wide expected result, disease, or programme, are not as tightly specified for detailed activity or expenditure lines and reporting as are voluntary contributions – specified, yet are still earmarked rather than highly flexible. At the moment, voluntary contributions – core designated funds also include some funds earmarked at the level of activity. WHO is actively improving its ability to track various levels of earmarking.
The total amount of ‘specified’ voluntary contributions for the period of 2008 to 2009 (including contributions to the WHO, UNICEF/UNDP/World Bank/WHO Special Programme of Research and Training in Tropical Diseases (TDR), the Stop TB Partnership, the UNDP/UNFPA/WHO/World Bank Special Programme on Research, Development and Research Training in Human Reproduction, the Roll Back Malaria Partnership and Water Supply and Sanitation Collaborative Council is around $2.3 billion dollars The Total General Fund for WHO, including specified voluntary contributions, ‘core’ voluntary contributions and contributions to WHO’s Framework Convention on Tobacco Control and the Stop TB Partnership Global Drug Facility is $2 744 594 186 dollars. Unofficial sources within WHO have confirmed that these voluntary contributions form around 80 percent of WHO operating budget. WHO confirmed that Roche’s $84 million figure relates to in-kind contributions following the H1N1 pandemic response.
It may be of interest to readers to know the following source of contributions to WHO and the size of their respective donations to get a glimpse of the diversity of donors.
United States of America: $424 540 852
The Bill and Melinda Gates Foundation: $338 737 334
United Kingdom of Great Britain and Northern Ireland: $205 510 011
Rotary International 155 669 958
Norway: $103 923 252
Canada $96 356 532
European Commission: $93 569 572
The Global Alliance for Vaccine Immunization (GAVI): $85 185 306
Hoffmann-La Roche and Co Ltd.: $84 000 000
Netherlands: $81 607 343
Spain: $59 113 396
Sweden: $54 601 263
Germany: $48 150 583
Italy: $37 157 862
Republic of Korea: $27 311 749
Japan: $24 520 679
Russian Federation: $20 050 000
France: $19 401 505
UNITAID: $12 278 432
Novartis: $10 549 561
Malaysia: $3 880 000
Region of Veneto, Italy: $2 637 064
Merck: $2 450 921
India: $1 170 429
Pakistan $972 460
Singapore: $616 705