Discusses World Health Organization's (WHO) funding priorities, i.e. health programs, meetings, salaries, etc. Criticizes massive fund expenditures budgeted for non-health related activities. Opines selection of health care programs are not being prioritized according to member nations' needs. States WHO should be called "to task for funding wasteful programmes and top-heavy monument addresses rather than the critical health issues in the developing world." Identifies article source and suggests media uses.
Page 1: 2501047810
NOV, 22 '89
DEPT, (TX): 0008
Suggested Uses:- ~obacco trade press
The World Health Organlsation has ~:he historical
credentials and the current capability to be an effective.
leading force for better health. ~et, WHO's 64~-page,
$655.7 million regulate budget, roposa~al for 1990 91 tells
another storys The ntaJority o~ funds are allocated to a
bloated bureaucracy cut of step with the evolving health
problems oZ the.developing wo~ld. (In ~ddition~ 1n.1990-91
WHO will raise ~7~9 ~illion for specialized
through contributzons from ~he Industrial countries.
its total budget will be about $1.~ billion).
The recent World Health Assembly Im ~eneva cost a whopping
$~.S million. WHO meetings -- meetings, not progca~es --
are budgeted at $14 milllon over the next two years. The
cost of the World Health Assembly alone for 1990-91 is more
than twice the p~oposed budget a11o~atlon for combating
malaria in Africa. More than.that of the proposed regular
budget is earmarked for activities outside the recipient
countries, and 73~ of this money is for salaries and
What do these salarie~ buy? A careful analysis of the
budget proposal ~eveals that WHO haJ; generated a multitude
of pcogrammes unrelated to the need~ of the count~ies it
For example, how do the bureaucrats ~ustify a $2.7 million
allocation for "increasing awa~enesl~ of the health
implications of the social and beha~ioural aspects of
social action and change" when WHO'~|~ total malaria funding
will be reduced by one third? What were the data that le~
to the decision to fund a review of "legislation from
selected countries that ~equire modification in order to
enhance their positive effects on m~ntal health," as
opposed to allocating funds to control new types of malaria
transmission in Africa?
What is the rationale behind funding a WHO "global oral
data bank" that can "calculate t~population weighted mean
number of decayed mis~i~g orcft~...ed~eeth at 12 years of
age" for all the co~ntr~es i~world since 1980, while
decreasing funding for tuberculosi~ programmes? Oc behind
reducing funds for im=unization iff Southeast Asia, yet
making funds available to develop/lists of basic drugs
needed in "isolated circumpola=/~re~s" that Is, d~ug lists
for the North Pole? / .
Page 2: 2501047811
NO:~/. 22 '89
DEPT. (TX): 0008
request. WHO's Own budget proposa~ betrays a pattern of
member states' lack of interest in the programmes being
An exi'sting programme devoted to "~iealth ~iskz of
Potentiall~ Tox£o Chemicals" is ty~ical. In Africa, no
member state request~d the assistamce of this ~rogramme.
Zn the Eastern ~editerranean, South A~erica ano Western
Pacific, these services are provided through other WHO
st Asia was
environmental prog~am~eso Onl¥.~n Southea there
any interest in this pzogramme en the part of a single
member state. Yet two new staff p~sitions have been
created for this programme, and the budget of $~.2 million
received a 31~ increase.
The problem is particularly acute in Africa, which sorely
needs assistance in health care and health financing. WHO
offers the region more than 50 p~ogrammes, but only
one-tenth of these hold any significant interest for
African countries. Twenty-five WH~ programmes were chosen
by fewer than five African count~ies. Six programme~ were
chosen by only two, and nine prostates were not chosen at
all. According to the budget proposal, the largest request
from African nations 'was for "H~man Resources Development"
(for instance, training village health workers). Yet, this
budget item was reduced by $4 million in real terms.
There is nothing inevitable about this state of affairs.
I~ is not particularly hard to obtain the information that
would let WHO tailor ~udgets and of:~erings to ~he actual
needs o~ the member nations.
A survey soon to be ~ublished by my institute shows that
ministers of health ~n developi~g nations have a clear
sense of their countries' prior~tie~|, listing their key
needs as i) assistance with financing for health serv£ce~
and 2) management. ~hey realize that the new disease
patterns resulting from ra~idly ~o~ing urbanizat~on will
require sustainable health care fin~ncing.
Zf WHO is slow to react to these ch~nging realities, i~
could be because they are hard to gauge from Geneva.
Nearly one third of W~O's staff pos~tions are Geneva-based.
Another third a~e distributed among seven ~egional office~
in such hardship post~ as Washin~ton, D.C., and Copenhagen.
Labour costs in Geneva; a~e the h~ghest by far, at ~4,385
per professlonal.staf~er and $58,830 per support staffer.
Simply ~ransferr~n~ staff from headquarters to the
?ountries they serve would both increase the amount of
~nput from local health officials and reduce costs.
we should not begrudge the overall e~xpense that accompanies
Page 3: 2501047812
NOV, 22 '89
17:33 BURSTON MARSTELLAR P, 7/9
DEPT, (TX): 0008
tht noble and ambitioue goal o~ p~viding badly needed
assistance to develol~ing nations. NOr should we, out of
despair, begcudge our tax dollars %hat go to support
eggorts in international health ca~e. Ou~ concecn
instead motivate us ~o call WHo to task go~ £unding
wastegul programmes and top-heavy sonument addresses
than ~he critical hea~th issues ~n the developing world.
~r Pa~l Dietr~ch, for~e~ publ£she~ and
Chie~ o~ Sa~:u~day Review, is President of The
Catholic D-n'%'~F~Ttyo--5-f--~,e~ica's Institute Health
and Developnent, in washington.