FINANCING THE WORLD-HEALTH-ORGANIZATION - GLOBAL IMPORTANCE OF EXTRABUDGETARY FUNDS

From 1948, when WHO was established, the Organisation has relied on th e assessed contributions of its member states for its regular budget. However, since the early 1980s the WHO World Health Assembly has had a policy of zero real growth for the regular budget and has had to rely increasingly, therefore, on attracting additional voluntary contribut ions, called extrabudgetary funds (EBFs). Between 1984-85 and 1992-93 the real value of the EBFs apparently increased by more than 60% and i n the 1990-91 biennium expenditure of extrabudgetary funds exceeded th e regular budget for the first time. All WHO programmes, except the As sembly and the Executive Board, receive some EBFs. However, three cosp onsored and six large regular programmes account for about 70% of thes e EBFs, mainly for vertically managed programmes in the areas of disea se control, health promotion and human reproduction. Eighty percent of all EBFs received by WHO for assisted activities have been contribute d by donor governments, with the top 10 countries (in Europe, North Am erica and Japan) contributing about 90% of this total, whereas the UN funds and the World Bank have donated only about 6% of the total to da te. By contrast, about 70% of the regular budget expenditure has been for organisational expenses and for the support of programmes in the a rea of health systems. Despite the fact that the more successful progr ammes are heavily reliant on EBFs, there are strong indications that d onors, particularly donor governments, are reluctant to maintain the c urrent level of funding without major reforms in the leadership and ma nagement of the Organisation. This has major implications for WHO's in ternational role as the leading UN specialised agency for health.