WHO ReformProgress and Implications for

the European Region

Dr Zsuzsanna JakabRegional Director

WHO reform: progress and implications• Fifth consecutive report to Regional Committee (RC)• Annual rolling plan on implications of reform for Europe• Document EUR/RC65/15 gives broad overview of progress• Five key areas covered in 2015 by global governing bodies:

– strategic budget space allocation– framework for engagement with non-State actors– reform implementation, with emphasis on governance reform– strengthening WHO accountability framework– global staff mobility, as part of human resources reform.

Related reform issues to be discussed

In addition to an overall review of progress on WHO reform, agenda item 5 (h) includes separate presentations on:

• WHO work in outbreaks and emergencies, with health and humanitarian implications

• overview of global governance reform• accountability and compliance.

Strategic budget space allocation• Key issue of reform: how to find a rational, fair and equitable methodology for allocating the

budget among HQ and the six regions;• Two major exercises undertaken in the past – both since discontinued;• This time, Member State-driven through Programme, Budget and Administration Committee

(PBAC) Working Group (WG);• After long and difficult negotiations, consensus at 137th session of Executive Board (EB) only

on technical cooperation with countries (segment 1);• Tribute to the active involvement of European Member States, and to Chair of PBAC WG

(Dr Dirk Cuypers, Belgium).

Strategic budget space allocation: implications • Broad agreement reached at EB136 (January 2015) on general principles to be applied for

budget segments 2, 3 and 4;• Consensus decision EB137(7) relates only to segment 1 – technical cooperation at country

level, amounting to US$ 933 million;• WHO Regional Office for Europe share of segment 1 to gradually increase from 5% to 6.4%

over next three bienniums;• Due to 8% overall budget increase, no net reduction to any Region in 2016–2017;• Regional Office pilots application of methodology for allocation of assessed contributions

among biennial collaborative agreement countries for 2016–2017.

WHO engagement with non-State actors • Of key importance to the overall governance of global health;• Has been discussed repeatedly – and inconclusively – over four years;• Main impediments continue to include:

– conflict of interest– transparency– resources– role of the Engagement Coordination Group– feasibility of the implementation.

• World Health Assembly adopted resolution WHA68.9 on the way forward.

Non-State actors: next steps• Consensus reached through WHA68.9 that process must be concluded by Sixty-

ninth Health Assembly in 2016, following final review by EB138;• Following Sixty-eighth Health Assembly, open-ended intergovernmental meeting

convened 8–10 July 2015, with good progress;• Further informal session before next formal meeting scheduled for 7–10

December 2015;• Implications for European Region: Standing Committee of the Regional Committee

(SCRC) to review Regional Office partnership strategy following global agreement.

Overview of reform implementation• Important lessons learned from unprecedented complexity and scale of Ebola

outbreak;• Separate discussion on this issue scheduled later this afternoon;• In addition, weaknesses in progress and coherence of governance reform identified

by EB136 and Chair of Independent Expert Oversight Advisory Committee;• Member State consultative process on governance reform established: Estonia and

Russian Federation represent European Region in WG;• Separate discussion also on this issue later today.

Governance reform: European perspective

• European Member States proactive on governance reform since 2010, with successive subgroups set up by SCRC

• Summary of European governance reform initiatives posted on Headquarters website, covering:

– procedures for nomination of Regional Director– strengthening governance oversight by RC and SCRC– management of RC agendas– management of resolutions and amendments

– transparency of and criteria for nomination of members to the EB and the SCRC.

Accountability and compliance: regional perspective• 2011: Compliance team formally established• 2012: Financial certification introduced for contracts exceeding US$15 000• All 36 country offices and geographically dispersed offices routinely reviewed for

financial compliance according to a risk assessment• Sharp decrease in single source contracts• No long-outstanding open audit recommendations for Regional Office• SCRC is regularly informed through extensive oversight reports • Separate presentation to be provided by I. Hollo, Division Director, Administration and

Finance.

Human Resources reform: global mobility scheme• Consequences of Ebola outbreak: difficulties in managing rapid

deployment of 700 staff – later revised upwards to 1000 positions;• New mobility scheme: gradual implementation from early 2016;• Initially on voluntary basis – after 2018, mandatory for all staff

holding rotational posts in P and D categories;• Best guess: to probably involve 300–400 staff movements per year;• Overall cost: between US$ 8–9 million per biennium.

Reform of WHO work in outbreaks and emergencieswith health and humanitarian consequences • An active process overseen by WHO Director-General

– the Advisory Group on Reform of WHO’s Work in Outbreaks and Emergencies with Health and Humanitarian Consequences

– a Project Secretariat• With a six-step roadmap:

– a unified WHO programme for health emergencies– clear performance metrics for the programme, built on partnerships

with other responders – a global health emergency workforce– a new business processes to facilitate a rapid and effective response– a contingency fund– accelerated research and development in epidemics

or health emergencies.

Thank you