WHO Seeks to Raise US$7 Billion in First Ever Investment Round in 2024, Executive Board to Consider Proposal This Month
WHO Seeks to Raise US$7 Billion in First Ever Investment Round in 2024, Executive Board to Consider Proposal This Month
Newsletter Edition #205 [The Files In-Depth]
Hi,
We present to you our first edition of 2024!
Geneva will continue to be the cynosure of health policy debates this year, in what could be a make or break one for crucial negotiations on the reforms for the governance of health emergencies.
For WHO, the nucleus of this ecosystem in some sense, it could be a year where it takes decisive steps to fix its woeful financial crunch. In today’s story, we bring you an update on the proposed new investment round that will have implications on how WHO raises funds and how it meets its mandate.
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I. STORY OF THE WEEK
WHO Seeks to Raise US$7 Billion in First Ever Investment Round in 2024, Executive Board to Consider Proposal This Month
The year 2024 could prove to be significant for the chronically under-funded World Health Organization, as it seeks to raise US$7.1 billion on a “voluntary” basis for technical programmes from a range of donors.
The indicative estimate of US$ 7.1 billion is intended to cover the base segment of the WHO budget during the 2025-2028. The base budget is described as “the largest component and the scope is set by WHO, covering and work done across all three strategic priorities as well as the enabling functions – by country offices, regional office and headquarters.”
While this amount is not big relative to the vast mandate of the organization, and in comparison, to other global health agencies, it will mark a significant shift in the way WHO raise funds and delivers on its ever-expansive responsibilities.
The timing of the investment round has been made to coincide with the new General Programme of Work or GPW14 that sets the strategy of the organization. The goal is to fully finance the base segment of the budget. According to WHO, the “indicative” GPW is currently estimated to cost US$11.1 billion during 2025-2028. The GPW is currently under development. The amount WHO seeks to raise, US$7.1 billion is outside of US$ 3 billion in assessed contributions and US$938 million in program support costs.
In a proposal that will be considered by the 34-member Executive Board at its 154th meeting later this month, the report by the Director General says, “…WHO investment round aims to safeguard the global political momentum for health in order to rally stakeholders behind the GPW 14 and move the Organization’s finances towards more predictability and flexibility.”
The report states:
“The WHO investment round is a key component of the Secretariat’s resource mobilization approach to ensure full financing of the base budget of the GPW 14. It will be carried out in line with the principles established by the Working Group on Sustainable Financing and is complementary to the other efforts of the Member State-led journey towards establishing the sustainable financing of WHO, including agreements on further increases in assessed contributions as well as the implementation of reforms.
The WHO investment round seeks to secure predictable funding as the foundation for a stable workforce; increase flexible funding to reduce the persistent pockets of poverty; and enable WHO to sustain and further develop the systems and capacities needed to fulfil its core functions in support of its Member States in order to implement the GPW 14.
The success of the WHO investment round will not be measured solely by the funding raised but will also take into account predictability, flexibility, broadening of the donor base and increased efficiency. The overall financial commitment will look at the amount of funding available for the GPW 14 base budget across outputs and the three levels of the Organization, leaving no pockets of poverty….”
WHY IS THIS IMPORTANT:
WHO is a member-state driven organization. And how it raises its resources and from whom will have implications on its policy directions and its priorities. To be sure, as a UN agency, it has a different nature, compared to other global health agencies. Stakeholders whether it is the NGOs, or the private sector will be interested in this from different points of view. Ultimately the buck stops with member states on how they want to shape WHO finances and there by the organization itself.
THE ASK: HOW MUCH AND FOR WHAT
THE NUMBERS
WHO has worked on the financial envelope of the GPW, that tries to estimate of the funding it will need during four-year period of 2025-2028. “The overall estimated base budget segment for the draft GPW 14 builds on the approved base segment of the Programme budget 2024–2025, with additional financial requirements for emerging priorities (i.e. strengthening country offices, poliomyelitis transition, accountability, data and innovation),” a document explains.
While arriving at this assessment of how much WHO needs, WHO focused on the base segment of the programme budgets, “as the budget for the other segments is shaped by events (e.g. outbreaks and humanitarian crises) and/or other actors (i.e. partnerships such as the Global Polio Eradication Initiative),” the proposal explains.
The period 2025-2028 for the GPW14 covers two “half” programme budgets for the years 2025 and 2028, as well as the entire Programme budget for the biennium 2026–2027.
According to the proposal, “While these high-level budget envelopes will not replace the subsequent programme budgets for 2026–2027 and 2028–2029, they will guide them and enable contributors to make informed commitments at the WHO investment round in late 2024. The WHO investment round will build on this indicative financial envelope for the base segment of the programme budget, while deducting assessed contributions for 2025–2028 (under the assumptions set out in decision WHA75(8)) and the costs of the enabling functions for the same period. Hence, the investment round envelope will result in a voluntary contribution funding need for technical programmes of approximately US$ 7.1 billion (net of project support cost).”
THE NEW GENERAL PROGRAMME OF WORK: GPW14
On GPW, WHO says:
“The GPW 13 was anchored in the health-related Sustainable Development Goals. It provided a road map to improve healthy lives and well-being for all at all ages. The conceptual framework for this was the triple billion targets1 (a) 1 billion more people living with better health and well-being by 2025; (b) 1 billion more people benefiting from universal health coverage; and (c) 1 billion more people protected from health emergencies.
The strategic objectives of GPW14 have been articulated thus:
“To promote health: (a) respond to climate change, the greatest health threat of the 21st century; and (b) address the root causes of ill health by embedding health in key policies across sectors.
To provide health: (a) advance the primary health care approach and essential health system capacities for health equity and gender equality; and (b) improve equity and quality in health service coverage and financial protection to advance universal health coverage.
To protect health: (a) prevent, mitigate and prepare for emerging risks to health from all hazards; and (b) rapidly detect and sustain an effective response to all health emergencies.”
MODALITIES OF THE WHO INVESTMENT ROUND
It is envisaged that an investment round will be scheduled for the fourth quarter of 2024 that will seek participation from Heads of State and Governments. The Secretariat will work with Member States co-hosts from all regions to organize the event.
“The event, which will provide an opportunity for all Member States and other contributors to participate, virtually or in person, and to make financial pledges to the GPW 14 base budget,” WHO explains in its proposal. Co-hosting countries will be expected to drum up support for the investment round by “assisting in building momentum with other regional and global leaders, advocating for the investment round in relevant regional and international forums and helping to convene stakeholders and partners for the investment round event.
The document states that an investment case, currently under development is based on GPW 14 and WHO’s results framework and will seek to demonstrate the return on investment and the impact of WHO’s work. The investment case is expected to be pitched to governments, including ministers of health, finance and foreign affairs; parliamentarians; philanthropies; the private sector; and non-health specialists.
THE SCOPE OF THE RESOURCE MOBILISATION
The participation in the investment round will be fully voluntary and every pledge to the base budget of the GPW 14 will count, WHO says. This means current multi-year agreements beyond 2024 and any commitments for the period from January 2025 to end-2028, irrespective of the date or length of a given agreement will be taken into account as contributions to the investment round, according to the proposal. In addition, contributors that are unable to commit for the full four-year period but whose contribution covers the GPW 14 base segment will be counted, WHO explains.
In terms of targeting donors, WHO will capitalize on its “strong relations with sovereign donors as a mainstay”, and “will expand longer-term, consolidated outcome-based collaboration with philanthropic and foundations partners”. The proposal also says, “will continue engagement with the private sector, in line with the Framework of Engagement with Non-State Actors and facilitated by the WHO Foundation.” (The WHO Foundation was established in 2020.)
In adopting an investment round approach for WHO’s resource mobilisation, the secretariat has suggested changes on the definition of thematic flexible funding, the allocation mechanism and the way the funds are reported. It appears the goal is to reduce inefficiencies and transactions costs by making some adjustments to these processes.
The idea is to “allow provision of flexible funds to outputs (e.g., noncommunicable disease preparedness) and at country level (e.g., for small island developing States and Sahel countries). It is expected that this will facilitate contributors’ transition from earmarked to more flexible funding,” WHO says in its documents that will be considered at the EB meeting.
The proposal says:
“The investment round will be designed to promote greater flexibility in funding, both geographically and programmatically. The definition of thematic flexible funding will be expanded to create greater programmatic and geographic flexibility, thereby making it easier for contributors to pledge flexible rather than earmarked funding…The highest level of flexible funding remains funding for the core voluntary funding account, which is fully unearmarked and allows strategic allocation and corporate reporting. Thematic flexible funding can be provided combining both programmatic and geographical flexibility..”
The cost of running an investment round is pegged between US$ 3.25 million to US$ 5.55 million taking into account the main event, regional events, communication and resource mobilization materials and campaigns, and the development of the investment case.
WHO expects that the such an investment will result in efficiency gains for the organization in terms of “freeing up of staff time spent on funding proposal negotiations and writing; the reduced administrative (human resources, finance) burden of grant management and reporting resulting from more streamlined and better harmonized reporting; and maintaining a lean resource mobilization approach.” The expected efficiency savings range from US$ 15 million to US$ 40 million, based on modelling scenarios.
“The efficiencies resulting from the investment round will be even larger given the other non-quantified benefits that will result from the workforce stabilization and talent retention driven by the increased predictability of funding and the opportunity to refocus the technical workforce on its core mission, as a result of the time redirected to delivering core technical work and engaging in substantive discussions with Member States,” WHO adds.
NEXT STEPS
While the main investment round is planned later in the year, WHO member states will first discuss the GPW14 at the Executive Board meeting this month. The results framework (outcome and outputs) is also expected to be finalized. This will inform a high-level budgeting process by the secretariat to provide “more refined indicative envelopes by outcomes”, that will be consider by the Seventy-seventh World Health Assembly in May 2024.
“While these high-level budget envelopes will not replace the subsequent Programme budgets for the bienniums 2026–2027 and 2028–2029, they will guide those budget processes and enable contributors to make informed commitments at the investment round later in 2024,” WHO explains in its proposal.
The investment case is expected to be launched in May. This will be followed by regional and global events to create momentum and outreach for the investment round, and will culminate in the final investment round in the fourth quarter of 2024.
Timeline of the financing discussions:
“In resolution WHA73.1 (2020) the Health Assembly called on Member States, inter alia, “to provide sustainable funding to the Organization to ensure that it can respond fully to public health needs in the global response to COVID-19, leaving no one behind” (paragraph 7 (15)).
In decision EB148(12) (2021), the Executive Board established a time-bound, results-oriented Working Group on Sustainable Financing, which looked at how to enable WHO to have the robust structures and capacities needed to fulfil its core functions as defined in the Constitution.
In decision WHA75(8) (2022), the Health Assembly adopted the Working Group’s recommendations, which included a request for the Secretariat to explore the feasibility of a replenishment mechanism to broaden further the financing base and raise voluntary contributions.
In decision WHA76(19) (2023), the Health Assembly urged Member States and other donors to ensure the full financing of the base budget segment of the Fourteenth General Programme of Work (GPW 14) and requested the Director-General to proceed with the planning of a WHO investment round and prepare a report for consideration by the Executive Board at its 154th session, through the Programme, Budget and Administration Committee, with a full plan that includes modalities and anticipated costs and efficiencies. In the same decision, the Health Assembly also requested the Director-General to develop both an evaluation element and a target funding envelope for the investment round, the latter based on the base segment to deliver GPW 14. 4. In line with decision WHA76(19), the Secretariat has developed the investment round plan, in consultation with Member States, and proposed next steps.”
Other relevant stories:
[EB152 Special]: WHO on the Replenishment Bandwagon; Proposals to Reform the Executive Board: Jan 2023
"A hole in the firewall": The WHO Foundation & WHO April 2021
A thread on all our stories on sustainable financing over the last three years
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