Bill Gates gives more funds to WHO than US govt?


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    In most organisations, those who are the biggest funders are also the ones with the biggest say in their running. In the case of the World Health Organisation (WHO), on the face of it, there seem to be two entities making the biggest voluntary contributions, the US government and the Bill and Melinda Gates Foundation. But a closer look at the list of voluntary contributors suggests that the Gates Foundation could now be the biggest contributor, bigger than even the US. 
At the 63rd World Health Assembly in May, a 24-page briefing document produced by the WHO secretariat gave details of voluntary contributions for the financial period 2008 and 2009. According to this document, the US contributed $424.5 million and the Gates Foundation $338.7 million. 

    However, a careful examination of the list of voluntary contributions and the donors shows there are several organizations like the Global Alliance for Vaccines and Immunisation (GAVI) — which has contributed over $85 million — and the Programme for Appropriate Technology in Health (PATH) that has given over $9 million to WHO. The Gates Foundation happens to be one of the biggest 
donors for both GAVI and PATH. A look at GAVI's list of donor contributions and commitments shows that the Gates Foundation has given over $1.14 billion from 1999 to 2009, far more than the US, which contributed just $569 million during 2001-09. That would suggest that the Gates Foundation would have a big say in GAVI and PATH. So, GAVI's contribution to WHO could be read as further influence of the Gates Foundation in the world body. 

    The Gates Foundation also happens to be a generous donor to many foundations and universities making contributions to the WHO. For instance, the John Hopkins University, which contributed about $4.3 million to WHO, got about $88 million in 2009 alone from the Gates Foundation. The International Development Research Centre, which gave $3.7 million to WHO, was given $40 million by the Gates Foundation for advocacy and public policy in 2009. The Global Fund to Fight AIDS, Tuberculosis and Malaria, which gave over $5.5 million to WHO, had got about $670 million between 2001 and 2009 from the Foundation. In short, the Gates Foundation could be the biggest influence in WHO. Another set of contributors is big pharma. Over a dozen pharma firms 
have together given about $120 million to WHO, which does not include the millions that the industry pours into foundations and organisations like the World Diabetes Foundation, World Lung Foundation, which too have made significant contributions to WHO. The bulk of the direct industry contribution is accounted by Hoffman-La Roche's contribution of $85 million, which is said to relate to in-kind contributions following the H1N1 pandemic response. 

    The different kinds of voluntary contributions that are called extra budgetary funds (EBFs) amounting 
to a total of $3.3 billion constituted over 77% of WHO's approved budget of $4.2 billion for 2008-2009, showing just how dependent the organisation is on these contributions. Assessed contributions provided by member states, which form the basis for WHO's regular budget funds (RBFs) amounted to just about 23%, less than a quarter of the approved budget. Unlike regular budget funds, voluntary contributions are tied to specific donor-determined projects, giving donors greater control over how their contribution is spent. The relative contribution of RBFs and EBFs has changed over time. In 1970, EBFs accounted for 20% of WHO expenditure, with over half these funds coming from other UN organisations. In the 1990/91 biennium, for the first time, EBFs exceeded RBFs. Today, EBFs account for over threequarters of WHO's expenditure, most of which is sourced from member states, about 60%. Six of these member states — the US, UK, Norway, Canada, Netherlands and Spain — account for a third of the contributions.
 
    The relative contribution of each state to the RBF or core budget of the WHO is calculated using a UN funding formula based on a country's population and size of economy. This too results in a small number of countries providing most of WHO's core budget and hence having greater influence. 
    The allocation of the budget is supposedly determined by World Health Assembly and WHO Regional Committee meetings. But, in practice, say critics, prioritisation of health goals and programmes and consequently budget allocation is heavily influenced by big donors and powerful member states. This vulnerability of WHO to donor influence seems inevitable considering the organisation's increasing dependence on these voluntary contributions.











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