ABSTRACT
In January 2011, the World Health Organization’s (WHO) directorgeneral (DG), Margaret Chan, announced that the organization faced a US$300 million shortfall in its 2012-13 budget.1 In February 2013, at an Executive Board meeting in Geneva, the European Union delegation questioned a change to the budget formula, and in response the DG allegedly opined, “The bottom line is, the [state] membership does not trust the Secretariat.”2 This is a curious statement of immense importance for the current reform debate concerning WHO, but it has been relatively overlooked to date. Why do states not trust the secretariat? Even if this is not the case, why do WHO staff feel they lack the trust of the member states, which entrusted them with the mandate to promote and seek “health for all”? In 2011, Chan created the WHO Task Force on Reform to undertake
an independent evaluation of the wider political, financial, and managerial challenges facing the organization. It identified four broad reform challenges: internal governance; finances; management; and asserting its leadership within global health governance.3 These reforms require the assent of the World Health Assembly (WHA), the legislative body of WHO, and, of course, member states’ financial support. In May 2012, the WHA provided preliminary consent to the task force and budgetary reform.4 It is anticipated that the specific reform recommendations of the task force will not be resolved for some time, however; as Chapter 6 in this volume suggests, the priorities will be program and priority setting, governance reform, and managerial reform.
