World Health Organization: Reform Agenda Developed, but U.S. Actions to Monitor Progress Could be Enhanced

A letter report issued by the Government Accountability Office with an abstract that begins "In May 2012, 194 member states approved components of the World Health Organization's (WHO) reform agenda, encompassing three broad areas--priority-setting, governance, and management reforms--that generally address the challenges identified by stakeholders. According to WHO officials, member state representatives, and other stakeholders, some of the challenges facing WHO include its (1) lack of clear organizational priorities; (2) lack of predictable and flexible financing; and (3) highly decentralized organizational structure. In developing its reform agenda, WHO consulted with member states, employees, and other parties to gather their views and feedback. In addition, WHO has commissioned three ongoing evaluations to provide input into the reform process. The first stage of one of the planned evaluations was conducted by WHO's External Auditor, which concluded in March 2012 that WHO's reform proposals are comprehensive in addressing challenges faced by the organization. WHO continues to consult with member states on priority-setting and governance proposals, which generally require extensive deliberation and consensus from member states. In November 2011, the WHO Executive Board approved WHO's management reform proposals in several areas, and requested further development of proposals in other areas. In May 2012, WHO developed a high-level implementation and monitoring framework that includes reform objectives, selected activities, 1-year and 3-year milestones, and intended impacts. Certain factors could impede WHO's ability to successfully implement its reform proposals, including the availability of sufficient financial and technical resources and the level of sustained support from internal and external stakeholders.