United States General Accounting Office

GAO Report to the Chairman, Committee on

Foreign Relations, U.S. Senate

February 1997 UNITED NATIONS

U.S. Participation in

Five Affiliated

International

Organizations

GAO/NSIAD-97-2

GAO United States

General Accounting Office

Washington, D.C. 20548

National Security and

International Affairs Division

B-270713 

February 27, 1997

The Honorable Jesse Helms

Chairman, Committee on Foreign Relations

United States Senate

Dear Mr. Chairman:

As you requested, this report provides information on the progress and

status of management, administrative, and program reforms in five

organizations affiliated with the U.N. system. These organizations are the

World Health Organization (WHO), Pan American Health Organization

(PAHO), International Labor Organization (ILO), U.N. Conference on Trade

and Development (UNCTAD), and U.N. Population Fund (UNFPA). Because

many of the reform initiatives to improve the efficiency and effectiveness

of the organizations have been only adopted recently, we did not assess

the reforms’ implementation or evaluate their effectiveness.

Background The United States has been associated with WHO, PAHO, ILO, UNCTAD, and

UNFPA since their founding. In 1995, the United States paid about

$295 million in regular budget and extrabudgetary contributions to the five

organizations.1

 In recent years, budgetary constraints and competing

domestic priorities have led the Congress to question the value and

relevancy of U.S. participation in these organizations. Although it

acknowledged that the organizations are not operating as efficiently and

effectively as they should be, the State Department believes that continued

membership in the five organizations we studied is important to the United

States because their activities contribute in varied and cost-effective ways

to the U.S. security, prosperity, safety, and health.

A number of studies, proposals, and recommendations for change have

been suggested by member states and other experts, including the U.N.

Office of Internal Oversight Services, the Joint Inspection Unit, the

External Auditors, the Geneva Group, the Group of 77, the Group of 7, and

1

In addition to the organizations’ regular budgets, they receive extrabudgetary contributions from

various donor countries and institutions for specific programs.

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nongovernmental organizations.2 The U.S. Mission to the United Nations

and the State Department have advanced a reform agenda to improve the

efficiency and effectiveness of each organization. After being urged by the

Congress to prioritize funding requirements for international organizations

to which the United States contributes, the State Department announced

in May 1996 key criteria that it would use in continuing to review and

evaluate U.S. membership in various international organizations.3

Table 1 provides an overview of the five organizations we studied.

Appendixes I through V provide additional information about U.S.

participation in these organizations.

2

Each of the five U.N. agencies we studied has an External Auditor that is responsible for conducting

audits of the finances of the organization and reporting to the governing bodies. The External Auditors

are selected from among member states’ Supreme Audit Institutions and are members of the U.N.

Panel of External Auditors. The Geneva Group was formed in 1964 to influence budgetary control and

management improvement in the U.N. specialized agencies. The group consists of 14 major contributor

nations, including the United States. The Group of 77 was established in 1985 to promote economic

cooperation among developing countries. The group consists of over 100 developing countries and the

Palestine Liberation Organization. The Group of 7 was created in 1985 to facilitate economic

cooperation among the seven major non-Communist economic powers, including the United States.

3

During testimony on the administration’s fiscal year 1997 budget request before the Subcommittee on

Commerce, State, Justice, and Judiciary, House Committee on Appropriations, the U.S. Permanent

Representative to the United Nations said these criteria are (1) the level of direct political or economic

benefits to the United States through consultation with U.S. stakeholders, (2) the percentage of the

budget devoted to activities that benefit the United States, (3) the scope and depth of the U.S.

constituency, (4) the relevancy of the organization’s mandate to contemporary global issues,

(5) program effectiveness and quality of management, (6) budgetary restraint and transparency, and

(7) responsiveness to overall reform efforts.

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Table 1: Overview of Selected International Organizations

Name, location,

and date created Purpose

Membership and

funding sourcea

1996-97 Regular budget

and U.S. assessmentb Unique characteristics

WHO,

Geneva

(1948)

Obtain the highest

possible level of health

for people worldwide.

190 member states and

2 associate members;

funded by

assessments and

voluntary contributions.

$842.6 million (budget)

and $214.8 million

(assessment)

Specialized agency that

provides technical cooperation

and international standard

setting; six regional offices

manage most country

technical cooperation.

PAHO,

Washington, D.C.

(1902)

Promote and coordinate

efforts to combat

disease, lengthen life,

and promote physical

and mental health.

35 member states,

3 participating

governments,

1 associate member,

and 2 observers;

funded by

assessments and

voluntary contributions.

$168.6 million (budget)

and $99.4 million

(assessment)

Inter-American agency that

serves as WHO’s regional

office for North, South, and

Central Americas, and the

Caribbean and specialized

agency of the Organization of

American States. Provides

leadership on regional and

hemispheric health issues,

technical cooperation, and

related support to member

countries.

ILO

Geneva

(1919)

Promote social justice

for working people

worldwide.

174 member states;

funded by assessments

and voluntary

contributions.

$579.5 million (budget)

and $144.9 million

(assessment)

Specialized agency composed

of a tripartite structure with

delegates from each

government, employer groups,

and worker groups.

UNCTAD,

Geneva

(1964)

Integrate developing

countries into the

international trading

system and promote

development through

trade and investment.

188 member states

(members of the United

Nations are members of

UNCTAD); funded by

the regular U.N. budget.

$124.1 million (budget)c Permanent component of the

U.N. General Assembly and a

part of the U.N Secretariat.

UNFPA,

New York

(1969)

Provide access to

reproductive health

services, including family

planning information and

services.

85 donor nations; funded

by voluntary

contributions.

$642.4 million (budget)

and $35 million

(voluntary contribution)d

Subsidiary component of the

U.N. General Assembly;

specialized voluntary fund.

aThe United Nations has 185 member states. However, some organizations, such as WHO and

UNCTAD, have additional members that are not members of the United Nations.

bThese amounts represent the regular budgets of the five organizations and the amount of the

U.S. assessment (or voluntary contributions in the case of UNFPA). However, most of the

organizations also receive extrabudgetary support, which substantially may increase their total

budgets. This information is included in appendixes I through V.

cAs part of the U.N. Secretariat, UNCTAD’s budget is allocated from the U.N. budget. The United

States pays 25 percent of the total U.N. budget and does not pay a separate assessment for

UNCTAD.

dThis number represents U.S. voluntary contributions.

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Results in Brief Policies and agendas adopted by WHO, PAHO, ILO, UNCTAD, and UNFPA

coincide with U.S. foreign policy objectives, which include promoting

prosperity, sustainable development, and peace; building democracy;

providing humanitarian assistance; and advancing diplomacy. Assessments

by U.S. officials and other experts conclude that programs and activities of

the five organizations provide significant benefits by, among other things,

setting international standards for living and working conditions;

improving global health; and collecting, analyzing, and disseminating

global information on trade, health, population, and employment. The

programs and activities also provide opportunities for joint scientific

research among the technical experts of participating countries in

combating deadly diseases, such as Acquired Immune Deficiency

Syndrome (AIDS) and the Ebola virus.

U.S. officials asserted, and other experts agreed, that it would be difficult,

if not impossible, for any federal agency or private institution to perform

the mandates of the five organizations. These organizations are now

generally considered politically neutral by most governments (including

the United States) and provide the United States access to countries in

which it would otherwise face legal, financial, or jurisdictional obstacles,

such as Zaire during the Ebola outbreak of 1995. In addition, membership

in these organizations allows the United States to work with other nations

in sharing the burden of dealing with challenges that threaten domestic

security, international stability, and human well-being around the world.

Declining resources available from donor countries, the increasing number

of worldwide crises, and the demands for better collaboration between the

donor organizations and the recipient countries have caused the five

organizations to recognize the need for improved management and

administration. Each has begun to address weaknesses in the management

and administration of its operations and programs. These weaknesses,

which include the lack of budget transparency and overlap and duplication

of programs and activities, have been the subject of frequent criticism by

the Congress, State Department, and other U.S. foreign policy analysts.

The organizations have responded slowly, but favorably, to the reform

proposals. PAHO, ILO, and UNFPA, which the United States generally

considers to be responsive to recommended management and

administrative improvements, have initiated a number of reforms. These

include reducing the length and frequency of meetings and implementing

monitoring, evaluation, and reporting systems. ILO, for example, has

reduced the length of its conference, focused more on priority policy

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issues, and tightened its rules of debate to prevent discussion of

extraneous political issues.

In contrast, WHO and UNCTAD have been slower than the other three

organizations in undertaking significant management and administrative

improvements. Nonetheless, since 1993, WHO has undertaken several

reforms, including establishing five priority areas for allocating scarce

program resources and strengthening internal audit functions. Although

the United States believes that strengthening the internal audit function is

imperative to efficient management, WHO still has not clearly defined the

function’s degree of independence or established specifically which

internal audit reports would be provided to WHO’s members. UNCTAD was

even slower in initiating reforms, but provisions were adopted at its 1996

conference for streamlining institutional arrangements, focusing on a

smaller number of priority issues, reducing the length and number of

meetings, and enhancing transparency in UNCTAD’s program and budget.

The United States and other member states are continuing to push for

reforms in each of the five organizations we studied.

Organizations’

Policies Coincide With

U.S. Interests

The United States has a significant voice in the policies of the

organizations because it is a leading contributor to and participant on the

governing boards and major committees. Our analysis showed that recent

policies adopted by the organizations coincided with U.S. foreign policy

objectives. For example, ILO has adopted policies and programs that

support the goals established by the President’s Committee on ILO. These

goals include preserving and strengthening worker rights, improving

working conditions, and creating employment. ILO has seven core labor

conventions that relate directly to its main purpose—to promote social

justice and human rights.

UNFPA, which funds population programs in developing countries, has

documented policies on abortion and human rights that are consistent

with U.S. family planning objectives. U.S. policy supports access to family

planning services to all those who need them, but opposes any coercive

methods or abortion as a part of any population program. UNFPA also

opposes abortion or coercive sterilization as methods of family planning.

UNFPA’s program strategy seeks to prevent abortion by increasing access to

family planning services and reduce maternal deaths through better

management of complications of unsafe abortions.

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Membership in WHO, PAHO, ILO, UNCTAD, and UNFPA permits the United States

to pursue programs that protect its interests and increase its prosperity

worldwide, a key U.S. foreign policy objective. Assessments by U.S.

officials showed that the organizations’ programs provide vital services

that directly affect U.S. security, safety, and prosperity. For example, WHO

sets food product and quality standards worldwide in collaboration with

the Food and Agriculture Organization (FAO) through a trade

standardization program. These standards, and the U.S. role in setting

them, are important to the health and safety of U.S. consumers of products

from other countries. WHO and PAHO conduct programs in collaboration

with the Centers for Disease Control and Prevention and the U.S. military

health authorities that protect the United States against the spread of

infectious diseases from abroad. ILO works to eliminate the exploitation of

child labor, an objective of U.S. policy. UNCTAD promotes open markets in

developing countries, which helps U.S. exporters, businesses, and workers

and thus contributes to the goal of enhancing prosperity in the United

States.

A large number of U.S. companies, nongovernmental organizations,

academia, and the general public benefit financially from the work on

behalf of the five organizations. Procurement and contracting data

supplied by the organizations showed that, in 1995, WHO awarded

$13 million in contracts to U.S. companies, PAHO $18.3 million, ILO

$3.1 million, UNCTAD $0.4 million, and UNFPA $7.4 million. For example, in

1995, UNFPA purchased $1.8 million in contraceptives from Wyeth

International, a company based in Philadelphia.

The organizations also fund research contracts with many U.S. institutions

through their various programs. For example, WHO program funding data

showed that the Special Program for Research and Training in Tropical

Diseases provided more than $67 million in research funding to U.S.

institutions from the time of its creation in 1978 to 1994. In addition, PAHO

works with the U.S. academic community, the Centers for Disease Control

and Prevention, the National Institutes of Health, the Department of

Defense, the U.S. Agency for International Development (USAID), and U.S.

nongovernmental organizations in the execution of its technical

cooperation activities.

Moreover, the organizations promote jobs, investments, and other

opportunities for U.S. citizens. For example, WHO’s role in setting

standards for biotechnology products, such as vaccines, allows U.S.

companies to participate more effectively in the global market. Some of

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the vaccines purchased by WHO are being developed in the United States by

the National Institutes of Health and the Wistar Institute and produced by

U.S. pharmaceutical companies. Also, recent staffing data showed that the

five organizations employed about 7,700 staff members, about 363, or

about 5 percent, of whom are Americans.4

 U.S. citizens also hold senior

positions in the organizations, including the Deputy Director General at

ILO, the Assistant Director General for Communicable Diseases and the

Legal Counsel at WHO, the Deputy Director and the Chief of Administration

at PAHO, the Director for Global Interdependence at UNCTAD, and the

Director for Information and External Relations at UNFPA.

Under the guidance of UNCTAD, the Global Trade Point Network facilitates

trade transactions, bringing together the services of all potential agents

involved in trade (e.g., customs, banks, insurance, and transporters).

Within UNCTAD’s Global Trade Point Network, Trade Point USA, a nonprofit

trade information and services company operating out of Columbus, Ohio,

is the oldest network Trade Point in the United States. The purpose of the

network is to lower trade transaction costs and broaden participation in

trade, particular for micro-, small-, and medium-sized enterprises. Trade

Point USA currently provides on-line services through an Internet-based

trade information and marketing service. Trade Point USA reports that the

usage of its on-line information service has increased from 10,255 times in

June 1995 to 305,325 times in June 1996.

The House of Delegates for the American Medical Association recently

endorsed plans to collaborate with WHO in the expansion of the

association’s global activities. Moreover, UNFPA supports two publications

of the Population Council, the Population and Development Review and

Studies in Family Planning, which are used by hundreds of U.S.

universities, libraries, and individuals.

Although most of ILO’s benefits to the United States are indirect,

Department of Labor officials stated that the organization’s work on

occupational health and safety is important for ensuring proper working

conditions worldwide. Since 1989, ILO has taken a lead role in supporting

international efforts to develop a harmonized system on the classification

and labeling of chemicals. WHO also works closely with ILO and the U.N.

Environment Program on the International Program on Chemical Safety.

These organizations annually evaluate the risks posed by over 100

chemicals, and about 15 of these evaluations are published in the

4

The United States contributes about 25 percent of the regular budgets of WHO and ILO and about

60 percent for PAHO, where U.S. citizens comprise 16 percent of the total staff.

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Environmental Health Criteria series each year. WHO produces and

distributes the “IPCS News,” the newsletter of the International Program

on Chemical Safety, on behalf of the sponsoring agencies. This

information is vital to the United States, since it is a major importer and

exporter of chemicals. In addition, ILO standards are used as criteria in

various U.S. legislation, such as the Cuban Liberty and Democratic

Solidarity Act of 1996 (sec. 205 (a) of P.L. 104-114) and the Foreign

Operations, Export Financing, and Related Programs Appropriations Act

for Fiscal Year 1995 (sec. 526 (e) of P.L. (103-306). For example, the fiscal

year 1995 appropriations act requires that the Department of the Treasury,

along with the U.S. Executive Directors of the International Financial

Institutions, work to (1) establish a process within the institutions to

evaluate borrowing countries’ recognition of international worker rights

and (2) include the status of such rights as an integral part of the financial

institutions’ policy dialogue with each borrowing country.

Organizations Enhance

International Cooperation

The executive branch supports the five organizations because it believes

they are unique and valuable instruments of multilateral cooperation. U.S.

officials stated that participation in WHO, PAHO, ILO, UNCTAD, and UNFPA

allows the United States to work collaboratively and more cost effectively

with other nations to deal with global challenges, such as unsustainable

population growth and emerging and reemerging diseases. Although many

of these challenges start beyond U.S. borders, they are increasingly

becoming problems within them and require more resources than are

available from any single nation.

The capacity of the U.S. government to provide responses to global crises

is increasingly limited. According to U.S. officials we interviewed, U.S.

government agencies do not have the mandate, flexibility, or funds

necessary to respond to the many international challenges that threaten

U.S. interests. For example, declining resources forced the Army to

abandon its antiviral research program, which was designed to conduct

research and develop drugs to combat infectious diseases caused by

viruses.

U.S. officials stated that most of the major threats to peace, prosperity,

and health are problems that national governments are ill equipped to deal

with on their own. Moreover, the five organizations enable the United

States to address transnational problems not readily amenable to bilateral

diplomacy. For example, in Central America, PAHO, with the support of the

United States, used health initiatives to bridge the gaps between warring

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factions as a first step toward peace. In addition, at the request of the

United Nations, the Organization of American States, and the United

States, PAHO provided basic health services in Haiti and coordinated the

importation and distribution of fuel to ensure the safe delivery of food and

humanitarian supplies during the international embargo of the military

government.

According to U.S. health experts, one of the major achievements of the

polio eradication initiative by WHO and PAHO was its impact on the level of

commitment by national governments in North, South, and Central

Americas. Overall contributions by these national governments for

immunizations programs in nine priority countries increased from 

66.3 percent in 1990 to 92.5 percent in 1995. In addition, studies by U.S.

officials and other experts showed that participation in WHO and PAHO have

provided considerable savings of U.S. dollars and lives. According to the

Task Force for Child Survival and Development based in Atlanta, for every

U.S. dollar invested in vaccinations, approximately $7 to $20 is saved as a

result of the prevention of disability, death, and medical costs otherwise

associated with childhood diseases. For example, WHO, PAHO, and other

international health experts report that the global smallpox vaccination

initiative led by WHO has saved about $20 billion ($2 billion in the United

States alone) since 1977 by eradicating smallpox worldwide. Experts

anticipate similar savings to accrue to the United States and other

countries once poliomyelitis has been eradicated worldwide, which is

expected to occur within the next 5 to 10 years.

Moreover, the organizations have used the combined resources of the

United States and other nations in responding to global crises, such as

famine, natural disasters, and the displacement of people from their

homes. For example, in late 1994, UNFPA began implementing projects to

train Rwandan refugees in Burundi as outreach workers to provide

reproductive health and family planning information and services to the

residents of the refugee camps. Human Immunodeficiency Virus (HIV)

prevention was stressed as part of the package of services. In 1994, in the

aftermath of the civil war in Mozambique, ILO and the Mozambique

National Employment and Vocational Training Institute commenced a

project to provide more than 4,000 demobilized soldiers with the

necessary skills and basic tools to find a job or become self-employed.

According to U.S. officials, international organizations are often in the best

position to respond quickly to crisis situations. For example, WHO is often

in the best position to recognize the early stages of infectious disease

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outbreaks through its interactions with the various networks of its

member countries and collaborating centers. Also, WHO is often best suited

to coordinate international health activities that often draw on experts

knowledge from multiple countries, including the United States (e.g.,

Centers for Disease Control and Prevention, National Institutes of Health,

and Food and Drug Administration). According to an interagency working

group on emerging and reemerging infectious diseases, no U.S. agency has

a clear mandate to respond to epidemics outside U.S. borders, and no

executive structure exists either to oversee international disease

surveillance or mobilize a response when an outbreak occurs.

End of Cold War Reduced

Barriers to Cooperation

During the Cold War period, other nations, particularly the Soviet Union,

often used international organizations, including some of those in this

study, as forums for anti-American debate and propaganda that were

irrelevant to the organizations’ mission. For example, in 1977, the United

States temporarily withdrew from ILO because of concerns about four

trends: erosion of tripartite representation, selective concern for human

rights, disregard of due process, and increasing politicization. Moreover,

State Department and U.S. Trade Representative officials once

characterized UNCTAD as being a forum of confrontation largely along the

lines of the industrialized countries of the Northern Hemisphere versus the

developing countries of the Southern Hemisphere.

The end of the Cold War ameliorated many of the differences that once

influenced the agendas of the organizations. Representatives from both

developed and developing nations that we interviewed acknowledged that

the climate within the organizations has changed and that there is more

support for U.S. values and ideals. For example, a U.S. delegation member

noted that, although earlier conferences sometimes had an anti-American

tone, the 1996 UNCTAD conference was almost completely devoid of the

negative political rhetoric. Moreover, members of the 1996 conference

were generally receptive to U.S. proposals.

U.S. officials shared similar comments about governing board meetings

and conferences held at the other organizations. Moreover, former

adversaries are becoming partners in diplomacy. For example, the United

States and Russia have worked together to improve the functioning of WHO

and ILO. In March 1996, the Russian Permanent Representative joined the

United States and five European nations in letters to WHO and ILO Directors

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General urging a inspector general-type oversight function within the WHO

and ILO Secretariats.5

Although the climate has changed within the organizations, other member

states occasionally succeed in using the organizations for advancing

politically motivated agendas. For example, at the 1996 WHO World Health

Assembly, Turkey used the assembly to criticize a resolution put forth by

the Cyprus delegation that called on WHO to give assistance to refugees and

displaced persons in Cyprus. The Turkish delegation argued that Cyprus’

per capita income level of $13,000 a year did not warrant WHO’s assistance.

Organizations

Recognize the Need

for Reform

Because of declining resources, the increasing number of worldwide

crises, and growing concerns among donor governments about the need

for improved management and value for money, the five organizations

have recognized the need for management, administrative, and program

reforms. The organizations have begun to address weaknesses in their

management and operations. PAHO, ILO, and UNFPA, which the United States

generally considers to be responsive to recommended management and

administrative improvements, have initiated a number of reforms. In

contrast, WHO and UNCTAD have been slower in undertaking significant

management and administrative improvements.

In 1995, the United States developed a reform agenda that it encouraged

the organizations to adopt. The agenda included recommendations aimed

at making the organizations less wasteful, more productive and focused,

and better able to meet future challenges. For example, the United States

recommended that WHO develop a more transparent budget presentation

format to improve member state oversight and enhance priority setting.

Also in 1995, the executive branch adopted a new budget policy for

international organizations, which replaced its decade-old zero real growth

budget policy. The goal of the new policy was to reduce many of the

budgets of international organizations below current levels, particularly in

large agencies. Exceptions, on a case-by-case basis, were to be made to

maintain current budget levels or zero nominal growth. In rare cases, the

5

The letters characterized the following attributes for an inspector general-type of oversight function:

(1) broad internal oversight authority is vested in a single individual or unit with total operational

independence; (2) the head of the unit reports to the head of the agency, but the unit head’s

appointment is subject to approval of the membership; (3) the executive head of the agency is required

to transmit the internal oversight unit’s annual report and other report to the membership unchanged;

(4) procedures need to be followed to track compliance with recommendations for corrective action;

and (5) a hotline system, with whistleblower protection, is in place to deter waste, fraud, and

mismanagement.

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United States would support very minor increases to provide for partial

offsets of nondiscretionary cost increases and exchange rate movements.

However, the United States does not have veto power and cannot block

the approval of proposed budgets by the majority of other member states.

According to State Department officials, under this new policy the

organizations were expected to absorb most mandatory cost increases

through reprogramming. Table 2 shows proposed and approved budgets of

the five organizations—WHO, PAHO, ILO, and UNCTAD—and the U.S. position

on these budgets. UNFPA’s budget presentation is divided into two parts, a

multiyear workplan and a biannual program support budget. Therefore,

UNFPA’s budget process is not comparable to the other organizations.

Table 2: U.S. Position on the 1996-97

Proposed and Approved Budgets Dollars in millions

Organization

Approved

budget

1994-95

Proposed

budget

1996-97

Approved

budget

1996-97

U.S.

vote

WHO $822.1 $955.6 $842.6 a

PAHO $164.5 $174.2 $168.7 No

ILO $466.5 $579.5 $579.5 No

UNCTAD $113.6 $124.1 $124.1 b

aThe WHO budget is adopted by consensus. According to the State Department, the United

States “disassociated” itself from the consensus.

bUNCTAD’s budget is approved by the U.N. General Assembly as part of the U.N. budget. The

United States joined the consensus in approving the 1996-97 U.N. budget.

The program officers in the State Department’s Bureau of International

Organization Affairs are responsible for continually assessing U.S.

membership in international organizations. House Conference Report

104-863, which accompanies Public Law 104-208, also requires that the

State Department assess U.S. interests in international organizations and

submit a report to the Congress not later than January 30, 1997.

At the direction of the President, the executive branch is presenting its

reform proposals to other governments and the five organizations.

Additional studies, proposals, and recommendations for change have also

been made by other experts, including the U.N. Office of Internal

Oversight Services, the Joint Inspection Unit, the External Auditors, the

Geneva Group, the Group of 77, the Group of 7, and nongovernmental

organizations. For example, in April 1996, Australia published its proposal

for modernizing WHO. In April 1993, Sweden presented a proposal for

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budgetary reform in the United Nations, including ILO and WHO, to the

members of the Geneva Group.

Analyses of reform initiatives for each of the organizations by us and

others showed that the organizations have responded slowly, but

favorably, to the reform proposals. The following sections discuss the

status of management, administrative, and program reforms at each of the

five organizations.

WHO The United States has been a leader in pursuing management and

administrative improvements at WHO. U.S. officials and others have urged

WHO to adopt a number of measures aimed at improving the economy,

efficiency, effectiveness, and accountability of the organizations’

operations and programs. Recommended management and administrative

improvement efforts cover a wide range of issues, from strengthening the

internal audit function to improving budget transparency.

In 1992, the Executive Board, at the U.S. initiative, created a working

group to examine WHO’s role in responding to global change. The working

group, which includes the U.S. member of the Executive Board, reviewed

WHO’s contributions and effectiveness, identified main issues that needed

action, and made 47 recommendations for a fundamental revision of WHO

operations to meet new challenges. These recommendations included

proposals by the United States and others. Since 1993, WHO has

implemented, or in some way addressed, a number of the management and

administrative reforms, including

• establishing contracting and procurement guidelines, which the External

Auditor believed were lacking;

• reducing the length of the annual World Health Assembly from 3 weeks in

1980 to 6 days in 1996;

• reallocating $41 million, or 5 percent, of the core budget for the 1996-97

biennial budget to priority programs, including eradication of specific

communicable diseases; prevention and control of specific communicable

diseases; promotion of reproductive, women’s, and family health;

promotion of primary health care and other areas that contribute to

primary health care, such as essential drugs, vaccines, and nutrition; and

promotion of environmental health, especially community water supply

and sanitation;

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• filling the long-vacant post of Deputy Director General (with someone in

an acting capacity) to deal with important day-to-day management and

policy issues in the absence of the Director General;

• restructuring and simplifying the presentation of the 1996-97 budget;

• issuing an annual publication that reports on the organizations’ efforts and

programs for improving the world health situation;

• reducing the proposed 1996-97 budget from $955.6 million to

$842.6 million;

• establishing reduction-in-force committees for staff in professional and

general services category posts and reduction-in-force procedures;

• cutting over 200 staff positions at headquarters in Geneva;

• strengthening internal audit functions (at the urging of the United States

and other members of the Geneva Group) to give the Office of Internal

Audit greater independence and a provision for external reporting to the

membership;6

 and

• becoming the first large U.N. specialized agency (following the

recommendation of the Executive Board and decision of the World Health

Assembly) to adopt a 2-term (10-year) limit for the service of the Director

General (except for the incumbent).

Ongoing management improvement efforts include

• implementing a modern management information system to support

planning, monitoring, and evaluation of WHO programs; provide a

comprehensive database on the world’s health status; and enable retrieval

of WHO policy documents;

• developing a transparent personnel policy and reporting system so that

program positions, pay grades, and temporary employees can be easily

tracked by the WHO governing body; and

• examining WHO’s 50-year-old constitution and the feasibility of making

changes in the text to enhance WHO’s effectiveness and efficiency.

Although WHO has made a number of changes to improve its operations,

member states from both developed and developing countries continue to

express concerns about the management and reform policies of the

organization. For example, because of WHO’s financial situation, the United

States and others have urged the organization to eliminate nonpriority

programs to bring the budget in line with available resources. Instead of

eliminating nonpriority activities to meet shortfalls caused by late or

nonpayment of regular budget assessments in 1995 by member states,

6

The Department of State commented that strengthening the internal audit function is imperative to

efficient management but that WHO still has not clearly defined the function’s degree of independence

or established specifically which internal audit reports would be provided to WHO members.

Page 14 GAO/NSIAD-97-2 United Nations
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including the United States, Russia, and Ukraine, WHO froze 10 percent of

the program budget.7

Moreover, despite financially difficult times, the number of senior-level

positions have increased. In the last 4 years, the number of senior-level

ungraded posts increased by 23 percent, from 13 in 1992 to 17 in 1996.

Other senior-level graded posts increased by 16 percent, from 42 in 1992 to

50 in 1996. Only the Director General has the authority to accept or reject

member state personnel management recommendations for the WHO

Secretariat.

The Executive Board subgroup on priority setting met with senior WHO

management in May 1996 and recommended that the priorities selected for

the 1996-97 biennium be continued throughout the 1998-99 biennium.

Some members of the board wanted to add to these priorities, but the

general consensus was to focus on the ones contained in the current

budget document. For example, Russia wanted to add noncommunicable

diseases, and Barbados wanted to add violence as public health issues and

other program activities.

The Departments of State and Health and Human Services have continued

to influence WHO’s reforms through WHO’s Executive Board process,

working directly with the WHO Secretariat and other member states to

create a consensus for reform. The Secretary of Health and Human

Services chairs the quarterly meeting of senior representatives from

Departments of Health and Human Services and State, USAID, and the U.S.

Mission. The Ambassador at the U.S. Mission in Geneva chairs the Western

European and Others Group, which deals with U.N. specialized agencies

and organizations issues. A senior U.S. Public Health Service officer is

assigned to the U.S. Mission in Geneva as International Health Attache.

PAHO According to officials from the Departments of State and Health and

Human Services, PAHO has undertaken a number of self-initiated actions

aimed at improving the efficiency and effectiveness of its operations. For

example, PAHO reduced the number of staff posts by 351, from 1,222 to 871,

since 1980; implemented and provided continued improvements to its

financial management information system; and closed a research center

7

As of August 31, 1996, the United States owed $18.9 million (for 1995), Russia $19.8 million (for 1995),

and Ukraine $19.3 million (for 1993-95). At the end of 1995, WHO borrowed $206 million from internal

funds to sustain its operations. WHO used the full balance of $28 million of its working capital fund

and borrowed from its internal funds the balance of $178 million. By October 31, 1996, $130 million of

the borrowed funds had been reimbursed.

Page 15 GAO/NSIAD-97-2 United Nations
B-270713 

deemed not cost-effective. PAHO’s headquarters was one of three offices to

reach WHO’s September 1995 target of 30 percent for the proportion of all

professional and higher graded posts in established offices to be occupied

by women. In addition, in 1995, PAHO’s entire staff participated in an effort

to revise the organizations mission statement. Each year, every unit at

PAHO undergoes a detailed performance review used to shape its program

and budget allocations for the next year.

Although PAHO undertook a number of actions to improve the efficiency

and effectiveness of its operations, the United States and others have

recently expressed concerns about the declining financial situation at

PAHO. Until 1995, the organization has had sufficient resources to fund its

operations and was reluctant to establish specific priorities for its program

and budget. However, in late 1995, the organization experienced a shortfall

because of late or nonpayment of regular budget assessments. The United

States, which contributes about 60 percent of PAHO’s regular budget, did

not make its last quarter payment for 1995. As a result, the organization

had to draw down its working capital fund to cover the shortfall. The

United States has since paid its assessment in full for 1995. According to

PAHO officials, the borrowed funds will be repaid when a surplus of

assessed contributions is available, but when this will occur is unknown.

Although the outlook for additional funds to support its 1996 operations

appeared negative, the organization refused to adopt the zero growth

budget policy. Despite the share of PAHO’s budget paid by the United

States, PAHO approved a 2.5-percent increase of its 1996-97 budget. The

United States was the only member state to vote against this increase, but

it has no authority to veto majority votes.

The United States has urged PAHO to eliminate nonpriority programs. In

March 1996, PAHO responded by announcing plans to trim back the PAHO

budget in selected nonpriority areas. In April 1996, PAHO began a review of

its environmental sanitation and veterinary public health programs, which

seemed to overlap with other organizations performing similar work. The

results of the review of environmental sanitation programs are not yet

available. The results of the review of veterinary public health programs

were presented at the December 1996 meeting of the Subcommittee on

Program and Planning of the Directing Council’s Executive Committee,

along with a recommendation that PAHO continue to conduct veterinary

public health programs, particularly those focusing on diseases such as

mad cow disease. PAHO also initiated a review of the need for all of the

organization’s technical centers, but the results of this review are not yet

available. Nonetheless, PAHO officials indicated that the country

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governments own the technical centers and make the final decisions about

them, regardless of outside recommendations.

ILO ILO has had a number of management improvements in recent years.

According to ILO, the reforms have focused on creating greater efficiencies

in the agency’s operations and improving ILO responsiveness to member

needs. According to U.S. government officials in Geneva, ILO had been in

the forefront of making reforms and was making good progress. Some of

ILO’s major reforms implemented include

• reducing the approved 1996-97 biennial budget by $21.7 million, from

$579.5 million to $557.8 million;

• moving a portion of its staff from headquarters in Geneva to the field;

• establishing an active partnership policy, which called for delegation of

authority to the field, assignment of multidisciplinary teams to the regions,

reviews of all country-level activities, redefined roles for headquarters

units, staff mobility, and closer working relationships between ILO and its

clients;

• adopting a business-based strategic publications policy, which plans for

editorial review of manuscript proposals for relevance, timeliness, and

marketability;

• decentralizing financial functions to field offices;

• developing action programs, which are designed to produce concrete and

timely outputs to constituents;

• reducing the duration and frequency of meetings, including the

International Labor Conference, Governing Body meetings, technical and

sectoral meetings, and regional conferences; and

• revising budget procedures to include cost estimates by program priority

instead of program department.

Ongoing management improvement efforts include

• conducting feasibility studies on outsourcing in-house printing operations,

mainframe computer operations, and central typing pool services and

transferring freelance translations services from contractors based in

Geneva to contractors based in lower cost countries and

• implementing a new monitoring, self-evaluation, and reporting system,

which requires that each unit prepare annual workplans, semiannual

progress reviews, and annual self-evaluations.

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Some important management and administrative improvements on the

current U.S. reform agenda still await significant action. The more

important items are (1) developing a mechanism for more equitable

sharing of exposure to exchange rate losses between member states and

the organization, (2) improving governing body oversight procedures to

ensure better compliance with audit and inspection recommendations, and

(3) declaring one or two activities in each of the three programming areas

as high priority for the biennial budget under development. The first item

reverses the U.S. 1991 position that insisted that ILO change its budget

calculations from U.S. dollars to Swiss francs, thus exposing all

dollar-based currencies to exchange rate losses. Before 1991, ILO’s budget

was determined in U.S. dollars, which placed the exchange rate burden on

ILO. According to the State Department, this method of determining ILO’s

budget necessitated frequent supplemental budget requests, which were

routinely approved.

In addition, the State Department has also urged ILO to create an office that

would have functions similar to an inspector general. According to ILO

officials, the Secretariat, in consultation with the United States and other

members, prepared amendments to its financial rules and regulations to

give its Office of Internal Audit greater independence and a provision for

external reporting to the membership. The proposed revisions were

presented and approved by ILO’s governing body at its November 1996

meeting. We did not assess the potential impact of these revisions.

UNCTAD UNCTAD has undergone an evolution of management and administrative

improvement efforts. Until early 1996, UNCTAD had not begun a

comprehensive reform effort, although the U.S. government has been

trying to reform UNCTAD’s program and organization since 1992. At the 1992

UNCTAD conference, the member states reformed the working methods of

UNCTAD and set some new priorities. These actions set a new

nonideological tone for UNCTAD’s proceedings and created a new

intergovernmental process similar to that of the Organization for

Economic Cooperation and Development, with an emphasis on analysis

and discussion.8

 According to State Department officials, U.S. leadership

was a significant factor in making these reforms.

8

The Organization for Economic Cooperation and Development was formed in 1961 to promote

consistent economic and social policies and practices of its 27 industrialized member nations through

systematic reviews and analyses. The reviews and analyses focus on areas such as education,

environment, and trade.

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However, despite U.S. expectations, UNCTAD’s efforts did not lead to

comprehensive reform. UNCTAD’s Secretariat remained overstaffed and

poorly managed, and its program remained unfocused. The United States

and others described UNCTAD’s program during that period as a hybrid,

reflecting both old priorities along with the new priorities of the 1992

UNCTAD conference. UNCTAD said that it was difficult to undertake a reform

agenda because, as an integral part of the U.N. Secretariat, it faced

bureaucratic obstacles within the Secretariat. Although it is true that

UNCTAD is not an autonomous agency and must follow the managerial

policies and apply the administrative procedures set by the General

Assembly, both U.N. and U.S. officials stated that UNCTAD had

opportunities for making reforms after the 1992 conference that it did not

use.

In September 1994, UNCTAD’s governing body, the Trade Development

Board, adopted a technical cooperation policy to guide program decisions

and directed that the working groups on the medium-term plan and the

program budget should annually review the technical cooperation policy.

To improve coordination, the working groups in 1995 directed the

Secretariat to develop memorandums of understanding with other

international organizations working on related technical cooperation

projects.

According to State Department officials, UNCTAD has done valuable work in

some areas, including trade and environment, risk management, and trade

efficiency. For example, UNCTAD conducts programs to encourage less

developed countries to use financial instruments in risk management.

Also, UNCTAD’s statistical publications, the Trade and Development Report

and the World Investment Report, are widely used in the United States and

other countries. However, State Department officials said that UNCTAD

could be more cost-effective and responsive to management and

administrative reforms. For example, the State Department believes that

many elements of UNCTAD’s work program have not made unique,

cost-effective, or valuable contributions to the international system and

therefore should be eliminated (and the Secretariat correspondingly

reduced). These elements include poverty alleviation, economic

cooperation among developing countries, global interdependence,

enlarged economic spaces, and export capacity. UNCTAD’s future work

program is undergoing a thorough review in light of the decisions made at

the 1996 UNCTAD conference.

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In December 1995, the U.N. Office of Internal Oversight Services issued a

report highly critical of UNCTAD and called for a major reorganization and

refocusing of UNCTAD’s program. Specifically, the report noted that almost

all of UNCTAD’s activities are also done by other organizations within the

U.N. system. For example, research on developing countries’ trade and

development problems is carried out in U.N. regional commissions and

U.N. headquarters. In addition, the report concluded that UNCTAD’s current

organizational structure inhibits policy cohesion and effective program

oversight and coordination functions within the Secretariat. Officials from

the Office of Internal Oversight Services stated that the plans to reorganize

UNCTAD, formulated by the new UNCTAD Secretary General in March 1996,

were an important first step in addressing the concerns raised in the

report.

Finally, at the April 1996 UNCTAD conference, the organization adopted a

wide range of management and administrative improvement initiatives.

UNCTAD’s Secretary General announced a complete reorganization of the

Secretariat. Some of the major initiatives adopted at this conference

include

• reducing the number of standing intergovernmental bodies by 75 percent,

from 20 to 5, and cutting the total number of annual meeting days by

50 percent, from 120 to 60 days;

• coordinating UNCTAD’s activities more closely with the World Trade

Organization, the International Trade Center, and other international

organizations;

• redefining UNCTAD’s program of work to include helping developing

countries enter the international trading system and providing guidance on

national policies; and

• increasing involvement of the private sector and nongovernmental

organizations in UNCTAD’s work.

State Department officials view the reforms adopted at the 1996 UNCTAD

conference as a successful outcome for the conference. The work of the

conference, in their view, provided for streamlining institutional

arrangements, focusing activity on a relatively small number of priority

issues, reducing the length and number of meetings, and enhancing

transparency in UNCTAD’s program and budget. A State Department official

attending the October 1996 meeting of the Trade and Development Board

stated that the meeting generally reflected the reformist orientation of the

UNCTAD conference held earlier in the year. However, State Department

officials stated the conference and other reform proposals are only a first

Page 20 GAO/NSIAD-97-2 United Nations
B-270713 

step and that UNCTAD’s member states must ensure that the reform

measures are successfully implemented.

UNFPA State Department and other U.S. government officials we interviewed

consider UNFPA to be generally responsive to management, administrative,

and program reform proposals. Since 1988, the organization has

undertaken a wide range of management and administrative

improvements. Some of the actions completed include

• establishing eight regional and subregional country support teams,

consisting of experts from WHO, the U.N. Educational, Scientific, and

Cultural Organization (UNESCO), FAO, and ILO;

• financing 42 specialist and coordinator posts to headquarters of the United

Nations, UNESCO, WHO, FAO, and ILO, as well as U.N. regional commissions

and WHO regional offices, whose staff provide backup services to country

support teams and country field offices and work on population issues

within their own agencies;

• introducing a new performance appraisal system that establishes an

annual individual work plan, monitors performance through the year with

an interim review, and provides a year-end appraisal and review by the

Management Review Group; and

• decentralizing operations to the UNFPA field offices.

The United States recommended action in two areas:

• reducing the number of smaller projects and combining them into fewer

but larger projects and

• streamlining its program planning, implementation, monitoring, and

evaluation.

According to a U.S. official, UNFPA has responded favorably to the U.S.

recommendation. For example, UNFPA’s 1995 Director’s report shows that

the number of new projects dropped from 610 in 1994 to 435 in 1995. We

did not assess UNFPA’s response to these recommendations or determine

whether they adequately addressed the State Department’s concerns.

Agency Comments The Departments of State, Health and Human Services, and Labor and

USAID generally agreed with our report. All of the agencies said that the

report provides a balanced assessment of U.S. participation in the five

international organizations. State noted that, even though many of the

Page 21 GAO/NSIAD-97-2 United Nations
B-270713 

reform initiatives have been only adopted recently, those that were

implemented several years ago are now in the process of being evaluated.

The Departments of State and Health and Human Services also indicated

that WHO’s current lack of effective leadership has been an important

factor in the somewhat slow progress WHO has made in instituting reforms.

The State Department said that the election of a new WHO Director General

in 1998 will provide a vitally needed impetus for moving ahead with a

strong reform agenda.

WHO, PAHO, ILO, UNCTAD, and UNFPA generally concurred with the report, but

UNCTAD emphasized that it is not an autonomous agency, as are the other

organizations discussed in our report, and that it must follow the

managerial policies and administrative procedures set by the U.N. General

Assembly. UNCTAD also said that, even though the U.N. Office of Internal

Oversight Services was critical of UNCTAD’s management performance,

other reports have been more favorable.

Each agency provided technical comments that have been incorporated

into the report as appropriate. Agency comments are reprinted in their

entirety in appendixes VI through XIV.

Scope and

Methodology

We conducted our review at the headquarters of WHO, ILO, UNCTAD, and the

World Trade Organization in Geneva, UNFPA in New York, and PAHO and the

World Bank in Washington, D.C. We reviewed policy documents,

resolutions adopted by governing boards, manuals, annual reports, budget

and financial documents, internal reports, External Auditor reports,

collaboration agreements between organizations, internal and external

management studies, reform proposals, and background literature on the

organizations. In addition, we obtained policy statements and documents

relating to U.S. foreign policy interests and objectives and the management

of U.S. participation in international organizations from the Department of

State in New York, Geneva, and Washington, D.C.

As an agency of the United States, we have no direct audit authority to

review the operations of international organizations, including WHO, PAHO,

ILO, UNCTAD, and UNFPA. However, these organizations consented to our

review, and the Secretariat and staff of each organization were open and

forthcoming in interviews and provided us with all information requested.

To determine whether U.S. participation serves U.S. foreign policy

interests, we compared U.S. foreign policy objectives with the policies and

Page 22 GAO/NSIAD-97-2 United Nations
B-270713 

program objectives of the five organizations. We also obtained the views of

administration officials responsible for setting U.S. foreign policy interests

and managing U.S. participation in international organizations, as well as

views from organizations that have often been publicly critical of the

United Nations. To determine whether U.S. interests can be served more

cost efficiently by other means, we obtained assessments from U.S.

officials and other experts on the impact of the organizations’ programs

and the benefits derived from U.S. participation. We also interviewed U.S.

government and private institution officials. To examine the progress on

management, administrative, and program reforms, we compiled

information on recent reforms initiatives from the five organizations and

compared their assessments of progress made with U.S. and other expert

assessments. The scope of our review did not include an assessment of the

status or effectiveness of reforms undertaken in the area of financial

management at any of the organizations.

We interviewed over 100 employees at all levels of the organizations,

ranging from the Directors General to the support staff; 19 representatives

from 14 member countries of the Geneva Group; 11 representatives from 

7 member countries of the Group of 77; the External Auditor from the

United Kingdom; and nongovernmental organizations, including

representatives from the American Federation of Labor and Congress of

Industrial Organizations, U.S. Council for International Business, the

Population Council, and the Center for Development and Population

Activities. We also interviewed officials in Washington, D.C., responsible

for U.S. participation in international organizations at the Departments of

State, Health and Human Services, Labor, and Commerce; the U.S. Trade

Representative Office; USAID, and the U.S. Mission to the United Nations.

We performed our review from November 1995 to October 1996 in

accordance with generally accepted government auditing standards.

We are sending copies of this report to appropriate congressional

committees, the Secretary of State, and other interested parties. Copies

will be made available to others on request.

Page 23 GAO/NSIAD-97-2 United Nations
B-270713 

Please contact me at (202) 512-4128 if you or your staff have any questions

about this report. Major contributors to this report are Lee Richardson,

Zina Merritt, and Richard Boudreau.

Sincerely yours,

Harold J. Johnson

Associate Director, International Relations

 and Trade Issues

Page 24 GAO/NSIAD-97-2 United Nations
Page 25 GAO/NSIAD-97-2 United Nations
Contents

Letter 1

Appendix I 

World Health

Organization

30

Organizational Structure 30

Governance 30

Reporting Mechanisms 31

Major Program Areas 31

Financial Resources 32

Personnel 33

Collaboration With Other International Organizations 34

U.S. Participation in WHO 35

Appendix II 

Pan American Health

Organization

38

Organizational Structure 38

Governance 39

Reporting Mechanisms 39

Major Program Areas 39

Financial Resources 40

Personnel 41

Collaboration With Other International Organizations 41

Appendix III 

International Labor

Organization

43

Organizational Structure 43

Governance 43

Major Program Areas 44

Financial Resources 44

Personnel 45

Collaboration With Other International Organizations 46

U.S. Participation in ILO 47

Appendix IV 

U.N. Conference on

Trade and

Development

48

Organizational Structure 48

Governance 48

Major Program Areas 48

Financial Resources 49

Personnel 49

Collaboration With Other International Organizations 50

U.S. Participation in UNCTAD 51

Page 26 GAO/NSIAD-97-2 United Nations
Contents

Appendix V 

U.N. Population Fund

52

Organizational Structure 52

Major Program Areas 53

Financial Resources 54

Personnel 55

Collaboration With Other International Organizations 55

U.S. Participation in UNFPA 57

Appendix VI 

Comments From the

Department of State

59

Appendix VII 

Comments From the

U.S. Agency for

International

Development

60

Appendix VIII 

Comments From the

Department of Health

and Human Services

62

Appendix IX 

Comments From the

Department of Labor

66

Appendix X 

Comments From the

World Health

Organization

68

Page 27 GAO/NSIAD-97-2 United Nations
Contents

Appendix XI 

Comments From the

Pan American Health

Organization

70

Appendix XII 

Comments From the

International Labor

Office

75

Appendix XIII 

Comments From the

U.N. Conference on

Trade and

Development

78

Appendix XIV 

Comments From the

U.N. Population Fund

81

Tables Table 1: Overview of Selected International Organizations 3

Table 2: U.S. Position on the 1996-97 Proposed and Approved

Budgets

12

Table I.1: WHO’s Budget 32

Table I.2: Distribution of WHO’s Regular Budget 32

Table I.3: U.S. Contributions to WHO 33

Table I.4: Number of WHO Staff Members 34

Table I.5: Location of WHO Staff Members 34

Table II.1: PAHO’s Budget 40

Table II.2: U.S. Contributions to PAHO 40

Table III.1: ILO’s Budget 44

Table III.2: U.S. Contributions to ILO 45

Table III.3: Number of ILO Staff Members 46

Table IV.1: UNCTAD’s Budget 49

Table IV.2: Number of UNCTAD Staff Posts 49

Page 28 GAO/NSIAD-97-2 United Nations
Contents

Table V.1: UNFPA’s Budget 54

Table V.2: U.S. Contributions to UNFPA 55

Table V.3: Number of UNFPA Staff Posts 55

Table V.4: Location of UNFPA Staff Posts 55

Abbreviations

AIDS Acquired Immune Deficiency Syndrome

FAO Food and Agriculture Organization

HIV Human Immunodeficiency Virus

ILO International Labor Organization

IMF International Monetary Fund

PAHO Pan American Health Organization

UNCTAD U.N. Conference on Trade and Development

UNDP U.N. Development Program

UNESCO U.N. Educational, Scientific, and Cultural Organization

UNFPA U.N. Population Fund

UNICEF U.N. Children’s Fund

USAID U.S. Agency for International Development

WHO World Health Organization

WTO World Trade Organization

Page 29 GAO/NSIAD-97-2 United Nations
Appendix I 

World Health Organization

The World Health Organization (WHO) was created in 1948, and the United

States became a member that same year. WHO’s constitution states that the

enjoyment of the highest attainable standard of health is one of the

fundamental rights of every human being. In 1977, the World Health

Assembly, WHO’s policy-making body, formulated its “Health for All by the

Year 2000” strategy, challenging governments and WHO to attain a level of

health that would permit all people of the world to lead socially and

economically productive lives. The objectives of WHO are pursued in part

through technical cooperation with member states and by directing and

coordinating international health work. These objectives are

complementary and include advocating health; stimulating specific health

action and disseminating information; developing norms, standards, plans,

and policies; developing models for monitoring, assessing, and evaluating

programs and projects; training; promoting research; and providing direct

technical consultation and resource mobilization.

Organizational

Structure

WHO has six regional offices located in Washington, D.C.; Alexandria,

Egypt; Brazzaville, Congo; Copenhagen, Denmark; New Delhi, India; and

Manila, Philippines. It also has liaison offices in Addis Ababa, Ethiopia;

New York, Washington, D.C; and Lyon, France (the International Agency

on Research and Cancer). WHO has 143 country offices, which are often

located within the national health ministry.

WHO recently appointed an acting Deputy Director General to deal with

day-to-day management and policy issues in the absence of the Director

General. The Director General has seven Assistant Directors General and

two Executive Directors who are responsible for managing and

administering the budgets of the major program divisions of WHO. Each of

the six regional offices has a director, who is responsible for managing the

programs and budgets of the regional offices. In addition, at headquarters,

over 30 directors of functional departments are responsible for planning,

monitoring, and evaluating the program activities of WHO.

Governance The World Health Assembly is composed of all 190 member states. It

meets annually in May to decide the overall direction of the organization

and the general program for a specific period and adopt the 2-year budget.

Most decisions are made by consensus, but a two-thirds vote is required if

called for on budget issues. No member has veto power. The World Health

Assembly elects the Director General as well as the 32 member states who

designate 1 person technically qualified in the field of health to serve on

Page 30 GAO/NSIAD-97-2 United Nations
Appendix I 

World Health Organization

the Executive Board. The board meets twice a year to review the work of

WHO in more detail and prepares issues for consideration by the World

Health Assembly. About one-third of the members are replaced annually.

The current U.S. member of the Executive Board is the Principal Deputy

Assistant Secretary for Health, Department of Health and Human Services.

The current U.S. term on the Executive Board will be completed in

June 1997. The United States will attend the board meeting as a

nonmember in 1998.

Reporting

Mechanisms

The Director General issues an annual report on the work of WHO. The

report makes an annual assessment of world health status and needs and

recommends relevant priorities for international health action to meet

those needs. It also reports on WHO’s efforts and programs for improving

the world health situation.

Major Program Areas WHO’s planning covers a 6-year period and provides a framework for

annual workplans. The most recent plan, The Ninth General Program of

Work for 1996-2001, establishes the global health policy framework for

action by the world health community (international organizations of the

U.N. system, including WHO; nongovernmental organizations; bilateral and

multilateral donor and development agencies; banks; and countries). The

four major orientations of the global health policy include integrating

health and human development in public policies, ensuring equitable

access to health services, promoting and protecting health, and preventing

and controlling specific health problems.

WHO encourages and assists member states to provide a vast number of

functions to achieve its objectives. The functions include technical

cooperation, consensus development, information dissemination and

other support focused on, but not limited to, prevention and control of

infectious diseases, including eradication of diseases where possible;

promotion of maternal and child health; environmental health, including

promotion of safe water and improved sanitation; occupational health;

promotion of improvements in health systems, with particular reference to

equity of access; occupational health; and reproductive health, nutrition,

and health problems of a noncommunicable nature (e.g., cancer and

cardiovascular disease).

Page 31 GAO/NSIAD-97-2 United Nations
Appendix I 

World Health Organization

Financial Resources WHO’s budget, maintained on a biennial basis, is the largest of the U.N.

specialized agencies. WHO’s regular budget comes from assessed

contributions from member states, and its scale of assessments is fixed

according to the U.N. scale of contributions adopted by the General

Assembly. (See tables I.1 through I.3.) Extrabudgetary contributions come

from various donor countries and institutions for specific health initiatives

or programs.

Table I.1: WHO’s Budget

Dollars in millions

Type of funding 1992-93 1994-95 1996-97

Regular budget $734.9 $822.1 $842.6

Extrabudgetary contributions 756.7 1,149.2 993.7a

Total $1,491.5 $1,971.3 $1,836.3

aThis amount was estimated as of January 1995.

Source: WHO.

Table I.2: Distribution of WHO’s

Regular Budget Dollars in millions

Location 1992-93 1994-95 1996-97

Headquartersa $257.6 $283.0 $298.5

Africa 136.4 154.3 154.3

Americas 71.5 79.8 79.8

Southeast Asia 87.0 95.9 96.2

Europe 45.9 49.0 50.8

Eastern Mediterranean 73.6 85.5 86.3

Western Pacific 62.9 74.6 76.7

Total $734.9 $822.1 $842.6

aMost of the budgetary increase from 1994-95 to 1996-97 was for headquarters operations and

activities.

Source: WHO.

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World Health Organization

Table I.3: U.S. Contributions to WHO

Fiscal year

Dollars in millions

Type of funding 1992 1993 1994 1995

Regular budget $83.4 $98.5 $92.5 $104.1

Extrabudgetary contributions 70.3 82.5 95.5 39.3

Total $153.7 $181.0 $188.0 $143.4

Note: Information on fiscal year 1996 contributions was not available at the time of our review.

Source: U.S. executive branch agencies.

For the past 3 years, WHO has experienced a severe financial crisis.

Because of budgetary shortfalls due to late or nonpayment of regular

budget assessments by member states, including the United States, Russia,

and Ukraine, WHO has had to rely on extensive borrowing from internal

funds. (See pp. 14-15 for details.) In addition, the budget approved by the

World Health Assembly in May 1995 for the 1996-97 biennium was

14 percent below the zero real growth (based on WHO’s zero real growth

calculation) that the Secretariat had hoped to obtain.

Personnel As of January 1, 1996, WHO had 3,828 employees: 1,363 professional and

2,465 general services staff. However, WHO has not met its target for the

recruitment of women to professional and higher graded posts. In 1993,

the Executive Board set a target date of September 30, 1995, for reaching

the 30-percent goal for women to occupy all professional and higher

graded posts. However, only three of eight offices—the Americas, Europe,

and headquarters—reached the goal by that date. As of December 1995,

WHO employed 758 men and 284 women, or about 27.3 percent of its staff,

in the professional and higher grade categories.

Because of budgetary constraints, WHO has taken a number of steps to

downsize the organization. For example, WHO has established a

reduction-in-force committees for staff in professional and general

services category posts and reduction-in-force procedures. In early 1996,

WHO abolished 207-1/2 regular budget positions. About 43 of the posts were

unoccupied. About 39 received termination notices, 33 mutually agreed to

leave, and 9 retired. Other solutions, such as reassignment or placement

into half-time posts, were provided for the remaining staff. Tables I.4 and

I.5 provide data on WHO staff levels.

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World Health Organization

Table I.4: Number of WHO Staff

Members Type of staff 1992-93 1994-95 1996-97

Professional 1,527 1,532 1,363

General services 2,991 2,741 2,465

Total 4,518 4,273 3,828

Source: WHO.

Table I.5: Location of WHO Staff

Members Location 1992-93 1994-95 1996-97

Headquarters 1,552 1,565 1,371

Regions 2,184 1,896 1,713

Countries 782 812 744

Total 4,518 4,273 3,828

Source: WHO.

Collaboration With

Other International

Organizations

WHO has official relations with over 180 nongovernmental organizations.

Along with other institutions, especially with the U.N. Children’s Fund

(UNICEF), WHO promotes the involvement of relevant socioeconomic

development sectors in health in line with its Health for All strategy.

UNICEF-WHO joint actions in the areas of child survival, the sick child

initiative, safe water and sanitation, breastfeeding, and safe motherhood

are some examples that call for intersectoral action and help put health in

the center of sustained development policies and programs.

Progress has been made in strengthening collaboration at country and

regional levels between WHO and the World Bank and other regional

development banks: the African Development Bank, the Asian

Development Bank, the European Bank for Reconstruction and

Development, the Inter-American Development Bank, and the Islamic

Development Bank. WHO advises and supports member states and the

banks on their health and health-related policies and the allocation of use

of their financial and technical resources to implement those policies.

Recommendations for action and World Bank and WHO partnership

principles were agreed to at the World Bank/WHO Review Meeting in

November 1994. During 1995, all of WHO’s regional offices organized

follow-up regional review meetings with the World Bank’s regional

representatives. Collaboration is aimed at ensuring that health aspects are

taken fully into consideration in development of projects financed by the

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Appendix I 

World Health Organization

World Bank and that WHO is fully involved in the early stage in planning

and throughout the implementation and evaluation phases at all

levels—country, regional, and global.

WHO has continued to collaborate with the Association of South-East Asian

Nations on advocacy measures against the Human Immunodeficiency

Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) and

pharmaceutical products. A memorandum of understanding with the

South Asian Association for Regional Cooperations was prepared in 1995.

Collaboration also continued with the League of Arab States and the

Organization of Islamic Conference.

The WHO working group on continental Africa was established in 1994 to

facilitate WHO’s contribution to the implementation of the U.N. “New

Agenda for the Development of Africa in the 1990s” strategy. WHO is

promoting awareness of the Treaty Establishing the African Economic

Community and has assisted the Secretariat of the Organization of African

Unity in drafting a health protocol for the treaty.

U.S. Participation in

WHO

The United States is active in virtually every aspect of the work and

functioning of WHO. As a founding member of WHO, the United States has

helped to define its role in international health work. The United States

has a greater number of its citizens on the staff of WHO—143 as of

January 1996—compared with other member states: the United 

Kingdom (57), France (57), Russian Federation (41), Germany (41), 

Japan (36), Canada (35), Italy (30), and Brazil (28). However, the number

of U.S. staff is still below the recruitment range, which is 193 to 262.

Many of the top scientific and administrative positions of the Secretariat

are held by U.S. citizens. Senior posts filled by U.S. citizens include the

Assistant Director General for Communicable Diseases, Director of the

Action Program on Essential Drugs, Director of the Division of Emerging

and Other Communicable Diseases Surveillance and Control, and the

External Relations and Information Officer in Washington, D.C. In

addition, of the 1,100 WHO collaborating centers, more than 162 are located

at U.S. institutes, many at National Institutes of Health and the Centers for

Disease Control and Prevention.

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World Health Organization

The U.S. government agencies that participate in the work of WHO include

the following:

Department of Agriculture

Department of Commerce

 National Oceanic and Atmospheric Administration

 National Institute of Standards and Technology

Department of Defense

 Office of Assistant Secretary of Defense for Health Affairs

 Department of the Army

 Department of the Navy

Department of Health and Human Services

 Office of Public Health and Science

 Agency for Health Care Policy and Research

 Centers for Disease Control and Prevention

 Food and Drug Administration

 Health Resources and Services Administration

 Indian Health Service

 National Institutes of Health

 Substance Abuse and Mental Health Services Administration

Department of State

 Bureau of Oceans and International Environment and Scientific Affairs

 Bureau of International Organizations

 Office of Medical Services

Department of Veterans Affairs

Environmental Protection Agency

National Aeronautics and Space Administration

National Security Council

Office of Global Climate Change Research Programs

Office of Management and Budget

Peace Corps

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World Health Organization

U.S. Agency for International Development (USAID)

White House Office of Science and Technology Policy

White House Council for Environmental Quality

Page 37 GAO/NSIAD-97-2 United Nations
Appendix II 

Pan American Health Organization

The International Sanitary Bureau, the predecessor of the Pan American

Health Organization (PAHO), was created in 1902 during the first

international meeting devoted to the health problems of the Western

Hemisphere. The bureau was essentially a source for information on the

countries’ sanitary conditions. The bureau was later charged with

conducting and promoting scientific studies on any deadly disease

outbreak in the North, South, and Central Americas and the Caribbean,

offering assistance in promoting and protecting the health of the countries’

populations and encouraging seaport sanitation. In 1923, the bureau was

entrusted with elaborating the Pan American Sanitary Code. The code,

which was adopted a year later by delegates of 18 countries, changed the

organization’s name to the Pan American Sanitary Bureau and broadened

its functions and responsibilities.

International health authorities understood that an international

organization with a broad health program was essential to cope with the

health problems of a world made increasingly smaller by faster

transportation. The XII Pan American Sanitary Conference created the Pan

American Sanitary Organization—which later became PAHO—and

established the Pan American Sanitary Bureau as its operative arm. In

1949, an agreement with WHO established the relationship between the two

organizations, with the bureau serving as WHO’s regional office for the

Americas.

PAHO’s mission is to foster and coordinate the efforts of the countries in

the Western Hemisphere to fight disease, lengthen life, and promote the

physical and mental health of their populations. To fulfill these mandates,

PAHO cooperates with member countries in (1) identifying immediate and

long-term health threats and developing approaches to overcome them;

(2) making the latest scientific and technical information in health

available; (3) providing assistance for developing and improving national

and local health services; (4) promoting research and development of

technology; (5) awarding grants and fellowships and organizing seminars

and training courses; and (6) supporting national activities and programs

that address public health problems. PAHO also works with member

countries’ ministries of health, social security agencies, and other national

health institutions in the health, education, environment, and agriculture

sectors.

Organizational

Structure

PAHO’s Secretariat is headed by a director who is elected every 4 years by

the Pan American Sanitary Conference. The Secretariat staff is composed

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Appendix II 

Pan American Health Organization

of health authorities from member states who are primarily, but not

exclusively, from countries in the Western Hemisphere. The Secretariat is

responsible for carrying out the policies and programs approved by the

governing bodies of the organization. PAHO has 8 scientific and technical

centers and 28 field offices. One of its field offices is located in El Paso,

Texas.

Governance The policies of PAHO are set by its governing bodies—the Pan American

Sanitary Conference, the Directing Council, and the Executive Committee.

The conference and the council also serve as the Regional Committee for

the Americas of the WHO. The conference meets every 4 years to elect the

Director of the Pan American Sanitary Bureau, establish PAHO’s general

policies and the bureau’s mandates, and serve as a forum for debating

major national and international health issues. The Directing Council’s

makeup mirrors that of the conference. Among other responsibilities, the

council reviews and approves PAHO’s biennial program budget and

considers important policy issues. The Executive Committee is made up of

representatives from nine member governments chosen by the conference

or the council for staggered 3-year terms. The committee meets twice

yearly to approve the provisional agendas for the conference and the

council and review policy issues that will be presented to those bodies.

Reporting

Mechanisms

In accordance with the PAHO’s constitution, the Director submits an annual

report on technical cooperation activities of the Pan American Sanitary

Bureau to its members. The Director also submits an interim financial

report.

Major Program Areas In September 1994, the Pan American Sanitary Conference approved five

strategic and programmatic orientations for PAHO for 1995-98. The five

orientations are health in human development, health systems and

services development, health promotion and protection, environment

development and protection, and disease prevention and control.

PAHO’s member states have asked PAHO to undertake activities that are

outside the scope of the WHO charter but are consistent with PAHO’s

constitution. One of these responsibilities is a veterinary public health

program, a mandate received from member countries. As a member of the

inter-American system, PAHO is frequently called on to carry out

assignments unique to the region, such as its responsibilities in carrying

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Appendix II 

Pan American Health Organization

out negotiations leading to the Health Initiative of the Americas, which

was part of the plan of action of the Summit of the Americas held in

Miami, Florida, in December 1994.

Financial Resources The largest portion of PAHO’s funds comes from assessments paid directly

by member countries. These assessments are calculated based on a

country’s population and national income. The remainder of the

organization’s regular budget comes from WHO. PAHO also receives

extrabudgetary resources from various U.N. agencies, other international

bodies for which it acts as an executing agency, foundations, and bilateral

donor countries, as shown in tables II.1 and II.2. About 82.9 percent of

PAHO’s budget is allocated for its program costs.

Table II.1: PAHO’s Budget

Dollars in millions

Type of funding 1992-93 1994-95 1996-97

Regular budget $152.6 $164.5 $168.6

PAHO share of WHO regular budget 71.5 79.8 79.8

Extrabudgetary contributions 142.3 194.5 63.0a

Total $366.4 $438.8 $311.4

aThis amount was estimated as of June 1995.

Source: PAHO.

Table II.2: U.S. Contributions to PAHO

Fiscal year

Dollars in millions

Type of funding 1992 1993 1994 1995

Regular budget $45.5 $46.1 $47.4 $48.7

Extrabudgetary contributions 14.6 10.5 10.6 2.9

Total $60.1 $56.6 $58.0 $51.6

Note: Information on fiscal year 1996 contributions was not available at the time of our review.

Source: U.S. executive branch agencies.

In late 1995, PAHO experienced a shortfall primarily because of late or

nonpayment of regular budget assessments. As a result, the organization

borrowed from its working capital fund. The United States, PAHO’s largest

contributor, was unable to make its last quarter payment. The United

States has since fully paid its 1995 assessment, but owes a total of about

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Appendix II 

Pan American Health Organization

$11 million for payments due before 1996. According to PAHO officials, the

borrowed funds will be repaid when a surplus of assessments

contributions is available, but when this will occur is unknown.

Personnel As of December 1, 1995, PAHO had a total of 686 employees—

271 professional and 415 general services staff. Women make up

59 percent of the total number of employees and 34 percent of the total

professional positions. PAHO employs about 109 U.S. citizens—

49 professional and 60 general services staff. Senior posts filled by U.S.

citizens include the Deputy Director and Chiefs of Budget, Finance,

Administration, Publications and Editorial Services, Public Information,

and the Pan American Center for Human Ecology and Health.

Collaboration With

Other International

Organizations

PAHO collaborates with a number of organizations. Some of PAHO’s current

collaborative efforts include

• vaccinations with UNICEF, the U.N. Development Program (UNDP), USAID,

and Rotary International;

• efforts to reduce maternal and child mortality and other programs to

improve children’s health with UNICEF at the regional and country levels;

• radiology and nuclear medicine with the International Atomic Energy

Agency;

• air and water pollution issues with the U.N. Environment Program and the

U.S. Environmental Protection Agency;

• food safety and animal health coordination with the Food and Agriculture

Organization;

• the Joint U.N. Program on the HIV and AIDS with WHO, UNDP, UNICEF, the U.N.

Educational, Scientific, and Cultural Organization (UNESCO), U.N.

Population Fund, and the World Bank;

• health conditions of refugees with the U.N. High Commissioner for

Refugees; and

• natural disaster response with the Red Cross.

Since 1994, PAHO has participated as a regular member in the World Bank’s

consultative groups meetings. PAHO also participated at the Inter-American

Development Bank’s annual board meeting, sponsored the first

Inter-American Conference on Society, Violence, and Health and

cosponsored by the Inter-American Development Bank; UNICEF; UNDP;

UNESCO; USAID; the Organization of American States; and the Inter-American

Dialogue, a think tank in Washington, D.C. It also played a key role in

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Pan American Health Organization

negotiations leading to the Health Initiative of the Americas, which was

part of the plan of action of the Summit of the Americas.

PAHO actively works with U.S. nongovernmental organizations,

foundations, and cooperations. For example, PAHO is working with the

Caribbean/Latin American Action, a nongovernmental organization, and

the private sector to explore how new information technologies can be

most effectively applied to health concerns in the region. PAHO also chairs

a Telemedicine Committee that brings together a diverse group, including

U.S. national laboratories and telecommunications companies. This plan is

designed to complement the Summit of Americas’ mandate to explore the

use of new telecommunications technologies.

In addition, PAHO collaborates extensively with U.S. military health

authorities and the Department of Health and Human Services. PAHO’s

programs are closely coordinated with national health authorities,

particularly the agencies of the Public Health Service (e.g., Centers for

Disease Control and Prevention, Food and Drug Administration, and

National Institutes of Health). These programs minimize the impact on

U.S. citizens of infectious diseases and seek to improve sanitation

conditions in neighboring countries.

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Appendix III 

International Labor Organization

The International Labor Organization (ILO) was established in 1919 under

the Treaty of Versailles as an autonomous institution associated with the

League of Nations. An agreement establishing the relationship between ILO

and the United Nations was approved in 1946, and ILO became the first

specialized agency associated with the United Nations. Today, ILO

continues to operate under its own constitution.

The primary objectives of ILO are promoting democracy and human rights,

fighting unemployment and poverty, and promoting equality and adequate

protection for all categories of workers. Among its activities, ILO

formulates international policies and programs to help improve working

and living conditions; creates international labor standards to serve as

guidelines for national authorities in putting these policies into action;

carries out an extensive program of technical cooperation to help

governments in making these policies effective in practice; and engages in

training, education, and research to help advance these efforts. ILO is

unique among world organizations in that worker and employer

representatives have an equal voice with government representatives in

formulating policies.

Organizational

Structure

ILO has 26 area and 5 regional offices through which it implements its

technical cooperation programs in 138 countries. In addition, 14

multidisciplinary teams located at 14 sites around the world support

country programs.

Governance ILO’s policy-making and legislative body is the International Labor

Conference, which is composed of the entire membership and meets every

June. The conference approves the biennial budget. ILO’s Executive Board

is the Governing Body, which is composed of 56 members (28 government

delegates, 14 worker delegates, and 14 employer delegates). The

Secretariat is headed by a Director General appointed by the Governing

Body. The Director General is responsible to the Governing Body for

managing the Secretariat. The United States has a permanent seat in the

Governing Body and the U.S. representative to the Governing Body is the

Deputy Under Secretary of Labor for International Affairs. The Governing

Body usually makes decisions on a consensus basis, and no member has

veto power.

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International Labor Organization

Major Program Areas ILO focuses broadly in three areas: promoting democracy and human

rights, fighting unemployment and poverty, and protecting working

people. ILO’s budget documents contain a wide array of programs within its

institutional focus, including international labor standards and human

rights, employment, enterprise and cooperative development, training,

industrial relations and labor administration, multinational enterprises and

social policy, working conditions and the environment, sectoral activities,

social security, statistics, development and technical cooperation, equality

for women, employers activities, and workers activities. Within these

programs, ILO employs such tools as technical meetings, research,

dissemination of information, standard setting, technical advisory services,

and field projects.

Financial Resources ILO’s regular biennial budget is divided into about 40 major programs. In

the 1996-97 biennium budget, four of the major programs are allocated

over half of ILO’s program funds. These programs are enterprise and

cooperative development, training, working conditions and environment,

and development and technical cooperation. Of the over $227 million in

extrabudgetary funds for the 1996-97 biennium, over $64 million is

expected to come from U.N. sources, such as UNDP. Tables III.1 and III.2

show ILO’s budgetary information for 1992-97.

Table III.1: ILO’s Budget

Dollars in millions

Type of funding 1992-93 1994-95 1996-97

Regular budget $405.7 $466.5 $579.5a

Extrabudgetary contributions 325.8 278.9 227.5

Total $731.5 $745.4 $807.0

aLater in the biennium, ILO reduced the approved 1996-97 biennial budget by $21.7 million, from

$579.5 million to $557.8 million.

Source: ILO.

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International Labor Organization

Table III.2: U.S. Contributions to ILO

Fiscal year

Dollars in millions

Type of funding 1992 1993 1994 1995

Regular budget $54.3 $61.7 $53.1 $62.1

Extrabudgetary contributions 0 0 0 2.1

Total $54.3 $61.7 $53.1 $64.2

Note: Information on fiscal year 1996 contributions was not available at the time of our review.

Source: U.S. executive branch agencies.

Table III.1 suggests that there is an increase in ILO’s budget for 1996-97,

compared with 1994-95. However, when the budget is adjusted for

projected inflation and changes in the exchange rate, we estimate a

2-percent decline in real terms in ILO’s budget. The apparent 24-percent

increase between the 1994-95 and 1996-97 ILO budgets, and the

corresponding increase in the U.S. assessment, is due primarily to changes

in the U.S. dollar-Swiss franc exchange rate used in formulating the ILO

budget (i.e., the 25-percent strengthening of the Swiss franc relative to the

dollar). The actual dollar cost to the United States will depend on the

exchange rate on the dates that the United States pays its assessed

contribution. For example, the exchange rate used in calculating the

1996-97 U.S. dollar payment of $579.5 million was 1.16 Swiss francs per

dollar. However, if the United States had paid its assessed contribution on

December 10, 1996, when the exchange rate was 1.33 Swiss francs per

dollar, the U.S. dollar payment would have been only 10 percent greater

than its actual contribution to the regular budget for 1994-95.

Personnel In March 1996, 72 U.S. citizens comprised 11.4 percent of the professional

staff. Although the United States contributes about 25 percent of ILO’s

regular budget, ILO considers 15-percent employment of U.S. citizens to be

a desirable target. According to an ILO official, more than 15 percent may

not be feasible, given the desire of other countries to have some

representation on ILO’s staff. U.S. citizens hold several senior positions

within ILO, including Deputy Director General, Director of Personnel, the

Chiefs of the Equality and Human Rights Coordination Branch; Public

Information; Information Technology and Communications; Publications;

and Chief Librarian. Table III.3 shows the total number of ILO staff

members between 1992 and 1995.

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International Labor Organization

Table III.3: Number of ILO Staff

Members Type of staff 1992 1993 1994 1995

Professional 712 707 712 694

General services 1,077 1,075 1,094 1,118

Total 1,789 1,782 1,806 1,812

Note: Professional staff at ILO headquarters decreased 13 percent, from 569 in 1992 to 495 in

1995. General services staff at ILO headquarters decreased 11 percent, from 732 in 1992 to 662

in 1995.

Source: ILO.

Collaboration With

Other International

Organizations

Within the U.N. system, ILO coordinates its programs with funds, programs,

and specialized agencies, including UNDP, the International Maritime

Organization, UNESCO, UNICEF, and the U.N. Industrial Development

Organization. In addition, ILO coordinates with the World Bank, the

International Monetary Fund (IMF), and the World Trade Organization

(WTO). A 1992 Joint Inspection Unit Report, United Nations Cooperation

With Multilateral Financial Institutions, cited the ILO-World Bank liaison

arrangement as a constructive example of an effective approach to

organizational cooperation. According to a World Bank official,

interagency cooperation was good, but it was ad hoc and, particularly at

the field level, dependent on personal relationships and contacts.

ILO officials stated that ILO and IMF did not have a consistent dialogue

underway or a systematic way to collaborate. The two organizations

disagreed on approaches to structural adjustment for economies in

transition or undergoing a balance of payments crisis. However, in

April 1996, ILO circulated a memorandum announcing a new agreement

between IMF and ILO to foster collaboration on a systematic basis. Both ILO

and IMF appear to be committed to creating a new collaborative

relationship that recognizes the differences between the two

organizations. The differences stem, at least in part, from the

organizations’ differing mandates.

Until December 1996, ILO’s relationship with WTO was informal but, in ILO’s

view, close at the working level. For example, a representative of WTO

attended meetings of ILO’s Working Party on the Social Dimensions of the

Liberalization of Trade as an observer. However, at the December 1996

WTO Ministerial meeting in Singapore, WTO’s member states adopted the

WTO Singapore Ministerial Declaration, which called for continued

collaboration with ILO. WTO’s members states also renewed their

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International Labor Organization

commitment to the observance of internationally recognized core labor

standards set by ILO, and ILO as the competent body to set and deal with

such standards.

U.S. Participation in

ILO

U.S. participation in ILO is guided by national interests as defined by the

President’s Committee on ILO. The Committee is chaired by the Secretary

of Labor and consists of the Secretaries of State and Commerce; the

National Security Advisor; the President of the American Federation of

Labor and Congress of Industrial Organizations; and the President of the

U.S. Council for International Business, which includes the U.S. Chamber

of Commerce and the National Association of Manufacturers. The State

Department addresses the financial issues related to U.S. government

membership and ILO management issues as well as U.S. foreign policy

issues. The Department of Labor addresses most of the technical issues

related to working conditions. Additionally, the Department of Commerce

addresses the issues which arise in the ILO’s Subcommittee on

Multinational Enterprises, Committee on Legal Issues and International

Labor Standards.

On the basis of the work of the President’s Committee on ILO, the

President’s 1997 budget request for ILO sets out U.S. interests and

immediate objectives for ILO. U.S. interests include preserving and

strengthening workers’ rights, improving working conditions, and creating

employment. Specific goals include safeguarding the mechanisms used in

applying ILO’s conventions, particularly the human rights conventions;

promoting a linkage between adherence to human rights labor standards

and increased access to international trade; supporting the program to

eliminate child labor; and promoting technical assistance programs in

areas of foreign policy interests. The U.S. government is actively seeking

reductions in ILO’s budget.

Page 47 GAO/NSIAD-97-2 United Nations
Appendix IV 

U.N. Conference on Trade and Development

The first U.N. Conference on Trade and Development (UNCTAD) in 1964 led

to its establishment later that year as the principal entity within the U.N.

General Assembly in the field of trade and development. Its mandate is to

promote international trade, particularly that of the developing countries

to accelerate their economic development. UNCTAD’s functions are policy

analysis, intergovernmental deliberations, consensus building and

negotiation, monitoring, implementation and followup, and technical

cooperation.

Organizational

Structure

UNCTAD has a permanent Secretariat located in Geneva that is headed by

the Secretary General, who is appointed by the U.N. Secretary General and

confirmed by the U.N. General Assembly. UNCTAD’s Secretary General

reports to the U.N. Secretary General. Under a reorganization, UNCTAD’s

recently appointed Secretary General has reduced the number of divisions

within the Secretariat from nine to four. The new divisions are

(1) Globalization and Development; (2) Services Infrastructure for

Development and Trade Efficiency; (3) Investment, Enterprise

Development, and Technology; and (4) International Trade in Goods and

Services, and Commodities. UNCTAD does not have a field structure of

permanent country offices.

Governance UNCTAD’s conference, the organization’s highest policy-making body, meets

every 4 years. The Trade and Development Board is the executive body of

UNCTAD and normally meets once a year. Its membership is composed of

every member of the conference that wishes to be a member; the board

currently has 138 members. The board is assisted in its work by the

Working Party on the Medium-Term Plan and the Program Budget. The

working party has 19 elected members. The United States is an elected

member of the working party.

Major Program Areas The 1996 UNCTAD conference declared that UNCTAD has a comparative

advantage in addressing trade-related development issues and that UNCTAD

should continue to facilitate the integration of developing countries and

those countries in transition in the international trading system. The

conference outlined the focus of UNCTAD’s analytical and deliberative work

for the next 4 years.

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Appendix IV 

U.N. Conference on Trade and Development

Financial Resources UNCTAD’s core operating expenses are funded through the U.N. regular

budget. UNCTAD does not receive direct assessments or voluntary

contributions to fund its regular budget. However, it receives

extrabudgetary funds from other sources, such as bilateral donors, trust

funds, and funds from UNDP, as shown in table IV.1. UNCTAD officials said

that UNCTAD, as an entity of the U.N. General Assembly, may not borrow

money. The United States pays 25 percent of the regular U.N. budget.

Table IV.1: UNCTAD’s Budget

Dollars in millions

Type of funding

1992-93

budget

expenditure

1994-95 budget

appropriation

1996-97

budget

estimate

Regular budget $100.1 $113.6 $124.1a

Extrabudgetary contributions 45.1 43.8 43.2

Total $145.2 $157.4 $167.3

aIn December 1996, UNCTAD further reduced its budget to $110.2 million.

Source: U.N. Secretariat.

As part of the U.N. Secretariat, UNCTAD’s budget is allocated from the U.N.

budget. The United States pays 25 percent of the total U.N. budget and

does not pay a separate assessment for UNCTAD.

However, U.S. executive branch agencies provided $0.6 million for fiscal

year 1995 in extrabudgetary contributions for specific UNCTAD programs.

Information on fiscal year 1996 contributions was not available at the time

of our review.

Personnel UNCTAD currently employs 19 U.S. citizens, or about 4 percent of UNCTAD’s

staffing level for 1996-97. The total number of UNCTAD staff posts is shown

in table IV.2.

Table IV.2: Number of UNCTAD Staff

Posts Type of staff 1994-95 1994-95 1996-97

Professional 288 258 258

General services 222 196 193

Total 510 454 451

Source: UNCTAD.

Page 49 GAO/NSIAD-97-2 United Nations
Appendix IV 

U.N. Conference on Trade and Development

In December 1995, the U.N. Office of Internal Oversight Services issued a

report on UNCTAD, which noted that the head offices of the nine divisions

within UNCTAD were large and top heavy. The report added that most

divisions appeared to be overstaffed at the professional and general

services levels. The report attributed the staffing problem to the existence

of nonperforming personnel who were accommodated in separate units or

by expanding the size of the head offices within the divisions. These

personnel, according to the report, were the result of a mismatch of staff

capabilities at a time of changing program demands.

In response, the UNCTAD Secretary General announced in April 1996 plans

to create a leaner organizational structure. His plans included a 25-percent

reduction at the senior level and staffing changes to reflect current staff

skill requirements. According to the State Department, during the 1996

UNCTAD Conference, the UNCTAD Secretary General also announced plans to

cut professional and general services staff by 6 percent in 1996-97. State

Department officials noted that the success of these plans will depend on

how well they are implemented.

Collaboration With

Other International

Organizations

Various aspects of UNCTAD’s work overlaps with that of other international

organizations, particularly the U.N. economic commissions, the

International Trade Center, WTO, and the World Bank. UNCTAD’s approach

to coordination with these organizations has been on a project-by-project

basis (e.g., a debt management program with UNDP and the World Bank and

a manual, Blueprint for Green Accounting, with the World Bank). The U.N.

Office of Internal Oversight Services’ December 1995 report was critical of

the level of coordination between UNCTAD and other international

organizations. In particular, the report called for better integration of

UNCTAD’s work with other parts of the U.N. system. According to UNCTAD,

the General Assembly’s Committee for Program and Coordination, of

which the United States is a member, has primary responsibility for

ensuring that proper coordination takes place within the U.N. Secretariat

and with U.N. Secretariat entities.

UNCTAD has recently attempted to better coordinate with WTO and the

International Trade Center and cooperate better with the World Bank. For

example, the 1996 UNCTAD Conference participants agreed to coordinate

UNCTAD’s technical cooperation programs more closely with WTO and the

International Trade Center, and UNCTAD and WTO have agreed to take some

steps to more closely coordinate their activities in support of developing

countries that wish to accede to WTO. Also, as part of a U.N. systemwide

Page 50 GAO/NSIAD-97-2 United Nations
Appendix IV 

U.N. Conference on Trade and Development

Special Initiative on Africa, UNCTAD, WTO, and the International Trade

Center have developed a plan of action for increasing Africa’s

export-oriented production and improving of export diversification and

markets. According to World Bank officials, in the fall of 1995, the

Secretary General of UNCTAD met with World Bank officials and called for

closer collaboration between the two institutions. Bank officials described

the action as improving the atmosphere between the two organizations

and thus an important first step.

U.S. Participation in

UNCTAD

The State Department and the Office of the U.S. Trade Representative are

the lead agencies for UNCTAD within the U.S. government. According to a

State Department official, an informal interagency working group meets as

needed in relation to meetings of the Trade and Development Board or

UNCTAD’s quadrennial conference to approve guidance for the meeting or

comment on a policy paper. Members of the group include the Office of

the U.S. Trade Representative, the Departments of Agriculture, Labor,

Commerce, Justice, State, and Treasury; and the Security and Exchange

Commission.

The United States believes UNCTAD should have a single purpose—to help

developing countries in their integration into the global economic system.

To accomplish this goal, U.S. officials state that UNCTAD must focus on a

small number of priority activities that provide practical assistance to

developing countries. An additional U.S. goal for UNCTAD is to make UNCTAD

complementary to, not competitive with, WTO.

Page 51 GAO/NSIAD-97-2 United Nations
Appendix V 

U.N. Population Fund

In 1966, the U.N. General Assembly authorized the United Nations to

provide technical assistance in the population field. The U.N. General

Assembly established a special fund for population activities in 1967,

which was later named UNFPA. Currently, UNFPA is the largest

internationally funded provider of population assistance to developing

countries. All contributions to UNFPA are voluntary.

UNFPA’s role is to build the capacity to respond to the needs in population

and family planning; promote awareness of population factors, such as

population growth, fertility, mortality, age structure, spatial distribution,

and migration; assist governments in developing population programs and

projects and provide financial assistance for their implementation. UNFPA

provides financial and technical assistance to developing countries at their

request.

Organizational

Structure

UNFPA is a subsidiary component of the United Nations and is subject to

the direction of the U.N. General Assembly. The governing body of UNFPA

is the UNDP/UNFPA Executive Board, which is composed of 36 member

states elected by the U.N. Economic and Social Council. The United States

is currently a member of the board. UNFPA’s chief executive is the

Executive Director, who is appointed by the U.N. Secretary General

normally for a 4-year term. The Executive Director manages UNFPA under

the direction of the board and is fully accountable to it for all aspects of

UNFPA’s operations.

The Executive Board provides general policy guidance and direction for

UNFPA and has overall responsibility for ensuring that UNFPA resources are

employed with maximum effectiveness and efficiency in assisting

countries in their population activities and programs. The board also has

responsibility for financial and administrative policies relating to UNFPA’s

work program, fundraising methods, and annual budget. UNFPA submits its

own budget estimates and operates under the financial regulations

approved by the board. Each year, the U.N. Economic and Social Council

receives a report from the board outlining decisions on UNFPA matters. The

U.N. Economic and Social Council forwards this report to the General

Assembly for its consideration.

UNFPA has 4 regions—Africa, Arab States and Europe, Asia and the Pacific,

and Latin America and the Caribbean—and has 100 field offices—15 in the

Arab States, 44 in sub-Saharan Africa, 23 in Asia and the Pacific; and 18 in

Latin America and the Caribbean. Of the 100 field offices, 66 are headed by

Page 52 GAO/NSIAD-97-2 United Nations
Appendix V 

U.N. Population Fund

a resident UNFPA representative, and 34 are headed by the country resident

UNDP representative, who is concurrently the UNFPA representative. At the

end of 1995, UNFPA was implementing 2,479 projects—1,910 country and

569 intercountry. UNFPA’s projects are largely implemented by member

organizations of the U.N. system, nongovernmental organizations, and

national governments themselves. UNFPA’s own role in project

implementation is mainly to provide procurement assistance in support of

government-implemented projects, procure equipment and supplies for

UNFPA implemented activities, and contract for personnel services.

Major Program Areas In l994, the United Nations convened the International Conference on

Population and Development in Cairo. UNFPA and the Population Division

of the U.N. Department for Economic and Social Information and Analysis

constituted the Secretariat for the conference and were heavily involved in

the 3 years of preparatory activities leading up to the conference. The l83

countries attending the conference adopted by consensus the

International Conference on Population and Development Program of

Action, which included recommendations for stabilizing the world’s

population.

In the months after the conference, UNFPA examined the policy and

program implications of the action plan, particularly as they related to

UNFPA’s policy orientations, program focus, and operational strategies.

UNFPA identified those components of the action plan for which it has a

comparative advantage and formulated a mission statement to serve as the

basis of its activities over the next 20 years. The mission statement

proposes that UNFPA assistance be used to (1) help ensure universal access

to sexual and reproductive health, including family planning to all couples

and individuals, by 2015; (2) support population and development

strategies that develop the capacity to do population programming; and

(3) promote awareness of population and development issues and

advocate for the mobilization of the resources and political will necessary

to accomplish UNFPA’s work.

Currently, about two-thirds of UNFPA’s funds are for reproductive health,

including family planning. Activities range from support for contraceptive

research and production to training, infrastructure, logistics, and

expansion and improvement of service delivery. Other priority areas

include information and education activities, population data collection

and analysis, research on demographic and socioeconomic relationships,

policy formulation and evaluation, and programs to improve the situation

Page 53 GAO/NSIAD-97-2 United Nations
Appendix V 

U.N. Population Fund

of women. Special efforts are also undertaken in the areas of AIDS control

and prevention and population and the environment.

Since the International Conference on Population and Development in

1994, UNFPA has revised its approach for the allocation of resources to

country programs. The conference laid out specific longer term goals in

three major areas: access to reproductive health; mortality reduction in

women and children; and universal education, especially for girls.

UNFPA’s revised system for allocating resources categorizes countries into

three groups according to their needs for specific types of assistance and

circumstances with regard to the progress they have made in meeting the

conference’s goals. For example, countries in the highest priority group

must have the greatest distance from achieving the goals of the conference

and low levels of development. Under the previous system of allocation,

the countries in this group received 51 percent of program resources.

Under the new allocation system, the share should go up to at least

67 percent. Within each group of countries, the actual level and type of

resources made available would primarily reflect UNFPA’s comprehensive

assessment of the country’s actual needs and capacities.

Financial Resources UNFPA is a voluntarily funded organization. It receives funds from donor

countries in support of programs in reproductive health, including family

planning, population and development, and advocacy. The Executive

Board is responsible for approving each year the program expenditure,

which is based on income projections, prior commitments, and

foreseeable needs. If the funds are not spent during a given calendar year,

the remaining funds are carried over to the next year. Tables V.1 and V.2

show UNFPA’s budgetary information for 1992 through 1997.

Table V.1: UNFPA’s Budget

Dollars in millions

Type of funding 1992-93 1994-95 1996-97

Regular budget $397.0 $586.4 $642.4

Extrabudgetary contributions 19.9 28.5 31.4

Total $416.9 $614.9 $673.8

Source: UNFPA.

Page 54 GAO/NSIAD-97-2 United Nations
Appendix V 

U.N. Population Fund

Table V.2: U.S. Contributions to

UNFPA

Fiscal year

Dollars in millions

Type of funding 1993 1994 1995

Regular budget $14.5 $40.0 $35.0

Note: Information on fiscal year 1996 contributions was not available at the time of our review.

Source: U.S. executive branch agencies.

Personnel In February 1996, UNFPA had 188 professional posts reserved for

international staff; 166 posts were occupied and 22 were vacant. At that

time, 107 of the posts were in headquarters and 81 were in the field. U.S.

citizens held 20 of these posts. Tables V.3 and V.4 provide details on

UNFPA’s overall staffing and the distribution of staff between headquarters

and the field.

Table V.3: Number of UNFPA Staff

Posts Type of staff 1992-93 1994-95 1996-97

Professional 293 304 329

General services 519 533 590

Total 812 837 919

Source: UNFPA.

Table V.4: Location of UNFPA Staff

Posts Location 1992-93 1994-95 1996-97

Headquarters 257 244 244

Field 555 593 675

Total 812 837 919

Source: UNFPA.

Collaboration With

Other International

Organizations

UNFPA has developed an array of mechanisms and relationships for

coordinating its programs. Coordination is essential for UNFPA to perform

its mission, particularly with other U.N. agencies and the World Bank.

UNFPA is primarily a funding agency for country-level activities. UNFPA must

identify the expertise of executing agencies—primarily other U.N.

agencies and recipient governments—and seek collaboration in

implementing its own program. Additionally, UNFPA has the lead role in

monitoring and following up on the International Conference on

Page 55 GAO/NSIAD-97-2 United Nations
Appendix V 

U.N. Population Fund

Population and Development’s Program of Action at the country, regional,

and global levels. UNFPA’s mandate from the conference creates extensive

areas of potential overlap with other U.N agencies, the World Bank, IMF,

and bilateral donors.

An example of a coordination mechanism at the country level is the

Program Review and Strategy Development Statement, which UNFPA has

developed for more than 40 recipient governments. The statement assists

(1) the government in developing or strengthening a national population

program strategy and becoming self-reliant in the formulation and

implementation of population policies and programs and (2) UNFPA,

nongovernmental organizations, and other donors in delineating their

programs for external assistance. Developing a strategy provides UNFPA

with an opportunity for discussions with the recipient country and other

multilateral and bilateral donors.

UNFPA also has eight multidisciplinary teams in the field to assist in the

delivery of technical assistance at the country level. The teams are led by

UNFPA staff, but team members are typically staff from other U.N. agencies,

such as WHO, ILO, the Food and Agriculture Organization, and UNESCO.

UNFPA’s coordination mechanism with the World Bank is ad hoc. According

to UNFPA and World Bank documents, extensive cooperation takes place at

headquarters and in the field. The World Bank describes the collaboration

as including senior interagency meetings, field contact, co-financing of

projects, cooperation on multidonor projects, consultation on

complementary objectives, and consultations on in-country activities.

The documents of the two organizations describe numerous collaborative

efforts. For example, UNFPA and the World Bank recently agreed that in

those countries where the bank has already carried out comprehensive

surveys and evaluations in the reproductive health and population sector,

UNFPA would use these products in its own planning and programming

work. Another example cited was that UNFPA’s Africa Division holds annual

consultative meetings with the bank to identify and promote opportunities

for collaboration on population issues and for support of regional and

country programs. At the field level, UNFPA has regularly participated in

World Bank meetings and workshops held in Dhaka, Bangladesh, to

strengthen collaboration and coordination of program inputs. UNFPA has

also procured contraceptives and equipment funded through a World Bank

project. However, UNFPA also reported that, in all regions, considerable

intraregional variations in its relations with the bank exist, ranging from

Page 56 GAO/NSIAD-97-2 United Nations
Appendix V 

U.N. Population Fund

frequent contacts and regular collaboration to no contacts or common

activities.

Despite extensive collaboration between UNFPA and the World Bank,

particularly in Asia and the Pacific and Africa, coordination at the

operational level is on a project basis. There is no formal agreement or

memorandum of understanding on collaboration. A UNFPA document stated

that UNFPA wants to institutionalize relations at the division and country

levels to a greater degree than before and thereby avoid the fluctuations in

relations that tend to occur. A World Bank document states that the bank

prefers establishing collaboration on a project and country basis.

U.S. Participation in

UNFPA

Although the United States has stressed the importance of population

objectives within the overall context of sustainable development, it has

not issued a policy detailing U.S. objectives for UNFPA. However, officials at

USAID and State clearly indicated that U.S. support for the work of UNFPA

and the International Conference on Population and Development’s

Program of Action was a high priority. USAID and State Department

officials stated that the U.S. national interests in UNFPA’s program stem

from U.S. objectives to (1) minimize the negative consequences of rapid

population growth, such as political crises associated with economic

stagnation, pressures from migration, pressures on the world food supply,

and environmental degradation and (2) maximize the positive

consequences of slower population growth and smaller family size, such

as better health for women and children, trade and economic

opportunities for the United States, improved environmental quality, and a

better chance for political institutions to be able to deal with challenges

and move toward democracy. USAID officials state that the agency regards

UNFPA programs as generally complementary to the activities supported

under the bilateral U.S. population assistance program, which provides

assistance in a more limited number of countries than UNFPA. A USAID

document indicated that USAID’s objectives incorporate principles from the

conference’s action plan. The document also states that USAID should

maintain a close working relationship with UNFPA in the population sector.

U.S. support for UNFPA has been shaped by various provisions in the

Foreign Assistance Act of l961, as amended, as they apply to U.S. bilateral

programs in population and family planning. In l985, the Congress passed

an amendment to the Foreign Assistance Act, which prohibited the United

States from providing assistance to any organization that supported or

participated in the management of a program of coercive abortion or

Page 57 GAO/NSIAD-97-2 United Nations
Appendix V 

U.N. Population Fund

involuntary sterilization. That same year, the USAID Administrator

determined that U.S. assistance to UNFPA would violate that amendment.

The Administrator found that, although UNFPA neither supported nor

promoted abortion or coercion, UNFPA’s support for the Chinese

government’s family planning program would render UNFPA ineligible for

U.S. funds. As a result, from fiscal year 1986 until fiscal year 1993, the

United States made no further contribution to UNFPA.

In 1993, USAID Administrator found that U.S. support of UNFPA was not in

violation of the amendment. As of December 1995, UNFPA’s current

program in China was completed, and China and UNFPA were discussing

whether UNFPA would have a follow-on program. UNFPA’s position is that, as

a U.N. intergovernmental agency, it is required to provide assistance if

governments request and qualify for it, assuming that it is in areas in which

UNFPA provides assistance and the governments agree to abide by

international standards and principles. As of June 1996, no decision had

been made regarding a follow-on program. The executive branch has

stressed that it would oppose any further UNFPA programs in China.

Page 58 GAO/NSIAD-97-2 United Nations
Appendix VI 

Comments From the Department of State

Page 59 GAO/NSIAD-97-2 United Nations
Appendix VII 

Comments From the U.S. Agency for

International Development

Page 60 GAO/NSIAD-97-2 United Nations
Appendix VII 

Comments From the U.S. Agency for

International Development

Page 61 GAO/NSIAD-97-2 United Nations
Appendix VIII 

Comments From the Department of Health

and Human Services

Note: GAO comment

supplementing those in

the report text appears at

the end of this appendix.

Page 62 GAO/NSIAD-97-2 United Nations
Appendix VIII 

Comments From the Department of Health

and Human Services

See comment 1.

Page 63 GAO/NSIAD-97-2 United Nations
Appendix VIII 

Comments From the Department of Health

and Human Services

Page 64 GAO/NSIAD-97-2 United Nations
Appendix VIII 

Comments From the Department of Health

and Human Services

The following is GAO’s comment on the Department of Health and Human

Services’ letter dated January 15, 1997.

GAO Comment 1. Our report recognizes and provides a number of examples of the

importance of WHO’s programs and normative functions. The additional

examples provided by the Department have been considered and have

reinforced our conclusion.

Page 65 GAO/NSIAD-97-2 United Nations
Appendix IX 

Comments From the Department of Labor

See p. 1.

Now on p. 3.

Now on p. 4.

Now on p. 17.

Now on p. 18.

Page 66 GAO/NSIAD-97-2 United Nations
Appendix IX 

Comments From the Department of Labor

Now on p. 23.

Now on p. 43.

Now on p. 45.

Page 67 GAO/NSIAD-97-2 United Nations
Appendix X 

Comments From the World Health

Organization

Page 68 GAO/NSIAD-97-2 United Nations
Appendix X 

Comments From the World Health

Organization

Page 69 GAO/NSIAD-97-2 United Nations
Appendix XI 

Comments From the Pan American Health

Organization

Note: GAO comment

supplementing those in

the report text appears at

the end of the appendix.

Page 70 GAO/NSIAD-97-2 United Nations
Appendix XI 

Comments From the Pan American Health

Organization

See comment 1.

Now on p. 16.

Now on pp. 16, 40.

Now on p. 16.

Page 71 GAO/NSIAD-97-2 United Nations
Appendix XI 

Comments From the Pan American Health

Organization

Now on p. 6.

Now on p. 16.

Page 72 GAO/NSIAD-97-2 United Nations
Appendix XI 

Comments From the Pan American Health

Organization

Now on p. 41.

Page 73 GAO/NSIAD-97-2 United Nations
Appendix XI 

Comments From the Pan American Health

Organization

The following is GAO’s comment on the Pan American Health

Organization’s letter dated November 8, 1996.

GAO Comment 1. We recognize that PAHO and the other four organizations have strategic

priorities and objectives incorporated in their workplans. However, when

faced with budgetary constraints, any organization, governmental or

nongovernmental, should identify lower priority programs and activities so

that they can be appropriately adjusted in line with available resources.

Our report does recognize, and PAHO has acknowledged, that the

organization recently conducted reviews of some of its programs and

activities to address the issues we presented in this report.

Page 74 GAO/NSIAD-97-2 United Nations
Appendix XII 

Comments From the International Labor

Office

Note: GAO comment

supplementing those in

the report appears at the

end of this appendix.

Now on p. 21.

Page 75 GAO/NSIAD-97-2 United Nations
Appendix XII 

Comments From the International Labor

Office

Now on p. 21.

Now on p. 2.

See comment 1.

Page 76 GAO/NSIAD-97-2 United Nations
Appendix XII 

Comments From the International Labor

Office

The following is GAO’s comment on the International Labor Organization’s

letter dated November 8, 1996.

GAO Comment 1. With the use of the currency adjustment rates provided by ILO, we

calculated ILO’s real growth based on the projected inflation and changes

in the exchange rate. We estimated a 2-percent decline in real terms in

ILO’s budget. The apparent 24-percent dollar increase between the 1994-95

and 1996-97 ILO budgets and the corresponding increase in the U.S.

assessment are due primarily to changes in the U.S. dollar-Swiss franc

exchange rate (i.e., the 25-percent strengthening of the Swiss franc relative

to the dollar used in formulating the ILO budget).

Page 77 GAO/NSIAD-97-2 United Nations
Appendix XIII 

Comments From the U.N. Conference on

Trade and Development

Note: GAO comment

supplementing those in

the report text appears at

the end of this appendix.

See comment 1.

Page 78 GAO/NSIAD-97-2 United Nations
Appendix XIII 

Comments From the U.N. Conference on

Trade and Development

Page 79 GAO/NSIAD-97-2 United Nations
Appendix XIII 

Comments From the U.N. Conference on

Trade and Development

The following is GAO’s comment on the U.N. Conference on Trade and

Development’s letter dated November 16, 1996.

GAO Comment 1. At the time of our fieldwork, the two studies referred to by UNCTAD had

not been completed.

Page 80 GAO/NSIAD-97-2 United Nations
Appendix XIV 

Comments From the U.N. Population Fund

Note: GAO comment

supplementing those in

the report text appears at

the end of this appendix.

See comment 1.

Page 81 GAO/NSIAD-97-2 United Nations
Appendix XIV 

Comments From the U.N. Population Fund

Now on p. 21.

Now on p. 56.

Page 82 GAO/NSIAD-97-2 United Nations
Appendix XIV 

Comments From the U.N. Population Fund

See p. 58.

Page 83 GAO/NSIAD-97-2 United Nations
Appendix XIV 

Comments From the U.N. Population Fund

The following is GAO’s comment on the U.N. Population Fund’s letter dated

November 11, 1996.

GAO Comment 1. Our report recognizes and provides a number of examples of

collaboration between UNFPA with other organizations. The additional

examples provided by UNFPA have been considered and have reinforced

our conclusion that the organization supports U.S. population goals.

(711167) Page 84 GAO/NSIAD-97-2 United Nations
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