When the size of national contributions is examined, it becomes clear that contributions are quite highly concentrated. Somewhat more than half of the funds are provided by the United States, the Union of Soviet Socialist Republics, and the United Kingdom. Threequarters of the contributions to the regular budget of WHO are made by the 11 countries which contribute more than $250,000 per year (tables 6-A and 6-C).

TABLE 6-C.-Contributions to the 1959 regular budget of WHO, by country

1 Minimum assessment of 0.04 percent.

2 Special assessment on largest contributor representing 32.51 percent of active members' assessments.

The budget of WHO does not include the budget of the Pan American Health Organization (formerly the Pan American Sanitary Organization). In 1958 the budget of the Pan American Health Organization was $3 million. In addition, it administered a special malaria fund amounting to $3.3 million (see table 6-D). The WHO did, however, include about $2.7 million for its region of the Americas. The PAHO serves as the regional organization of WHO.

TABLE 6-D.-Approved budgets of the Pan American Health Organization and the special malaria fund, and funds obligated in the region of the Americas from WHO for the years 1952–57, with estimated costs, 1958 and 1959

3. Malaria eradication special account

The malaria eradication special account, established by the Eighth World Health Assembly is credited with voluntary contributions from governments or other sources. Funds in the malaria eradication

special account may be used only for malaria eradication work.

In 1959, this account will approximate $6 million. This investment, even after taking account of the additional resources provided by national governments under their own malaria eradication programs, is undoubtedly one of mankind's finest bargains. For a relatively small sum an age-old scourge of mankind has, as pointed out in part III, been obliterated as a major health hazard over large portions of the globe. With sustained and intensified effort, backed by adequate research, further strides will be possible. Ultimately, the citadel of malaria-Africa-may be successfully stormed.

4. Expanded programs of technical assistance

WHO is responsible for the health aspects of general economic programs undertaken under the United Nations Expanded Program of Technical Assistance for Economic Development of Under-Developed Countries. Funds for the program, amounting to more than a fifth of WHO's total annual resources are derived from voluntary pledges which governments make to the special account established for that

purpose.

B. GENERAL EXPENDITURE PATTERNS

Both the current general pattern of expenditures and trends over the past years can be seen by looking at a simple percentage distribution (see table 6-E and chart 6-C).

2 Administrative expenses, as defined by the executive board uniformly for the period in question, cover all activities which facilitate and provide services for carrying out the objective of the Organization. They include all expenses arising from coordinating, administratively planning, organizing, staffing, and financing the programs. They include the Director General and his staff, public information, budgeting, accounting, general servicing, management, personnel administration, and other similar services.

TABLE 6-E.-Breakdown of obligations by major purposes, 1952-57, and estimated costs for 1958 and 1959 under the regular budget, malaria eradication special account, expanded program of technical assistance, and UNICEF reimbursements

! Includes $129,330 building fund (headquarters), 1 percent of total.

* Includes $100,000 (0.4 percent of total). Appropriated to repay working capital fund for amounts with. drawn in connection with erection of regional office building at Manila for western Pacific region.

1. Rising operating programs

About nine-tenths of all WHO expenditures are for operating programs. Currently about three-quarters of the total WHO budget supports field operating programs. Since 1952 there has been a substantial increase in the proportion of funds devoted to field operating programs and a decline in the proportion of funds spent for headquarters operating programs.

Organizational meetings continue to consume about 2 percent of the WHO budget, but the figure in 1952 was somewhat above and the current figure somewhat under 2 percent.

2. Declining share absorbed by administration

Administrative costs have decreased from 10.7 percent of total costs in 1952 to 7.8 percent in 1957 and are planned to decrease to 6 percent in 1959, with an absolute increase of $200,000 from 1952 to 1959, a period during which program operations increased by some $14.2 million, or more than 220 percent.

C. FINANCIAL AUDIT

The question of accountability for funds arises in connection with an organization which handles millions of dollars a year and spends money in most of the countries of the world. To deal with this problem, the accounts of the Organization are audited annually by an external auditor. This is done in great detail and with the utmost meticulousness. For example, the Financial Report and the Report

of the External Auditor to the World Health Assembly, January 1December 31, 1957 (No. 85 of the Official Documents of the World Health Organization), is a 67-page document.

The external auditor summarized his findings as follows:

GENEVA, March 21, 1958.

I have reviewed the Organization's overall system of financial control, particularly its application to the accounting and financial operations of these two regional offices. As a result of this examination I am of the opinion that the system functions well. I have also examined the reports of the internal auditors and have been able to follow up their work, which has given me complete satisfaction.

Finally, I would state that the financial situation of the organization is sound. This year when the World Health Organization celebrates its 10th anniversary it may be appropriate for me to make a brief general comment regarding the management of the funds of the Organization.

The Ad Hoc Committee appointed to act on behalf of the Executive Board to deal with my reports on the audits of the Organization's accounts included during earlier years in its remarks comments on the value of the auditor's reports. At that time I was obliged to draw attention to defects that existed-to speak frankly of an unsound financial position, or of the inadequacy of the Working Capital Fund, and the like. As time passed and these defects were overcome, and as the Secretariat gained in experience, these critical remarks disappeared from my reports. And now, the control exercised over all transactions has attained such a standard that I feel obliged to felicitate the World Health Organization on the occasion of its 10th anniversary on its very good and sound financial administration.

The audit was facilitated in every way by the officers of the Organization. Every opportunity was offered for examination of the records, vouchers and documentation, for all of which I wish to express my appreciation.

(Signed) UNO BRUNSKOG, External Auditor.

The United States can have full confidence that the funds which it supplies to WHO are accounted for to the penny.

D. THE SUBSTANCE OF FIELDWORK

The nature of the program that absorbs a large share of WHO funds-fieldwork involving direct assistance to governments provided at their request-can be shown in historical perspective. While such distributions must be interpreted with care in making detailed comparisons, some general observations are valid (table 6-F).

11

First, there have been no rapid or marked changes in program emphasis. Gradual evolution has been characteristic of program changes.

Second, every program but one has grown in absolute size.

Third, the largest declines have been in disease areas where scientific advances have made it possible to produce a striking degree of disease control with relatively moderate expenditures. Tuberculosis and venereal disease programs fall in this category.

Fourth, about a quarter of all WHO projects fell in both 1952 and 1957 in the field of public health administration and another category of miscellaneous projects.

11 For example, a decline is shown for maternal and child health program and an increase for nursing. However, some nursing expenses that were budgeted as maternal and child health expenses in 1952 had been transferred to nursing by 1957. As another example, some field programs are jointly financed with other agencies and some are not, and the cooperative arrangements change over the years.