WHO: Between Regional Principals and Philanthrolateralism

Abstract

The case of the WHO reveals the largest discrepancy between key formal rules governing budgeting procedures and the reality of budgeting dynamics and administration. The highly regionalized and fragmented structure of the WHO results in a budget process that is much more complex in practice than formal rules suggest. To accommodate strong regional interests and regionally organized principals, while at the same time managing budget constraints, the WHO budget process combines bottom-up, top-down, and horizontal administrative and political coordination. Due to the increasing importance of earmarked voluntary contributions for the financing of the WHO to approximately 80 percent of its budget, including very substantive financial support from the Bill & Melinda Gates Foundation of around a quarter of its budget, new administrative structures and procedures have been introduced. For example, the Financing Dialogue has become a new element of budgeting in international organizations that attempts to regain control over an ever-more segmented budgetary landscape.