oversight

United Nations: U.S. Participation in Five Affiliated International Organizations

Published by the Government Accountability Office on 1997-02-27.

Below is a raw (and likely hideous) rendition of the original report. (PDF)

                 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
             United States
GAO          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.


             The United States has been associated with WHO, PAHO, ILO, UNCTAD, and
Background   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,                                Membership and                     1996-97 Regular budget
and date created      Purpose                  funding sourcea                    and U.S. assessmentb   Unique characteristics
WHO,                 Obtain the highest             190 member states and         $842.6 million (budget)      Specialized agency that
Geneva               possible level of health       2 associate members;          and $214.8 million           provides technical cooperation
(1948)               for people worldwide.          funded by                     (assessment)                 and international standard
                                                    assessments and                                            setting; six regional offices
                                                    voluntary contributions.                                   manage most country
                                                                                                               technical cooperation.
PAHO,                Promote and coordinate         35 member states,             $168.6 million (budget)      Inter-American agency that
Washington, D.C.     efforts to combat              3 participating               and $99.4 million            serves as WHO’s regional
(1902)               disease, lengthen life,        governments,                  (assessment)                 office for North, South, and
                     and promote physical           1 associate member,                                        Central Americas, and the
                     and mental health.             and 2 observers;                                           Caribbean and specialized
                                                    funded by                                                  agency of the Organization of
                                                    assessments and                                            American States. Provides
                                                    voluntary contributions.                                   leadership on regional and
                                                                                                               hemispheric health issues,
                                                                                                               technical cooperation, and
                                                                                                               related support to member
                                                                                                               countries.
ILO                  Promote social justice         174 member states;            $579.5 million (budget)      Specialized agency composed
Geneva               for working people             funded by assessments         and $144.9 million           of a tripartite structure with
(1919)               worldwide.                     and voluntary                 (assessment)                 delegates from each
                                                    contributions.                                             government, employer groups,
                                                                                                               and worker groups.
UNCTAD,              Integrate developing           188 member states             $124.1 million (budget)c     Permanent component of the
Geneva               countries into the             (members of the United                                     U.N. General Assembly and a
(1964)               international trading          Nations are members of                                     part of the U.N Secretariat.
                     system and promote             UNCTAD); funded by
                     development through            the regular U.N. budget.
                     trade and investment.
UNFPA,               Provide access to          85 donor nations; funded $642.4 million (budget)               Subsidiary component of the
New York             reproductive health        by voluntary             and $35 million                       U.N. General Assembly;
(1969)               services, including family contributions.           (voluntary contribution)d             specialized voluntary fund.
                     planning information and
                     services.
                                              a
                                               The 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.
                                              b
                                               These 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.
                                              c
                                               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.
                                              d
                                                This number represents U.S. voluntary contributions.




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


                         The United States has a significant voice in the policies of the
Organizations’           organizations because it is a leading contributor to and participant on the
Policies Coincide With   governing boards and major committees. Our analysis showed that recent
U.S. Interests           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       The executive branch supports the five organizations because it believes
International Cooperation   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   During the Cold War period, other nations, particularly the Soviet Union,
Barriers to Cooperation   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.


                     Because of declining resources, the increasing number of worldwide
Organizations        crises, and growing concerns among donor governments about the need
Recognize the Need   for improved management and value for money, the five organizations
for Reform           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
                                                                                    Approved      Proposed      Approved
                                                                                      budget         budget       budget            U.S.
                                        Organization                                 1994-95        1996-97      1996-97            vote
                                                                                                                                       a
                                        WHO                                            $822.1         $955.6        $842.6
                                        PAHO                                           $164.5         $174.2        $168.7           No
                                        ILO                                            $466.5         $579.5        $579.5           No
                                                                                                                                       b
                                        UNCTAD                                         $113.6         $124.1        $124.1
                                        a
                                         The WHO budget is adopted by consensus. According to the State Department, the United
                                        States “disassociated” itself from the consensus.
                                        b
                                         UNCTAD’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.


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




          Page 13                                         GAO/NSIAD-97-2 United Nations
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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.


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



Page 16                                           GAO/NSIAD-97-2 United Nations
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          governments own the technical centers and make the final decisions about
          them, regardless of outside recommendations.


          ILO has had a number of management improvements in recent years.
ILO       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 has undergone an evolution of management and administrative
UNCTAD   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.



         Page 18                                                           GAO/NSIAD-97-2 United Nations
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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.


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


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


              We conducted our review at the headquarters of WHO, ILO, UNCTAD, and the
Scope and     World Trade Organization in Geneva, UNFPA in New York, and PAHO and the
Methodology   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
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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
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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                                                                                     30
                      Organizational Structure                                                 30
World Health          Governance                                                               30
Organization          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                                                                                    38
                      Organizational Structure                                                 38
Pan American Health   Governance                                                               39
Organization          Reporting Mechanisms                                                     39
                      Major Program Areas                                                      39
                      Financial Resources                                                      40
                      Personnel                                                                41
                      Collaboration With Other International Organizations                     41

Appendix III                                                                                   43
                      Organizational Structure                                                 43
International Labor   Governance                                                               43
Organization          Major Program Areas                                                      44
                      Financial Resources                                                      44
                      Personnel                                                                45
                      Collaboration With Other International Organizations                     46
                      U.S. Participation in ILO                                                47

Appendix IV                                                                                    48
                      Organizational Structure                                                 48
U.N. Conference on    Governance                                                               48
Trade and             Major Program Areas                                                      48
                      Financial Resources                                                      49
Development           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                                                                                      52
                       Organizational Structure                                                 52
U.N. Population Fund   Major Program Areas                                                      53
                       Financial Resources                                                      54
                       Personnel                                                                55
                       Collaboration With Other International Organizations                     55
                       U.S. Participation in UNFPA                                              57

Appendix VI                                                                                     59

Comments From the
Department of State
Appendix VII                                                                                    60

Comments From the
U.S. Agency for
International
Development
Appendix VIII                                                                                   62

Comments From the
Department of Health
and Human Services
Appendix IX                                                                                     66

Comments From the
Department of Labor
Appendix X                                                                                      68

Comments From the
World Health
Organization




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




Appendix XI                                                                                     70

Comments From the
Pan American Health
Organization
Appendix XII                                                                                    75

Comments From the
International Labor
Office
Appendix XIII                                                                                   78

Comments From the
U.N. Conference on
Trade and
Development
Appendix XIV                                                                                    81

Comments From the
U.N. Population Fund
Tables                 Table 1: Overview of Selected International Organizations                 3
                       Table 2: U.S. Position on the 1996-97 Proposed and Approved              12
                         Budgets
                       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.


                 WHO has six regional offices located in Washington, D.C.; Alexandria,
Organizational   Egypt; Brazzaville, Congo; Copenhagen, Denmark; New Delhi, India; and
Structure        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.


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



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                      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.


                      The Director General issues an annual report on the work of WHO. The
Reporting             report makes an annual assessment of world health status and needs and
Mechanisms            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.


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




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                                   WHO’s budget, maintained on a biennial basis, is the largest of the U.N.
Financial Resources                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
                                   a
                                   This 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
                                   a
                                    Most of the budgetary increase from 1994-95 to 1996-97 was for headquarters operations and
                                   activities.

                                   Source: WHO.




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Table I.3: U.S. Contributions to WHO
                                       Dollars in millions
                                                                                                         Fiscal year
                                       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.


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




                                   WHO has official relations with over 180 nongovernmental organizations.
Collaboration With                 Along with other institutions, especially with the U.N. Children’s Fund
Other International                (UNICEF), WHO promotes the involvement of relevant socioeconomic
Organizations                      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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                        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.


                        The United States is active in virtually every aspect of the work and
U.S. Participation in   functioning of WHO. As a founding member of WHO, the United States has
WHO                     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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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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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.


                 PAHO’s Secretariat is headed by a director who is elected every 4 years by
Organizational   the Pan American Sanitary Conference. The Secretariat staff is composed
Structure

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                      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.


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


                      In accordance with the PAHO’s constitution, the Director submits an annual
Reporting             report on technical cooperation activities of the Pan American Sanitary
Mechanisms            Bureau to its members. The Director also submits an interim financial
                      report.


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


                                         The largest portion of PAHO’s funds comes from assessments paid directly
Financial Resources                      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
                                         a
                                         This amount was estimated as of June 1995.

                                         Source: PAHO.



Table II.2: U.S. Contributions to PAHO
                                         Dollars in millions
                                                                                                           Fiscal year
                                         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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                          $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.


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


                          PAHO collaborates with a number of organizations. Some of PAHO’s current
Collaboration With        collaborative efforts include
Other International
Organizations         •   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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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.


                 ILOhas 26 area and 5 regional offices through which it implements its
Organizational   technical cooperation programs in 138 countries. In addition, 14
Structure        multidisciplinary teams located at 14 sites around the world support
                 country programs.


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




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


                            ILO’sregular biennial budget is divided into about 40 major programs. In
Financial Resources         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
                            a
                             Later 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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Table III.2: U.S. Contributions to ILO
                                         Dollars in millions
                                                                                                           Fiscal year
                                         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.


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




                                         Page 45                                                            GAO/NSIAD-97-2 United Nations
                                   Appendix III
                                   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.




                                   Within the U.N. system, ILO coordinates its programs with funds, programs,
Collaboration With                 and specialized agencies, including UNDP, the International Maritime
Other International                Organization, UNESCO, UNICEF, and the U.N. Industrial Development
Organizations                      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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                        Appendix III
                        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 is guided by national interests as defined by the
U.S. Participation in   President’s Committee on ILO. The Committee is chaired by the Secretary
ILO                     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.


                      UNCTAD  has a permanent Secretariat located in Geneva that is headed by
Organizational        the Secretary General, who is appointed by the U.N. Secretary General and
Structure             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.


                      UNCTAD’s conference, the organization’s highest policy-making body, meets
Governance            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.


                      The 1996 UNCTAD conference declared that UNCTAD has a comparative
Major Program Areas   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




                                     UNCTAD’s core operating expenses are funded through the U.N. regular
Financial Resources                  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
                                                                                   1992-93                               1996-97
                                                                                    budget         1994-95 budget         budget
                                     Type of funding                            expenditure          appropriation      estimate
                                     Regular budget                                   $100.1                  $113.6     $124.1a
                                     Extrabudgetary contributions                        45.1                   43.8        43.2
                                     Total                                            $145.2                  $157.4     $167.3
                                     a
                                     In 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.


                                     UNCTAD  currently employs 19 U.S. citizens, or about 4 percent of UNCTAD’s
Personnel                            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.




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                      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.


                      Various aspects of UNCTAD’s work overlaps with that of other international
Collaboration With    organizations, particularly the U.N. economic commissions, the
Other International   International Trade Center, WTO, and the World Bank. UNCTAD’s approach
Organizations         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



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                        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.


                        The State Department and the Office of the U.S. Trade Representative are
U.S. Participation in   the lead agencies for UNCTAD within the U.S. government. According to a
UNCTAD                  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.


                 UNFPA  is a subsidiary component of the United Nations and is subject to
Organizational   the direction of the U.N. General Assembly. The governing body of UNFPA
Structure        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



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                      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.



                      In l994, the United Nations convened the International Conference on
Major Program Areas   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



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                            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.


                            UNFPA is a voluntarily funded organization. It receives funds from donor
Financial Resources         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.




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                                     Appendix V
                                     U.N. Population Fund




Table V.2: U.S. Contributions to
UNFPA                                Dollars in millions
                                                                                                               Fiscal year
                                     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.




                                     In February 1996, UNFPA had 188 professional posts reserved for
Personnel                            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.




                                     UNFPA  has developed an array of mechanisms and relationships for
Collaboration With                   coordinating its programs. Coordination is essential for UNFPA to perform
Other International                  its mission, particularly with other U.N. agencies and the World Bank.
Organizations                        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



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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.


                        Although the United States has stressed the importance of population
U.S. Participation in   objectives within the overall context of sustainable development, it has
UNFPA                   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



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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.


              1. Our report recognizes and provides a number of examples of the
GAO Comment   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.


              1. We recognize that PAHO and the other four organizations have strategic
GAO Comment   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.


              1. With the use of the currency adjustment rates provided by ILO, we
GAO Comment   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.


              1. At the time of our fieldwork, the two studies referred to by UNCTAD had
GAO Comment   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.


              1. Our report recognizes and provides a number of examples of
GAO Comment   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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