728 



The cost of international collaboration in public health through 

 multilateral organizations may be relatively less in the future than 

 in the past. The "engineering'' lessons have been learned and institu- 

 tions can now devise more cost-eifective designs. Much is known about, 

 how, where, and when to provide technical assistance in international 

 healtli. As Bryant says, "to give effectively is an exacting task. To 

 give without doing harm is, surprisingly, equally exacting." ^^^ 



TOTAL COST OF WHO ACTIVITIES AND TOTAL U.S. CONTRIBUTION 



Actually, the United States contributes larger funds to WHO than 

 those indicated in Table 1 "The Recent Evolution of the WHO Budget 

 and U.S. Assessments." WHO's regular budget on which assessments 

 are based does not adequately reflect the total amount of funds avail- 

 able to the Organization and for which it is administratively respon- 

 sible. Table 2 provides some estimated data for 1968 to enable 

 comparison of sources of all funds administered directly or indirectly 

 by WHO and the U. S. assessed and voluntary contributions to those 

 sources as utilized by WHO. 



Since one study (Jackson) suggests that the WHO regular budget 

 might be. fixed at its present level and that future voluntary funds 

 for technical assistance be centralized under a "beefed up" and re- 

 organized UNDP, it becomes possible to visualize stronger U.S. influ- 

 ence over any future expansion of international health activities. 



TABLE 2.— SOURCE AND AMOUNT OF TOTAL FUNDS ADMINISTERED BY WHO, INCLUDING TOTAL U.S. 



CONTRIBUTIONS (1968) 



1968 obligations 

 for activities 



funded directly U.S. contributions 



or indirectly to WHO 



Source of funds by WHO activities— 1968 



Regular budget $56,123,000 $17,989,000 



UNDP: Expanded program of technical assistance U.N. Special Fund 7.616,526 3,046,810 



Voluntary funds for health protection 6. 922, 419 1, 288, 930 



International Center for Research on Cancer 1,600,000 150,000 



UNICEF 17,000,000 12,000,000 



PAHO (regular and other) 14,589,460 8,479,825 



Total .., 107,073,731 43,249,645 



Funds-in-trust. -_ 2,860,499 



That is to say, unlike the AVHO Executive Board and Health 

 Assembly where the U.S. has one vote out of 24 and 181 re^spectively, 

 in the UNDP the United States sits as a memloer of the Governing 

 Council wliich is composed of equal numbei'S of representatives of 

 developed and less developed States. In addition, the UNDP at the 

 present time is under strong and competent management by an 

 American administrator. The implications of these prospects become 

 even greater, if a larger amount of T".S. funds for loans, foreign aid, 

 and technical assistance are transferred from bilateral programs to 

 such multilateral agencies as the UNDP and others. 



It does not necessarily follow that increased United States technical 

 and programatic influence over international health activities is the 



"' Bryant, op. cit., page 29.S. 



