United Nations: U.S. Participation in Five Affiliated International
Organizations (Letter Report, 02/27/97, GAO/NSIAD-97-2).

Pursuant to a congressional request, GAO provided information on the
progress and status of management, administrative, and program reforms
in the World Health Organization (WHO), the Pan American Health
Organization (PAHO), the International Labor Organization (ILO), the
United Nations (U.N.) Conference on Trade and Development (UNCTAD), and
the U.N. Population Fund (UNFPA), all of which are affiliated with the
U.N. system.

GAO found that: (1) policies and agendas adopted by WHO, PAHO, ILO,
UNCTAD, and UNFPA coincide with U.S. foreign policy objectives; (2)
assessments by U.S. officials and other experts conclude that programs
and activities of the 5 organizations provide significant benefits; (3)
the programs and activities also provide opportunities for joint
scientific research among the technical experts of participating
countries in combating deadly diseases; (4) 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
5 organizations; (5) these organizations are now generally considered
politically neutral by most governments and provide the United States
access to countries in which it would otherwise face legal, financial,
or jurisdictional obstacles; (6) 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; (7) 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 5 organizations to recognize the need for
improved management and administration; (8) each has begun to address
weaknesses in the management and administration of its operations and
programs; (9) these weaknesses have been the subject of frequent
criticism by Congress, the State Department, and other U.S. foreign
policy analysts; (10) 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; (11) in
contrast, WHO and UNCTAD have been slower than the other 3 organizations
in undertaking significant management and administrative improvements;
(12) 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; (13) UNCTAD was even slower in initiating reforms, but
provisions were adopted at its 1996 conference for streamlining institu*

--------------------------- Indexing Terms -----------------------------

 REPORTNUM:  NSIAD-97-2
     TITLE:  United Nations: U.S. Participation in Five Affiliated 
             International Organizations
      DATE:  02/27/97
   SUBJECT:  International organizations
             International cooperation
             Financial management
             Public administration
             Foreign policies
             Budget cuts
             Internal audits
             Cost effectiveness analysis
             Prioritizing
IDENTIFIER:  WHO Special Program for Research and Training in Tropical 
             Diseases
             UNCTAD Global Trade Network
             Zaire
             Central America
             Rwanda
             Mozambique
             Soviet Union
             Russia
             Ukraine
             
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Cover
================================================================ COVER


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 Nations

(711167)


Abbreviations
=============================================================== ABBREV

  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

Letter
=============================================================== LETTER


B-270713

February 27, 1997

The Honorable Jesse Helms
Chairman, Committee on Foreign Relations
United States Senate

Dear Mr.  Chairman: 

As you requested, this report provides information on the progress
and status of management, administrative, and program reforms in five
organizations affiliated with the U.N.  system.  These organizations
are the World Health Organization (WHO), Pan American Health
Organization (PAHO), International Labor Organization (ILO), U.N. 
Conference on Trade and Development (UNCTAD), and U.N.  Population
Fund (UNFPA).  Because many of the reform initiatives to improve the
efficiency and effectiveness of the organizations have been only
adopted recently, we did not assess the reforms' implementation or
evaluate their effectiveness. 


   BACKGROUND
------------------------------------------------------------ Letter :1

The United States has been associated with WHO, PAHO, ILO, UNCTAD,
and UNFPA since their founding.  In 1995, the United States paid
about $295 million in regular budget and extrabudgetary contributions
to the five organizations.\1 In recent years, budgetary constraints
and competing domestic priorities have led the Congress to question
the value and relevancy of U.S.  participation in these
organizations.  Although it acknowledged that the organizations are
not operating as efficiently and effectively as they should be, the
State Department believes that continued membership in the five
organizations we studied is important to the United States because
their activities contribute in varied and cost-effective ways to the
U.S.  security, prosperity, safety, and health. 

A number of studies, proposals, and recommendations for change have
been suggested by member states and other experts, including the U.N. 
Office of Internal Oversight Services, the Joint Inspection Unit, the
External Auditors, the Geneva Group, the Group of 77, the Group of 7,
and 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. 



                                     Table 1
                     
                        Overview of Selected International
                                  Organizations

Name
,
loca
tion
,
and
date                                      1996-97 Regular
crea                    Membership and    budget and U.S.   Unique
ted   Purpose           funding source\a  assessment\b      characteristics
----  ----------------  ----------------  ----------------  --------------------
      Obtain the        190 member        $842.6 million    Specialized agency
WHO,  highest possible  states and 2      (budget) and      that provides
Gene  level of health   associate         $214.8 million    technical
va    for people        members;          (assessment)      cooperation and
(194  worldwide.        funded by                           international
8)                      assessments and                     standard setting;
                        voluntary                           six regional offices
                        contributions.                      manage most country
                                                            technical
                                                            cooperation.

PAHO  Promote and       35 member         $168.6 million    Inter-American
,     coordinate        states,           (budget) and      agency that serves
Wash  efforts to        3 participating   $99.4 million     as WHO's regional
ingt  combat disease,   governments,      (assessment)      office for North,
on,   lengthen life,    1 associate                         South, and Central
D.C.  and promote       member, and 2                       Americas, and the
(190  physical and      observers;                          Caribbean and
2)    mental health.    funded by                           specialized agency
                        assessments and                     of the Organization
                        voluntary                           of American States.
                        contributions.                      Provides leadership
                                                            on regional and
                                                            hemispheric health
                                                            issues, technical
                                                            cooperation, and
                                                            related support to
                                                            member countries.

ILO   Promote social    174 member        $579.5 million    Specialized agency
Gene  justice           states; funded    (budget) and      composed of a
va    for working       by assessments    $144.9 million    tripartite structure
(191  people            and voluntary     (assessment)      with delegates from
9)    worldwide.        contributions.                      each government,
                                                            employer groups, and
                                                            worker groups.

UNCT  Integrate         188 member        $124.1 million    Permanent component
AD,   developing        states (members   (budget)\c        of the U.N. General
Gene  countries into    of the United                       Assembly and a part
va    the               Nations are                         of the U.N
(196  international     members of                          Secretariat.
4)    trading system    UNCTAD); funded
      and promote       by
      development       the regular U.N.
      through trade     budget.
      and investment.

UNFP  Provide access    85 donor          $642.4 million    Subsidiary component
A,    to reproductive   nations; funded   (budget) and $35  of the U.N. General
New   health services,  by voluntary      million           Assembly;
York  including family  contributions.    (voluntary        specialized
(196  planning                            contribution)\d   voluntary fund.
9)    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. 


--------------------
\1 In addition to the organizations' regular budgets, they receive
extrabudgetary contributions from various donor countries and
institutions for specific programs. 

\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. 


   RESULTS IN BRIEF
------------------------------------------------------------ Letter :2

Policies and agendas adopted by WHO, PAHO, ILO, UNCTAD, and UNFPA
coincide with U.S.  foreign policy objectives, which include
promoting prosperity, sustainable development, and peace; building
democracy; providing humanitarian assistance; and advancing
diplomacy.  Assessments by U.S.  officials and other experts conclude
that programs and activities of the five organizations provide
significant benefits by, among other things, setting international
standards for living and working conditions; improving global health;
and collecting, analyzing, and disseminating global information on
trade, health, population, and employment.  The programs and
activities also provide opportunities for joint scientific research
among the technical experts of participating countries in combating
deadly diseases, such as Acquired Immune Deficiency Syndrome (AIDS)
and the Ebola virus. 

U.S.  officials asserted, and other experts agreed, that it would be
difficult, if not impossible, for any federal agency or private
institution to perform the mandates of the five organizations.  These
organizations are now generally considered politically neutral by
most governments (including the United States) and provide the United
States access to countries in which it would otherwise face legal,
financial, or jurisdictional obstacles, such as Zaire during the
Ebola outbreak of 1995.  In addition, membership in these
organizations allows the United States to work with other nations in
sharing the burden of dealing with challenges that threaten domestic
security, international stability, and human well-being around the
world. 

Declining resources available from donor countries, the increasing
number of worldwide crises, and the demands for better collaboration
between the donor organizations and the recipient countries have
caused the five organizations to recognize the need for improved
management and administration.  Each has begun to address weaknesses
in the management and administration of its operations and programs. 
These weaknesses, which include the lack of budget transparency and
overlap and duplication of programs and activities, have been the
subject of frequent criticism by the Congress, State Department, and
other U.S.  foreign policy analysts. 

The organizations have responded slowly, but favorably, to the reform
proposals.  PAHO, ILO, and UNFPA, which the United States generally
considers to be responsive to recommended management and
administrative improvements, have initiated a number of reforms. 
These include reducing the length and frequency of meetings and
implementing monitoring, evaluation, and reporting systems.  ILO, for
example, has reduced the length of its conference, focused more on
priority policy issues, and tightened its rules of debate to prevent
discussion of extraneous political issues. 

In contrast, WHO and UNCTAD have been slower than the other three
organizations in undertaking significant management and
administrative improvements.  Nonetheless, since 1993, WHO has
undertaken several reforms, including establishing five priority
areas for allocating scarce program resources and strengthening
internal audit functions.  Although the United States believes that
strengthening the internal audit function is imperative to efficient
management, WHO still has not clearly defined the function's degree
of independence or established specifically which internal audit
reports would be provided to WHO's members.  UNCTAD was even slower
in initiating reforms, but provisions were adopted at its 1996
conference for streamlining institutional arrangements, focusing on a
smaller number of priority issues, reducing the length and number of
meetings, and enhancing transparency in UNCTAD's program and budget. 

The United States and other member states are continuing to push for
reforms in each of the five organizations we studied. 


   ORGANIZATIONS' POLICIES
   COINCIDE WITH U.S.  INTERESTS
------------------------------------------------------------ Letter :3

The United States has a significant voice in the policies of the
organizations because it is a leading contributor to and participant
on the governing boards and major committees.  Our analysis showed
that recent policies adopted by the organizations coincided with U.S. 
foreign policy objectives.  For example, ILO has adopted policies and
programs that support the goals established by the President's
Committee on ILO.  These goals include preserving and strengthening
worker rights, improving working conditions, and creating employment. 
ILO has seven core labor conventions that relate directly to its main
purpose--to promote social justice and human rights. 

UNFPA, which funds population programs in developing countries, has
documented policies on abortion and human rights that are consistent
with U.S.  family planning objectives.  U.S.  policy supports access
to family planning services to all those who need them, but opposes
any coercive methods or abortion as a part of any population program. 
UNFPA also opposes abortion or coercive sterilization as methods of
family planning.  UNFPA's program strategy seeks to prevent abortion
by increasing access to family planning services and reduce maternal
deaths through better management of complications of unsafe
abortions. 

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 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 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. 


--------------------
\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. 


      ORGANIZATIONS ENHANCE
      INTERNATIONAL COOPERATION
---------------------------------------------------------- Letter :3.1

The executive branch supports the five organizations because it
believes they are unique and valuable instruments of multilateral
cooperation.  U.S.  officials stated that participation in WHO, PAHO,
ILO, UNCTAD, and UNFPA allows the United States to work
collaboratively and more cost effectively with other nations to deal
with global challenges, such as unsustainable population growth and
emerging and reemerging diseases.  Although many of these challenges
start beyond U.S.  borders, they are increasingly becoming problems
within them and require more resources than are available from any
single nation. 

The capacity of the U.S.  government to provide responses to global
crises is increasingly limited.  According to U.S.  officials we
interviewed, U.S.  government agencies do not have the mandate,
flexibility, or funds necessary to respond to the many international
challenges that threaten U.S.  interests.  For example, declining
resources forced the Army to abandon its antiviral research program,
which was designed to conduct research and develop drugs to combat
infectious diseases caused by viruses. 

U.S.  officials stated that most of the major threats to peace,
prosperity, and health are problems that national governments are ill
equipped to deal with on their own.  Moreover, the five organizations
enable the United States to address transnational problems not
readily amenable to bilateral diplomacy.  For example, in Central
America, PAHO, with the support of the United States, used health
initiatives to bridge the gaps between warring 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 outbreaks through its interactions with
the various networks of its member countries and collaborating
centers.  Also, WHO is often best suited to coordinate international
health activities that often draw on experts knowledge from multiple
countries, including the United States (e.g., Centers for Disease
Control and Prevention, National Institutes of Health, and Food and
Drug Administration).  According to an interagency working group on
emerging and reemerging infectious diseases, no U.S.  agency has a
clear mandate to respond to epidemics outside U.S.  borders, and no
executive structure exists either to oversee international disease
surveillance or mobilize a response when an outbreak occurs. 


      END OF COLD WAR REDUCED
      BARRIERS TO COOPERATION
---------------------------------------------------------- Letter :3.2

During the Cold War period, other nations, particularly the Soviet
Union, often used international organizations, including some of
those in this study, as forums for anti-American debate and
propaganda that were irrelevant to the organizations' mission.  For
example, in 1977, the United States temporarily withdrew from ILO
because of concerns about four trends:  erosion of tripartite
representation, selective concern for human rights, disregard of due
process, and increasing politicization.  Moreover, State Department
and U.S.  Trade Representative officials once characterized UNCTAD as
being a forum of confrontation largely along the lines of the
industrialized countries of the Northern Hemisphere versus the
developing countries of the Southern Hemisphere. 

The end of the Cold War ameliorated many of the differences that once
influenced the agendas of the organizations.  Representatives from
both developed and developing nations that we interviewed
acknowledged that the climate within the organizations has changed
and that there is more support for U.S.  values and ideals.  For
example, a U.S.  delegation member noted that, although earlier
conferences sometimes had an anti-American tone, the 1996 UNCTAD
conference was almost completely devoid of the negative political
rhetoric.  Moreover, members of the 1996 conference were generally
receptive to U.S.  proposals. 

U.S.  officials shared similar comments about governing board
meetings and conferences held at the other organizations.  Moreover,
former adversaries are becoming partners in diplomacy.  For example,
the United States and Russia have worked together to improve the
functioning of WHO and ILO.  In March 1996, the Russian Permanent
Representative joined the United States and five European nations in
letters to WHO and ILO Directors 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. 


--------------------
\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. 


   ORGANIZATIONS RECOGNIZE THE
   NEED FOR REFORM
------------------------------------------------------------ Letter :4

Because of declining resources, the increasing number of worldwide
crises, and growing concerns among donor governments about the need
for improved management and value for money, the five organizations
have recognized the need for management, administrative, and program
reforms.  The organizations have begun to address weaknesses in their
management and operations.  PAHO, ILO, and UNFPA, which the United
States generally considers to be responsive to recommended management
and administrative improvements, have initiated a number of reforms. 
In contrast, WHO and UNCTAD have been slower in undertaking
significant management and administrative improvements. 

In 1995, the United States developed a reform agenda that it
encouraged the organizations to adopt.  The agenda included
recommendations aimed at making the organizations less wasteful, more
productive and focused, and better able to meet future challenges. 
For example, the United States recommended that WHO develop a more
transparent budget presentation format to improve member state
oversight and enhance priority setting. 

Also in 1995, the executive branch adopted a new budget policy for
international organizations, which replaced its decade-old zero real
growth budget policy.  The goal of the new policy was to reduce many
of the budgets of international organizations below current levels,
particularly in large agencies.  Exceptions, on a case-by-case basis,
were to be made to maintain current budget levels or zero nominal
growth.  In rare cases, the 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)

                                         Approv  Propos  Approv
                                             ed      ed      ed
                                         budget  budget  budget
                                          1994-   1996-   1996-   U.S.
Organization                                 95      97      97   vote
---------------------------------------  ------  ------  ------  -----
WHO                                      $822.1  $955.6  $842.6     \a
PAHO                                     $164.5  $174.2  $168.7     No
ILO                                      $466.5  $579.5  $579.5     No
UNCTAD                                   $113.6  $124.1  $124.1    \\b
----------------------------------------------------------------------
\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 budgetary reform in the United Nations,
including ILO and WHO, to the members of the Geneva Group. 

Analyses of reform initiatives for each of the organizations by us
and others showed that the organizations have responded slowly, but
favorably, to the reform proposals.  The following sections discuss
the status of management, administrative, and program reforms at each
of the five organizations. 


   WHO
------------------------------------------------------------ Letter :5

The United States has been a leader in pursuing management and
administrative improvements at WHO.  U.S.  officials and others have
urged WHO to adopt a number of measures aimed at improving the
economy, efficiency, effectiveness, and accountability of the
organizations' operations and programs.  Recommended management and
administrative improvement efforts cover a wide range of issues, from
strengthening the internal audit function to improving budget
transparency. 

In 1992, the Executive Board, at the U.S.  initiative, created a
working group to examine WHO's role in responding to global change. 
The working group, which includes the U.S.  member of the Executive
Board, reviewed WHO's contributions and effectiveness, identified
main issues that needed action, and made 47 recommendations for a
fundamental revision of WHO operations to meet new challenges.  These
recommendations included proposals by the United States and others. 
Since 1993, WHO has implemented, or in some way addressed, a number
of the management and administrative reforms, including

  -- establishing contracting and procurement guidelines, which the
     External Auditor believed were lacking;

  -- reducing the length of the annual World Health Assembly from 3
     weeks in 1980 to 6 days in 1996;

  -- reallocating $41 million, or 5 percent, of the core budget for
     the 1996-97 biennial budget to priority programs, including
     eradication of specific communicable diseases; prevention and
     control of specific communicable diseases; promotion of
     reproductive, women's, and family health; promotion of primary
     health care and other areas that contribute to primary health
     care, such as essential drugs, vaccines, and nutrition; and
     promotion of environmental health, especially community water
     supply and sanitation;

  -- 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, 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. 


--------------------
\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. 

\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. 


   PAHO
------------------------------------------------------------ Letter :6

According to officials from the Departments of State and Health and
Human Services, PAHO has undertaken a number of self-initiated
actions aimed at improving the efficiency and effectiveness of its
operations.  For example, PAHO reduced the number of staff posts by
351, from 1,222 to 871, since 1980; implemented and provided
continued improvements to its financial management information
system; and closed a research center 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
governments own the technical centers and make the final decisions
about them, regardless of outside recommendations. 


   ILO
------------------------------------------------------------ Letter :7

ILO has had a number of management improvements in recent years. 
According to ILO, the reforms have focused on creating greater
efficiencies in the agency's operations and improving ILO
responsiveness to member needs.  According to U.S.  government
officials in Geneva, ILO had been in the forefront of making reforms
and was making good progress.  Some of ILO's major reforms
implemented include

  -- reducing the approved 1996-97 biennial budget by $21.7 million,
     from $579.5 million to $557.8 million;

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

  -- establishing an active partnership policy, which called for
     delegation of authority to the field, assignment of
     multidisciplinary teams to the regions, reviews of all
     country-level activities, redefined roles for headquarters
     units, staff mobility, and closer working relationships between
     ILO and its clients;

  -- adopting a business-based strategic publications policy, which
     plans for editorial review of manuscript proposals for
     relevance, timeliness, and marketability;

  -- decentralizing financial functions to field offices;

  -- developing action programs, which are designed to produce
     concrete and timely outputs to constituents;

  -- reducing the duration and frequency of meetings, including the
     International Labor Conference, Governing Body meetings,
     technical and sectoral meetings, and regional conferences; and

  -- revising budget procedures to include cost estimates by program
     priority instead of program department. 

Ongoing management improvement efforts include

  -- conducting feasibility studies on outsourcing in-house printing
     operations, mainframe computer operations, and central typing
     pool services and transferring freelance translations services
     from contractors based in Geneva to contractors based in lower
     cost countries and

  -- implementing a new monitoring, self-evaluation, and reporting
     system, which requires that each unit prepare annual workplans,
     semiannual progress reviews, and annual self-evaluations. 

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
------------------------------------------------------------ Letter :8

UNCTAD has undergone an evolution of management and administrative
improvement efforts.  Until early 1996, UNCTAD had not begun a
comprehensive reform effort, although the U.S.  government has been
trying to reform UNCTAD's program and organization since 1992.  At
the 1992 UNCTAD conference, the member states reformed the working
methods of UNCTAD and set some new priorities.  These actions set a
new nonideological tone for UNCTAD's proceedings and created a new
intergovernmental process similar to that of the Organization for
Economic Cooperation and Development, with an emphasis on analysis
and discussion.\8 According to State Department officials, U.S. 
leadership was a significant factor in making these reforms. 

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. 

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 step and that
UNCTAD's member states must ensure that the reform measures are
successfully implemented. 


--------------------
\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. 


   UNFPA
------------------------------------------------------------ Letter :9

State Department and other U.S.  government officials we interviewed
consider UNFPA to be generally responsive to management,
administrative, and program reform proposals.  Since 1988, the
organization has undertaken a wide range of management and
administrative improvements.  Some of the actions completed include

  -- establishing eight regional and subregional country support
     teams, consisting of experts from WHO, the U.N.  Educational,
     Scientific, and Cultural Organization (UNESCO), FAO, and ILO;

  -- financing 42 specialist and coordinator posts to headquarters of
     the United Nations, UNESCO, WHO, FAO, and ILO, as well as U.N. 
     regional commissions and WHO regional offices, whose staff
     provide backup services to country support teams and country
     field offices and work on population issues within their own
     agencies;

  -- introducing a new performance appraisal system that establishes
     an annual individual work plan, monitors performance through the
     year with an interim review, and provides a year-end appraisal
     and review by the Management Review Group; and

  -- decentralizing operations to the UNFPA field offices. 

The United States recommended action in two areas: 

  -- reducing the number of smaller projects and combining them into
     fewer but larger projects and

  -- streamlining its program planning, implementation, monitoring,
     and evaluation. 

According to a U.S.  official, UNFPA has responded favorably to the
U.S.  recommendation.  For example, UNFPA's 1995 Director's report
shows that the number of new projects dropped from 610 in 1994 to 435
in 1995.  We did not assess UNFPA's response to these recommendations
or determine whether they adequately addressed the State Department's
concerns. 


   AGENCY COMMENTS
----------------------------------------------------------- Letter :10

The Departments of State, Health and Human Services, and Labor and
USAID generally agreed with our report.  All of the agencies said
that the report provides a balanced assessment of U.S.  participation
in the five international organizations.  State noted that, even
though many of the reform initiatives have been only adopted
recently, those that were implemented several years ago are now in
the process of being evaluated.  The Departments of State and Health
and Human Services also indicated that WHO's current lack of
effective leadership has been an important factor in the somewhat
slow progress WHO has made in instituting reforms.  The State
Department said that the election of a new WHO Director General in
1998 will provide a vitally needed impetus for moving ahead with a
strong reform agenda. 

WHO, PAHO, ILO, UNCTAD, and UNFPA generally concurred with the
report, but UNCTAD emphasized that it is not an autonomous agency, as
are the other organizations discussed in our report, and that it must
follow the managerial policies and administrative procedures set by
the U.N.  General Assembly.  UNCTAD also said that, even though the
U.N.  Office of Internal Oversight Services was critical of UNCTAD's
management performance, other reports have been more favorable. 

Each agency provided technical comments that have been incorporated
into the report as appropriate.  Agency comments are reprinted in
their entirety in appendixes VI through XIV. 


   SCOPE AND METHODOLOGY
----------------------------------------------------------- Letter :11

We conducted our review at the headquarters of WHO, ILO, UNCTAD, and
the World Trade Organization in Geneva, UNFPA in New York, and PAHO
and the World Bank in Washington, D.C.  We reviewed policy documents,
resolutions adopted by governing boards, manuals, annual reports,
budget and financial documents, internal reports, External Auditor
reports, collaboration agreements between organizations, internal and
external management studies, reform proposals, and background
literature on the organizations.  In addition, we obtained policy
statements and documents relating to U.S.  foreign policy interests
and objectives and the management of U.S.  participation in
international organizations from the Department of State in New York,
Geneva, and Washington, D.C. 

As an agency of the United States, we have no direct audit authority
to review the operations of international organizations, including
WHO, PAHO, ILO, UNCTAD, and UNFPA.  However, these organizations
consented to our review, and the Secretariat and staff of each
organization were open and forthcoming in interviews and provided us
with all information requested. 

To determine whether U.S.  participation serves U.S.  foreign policy
interests, we compared U.S.  foreign policy objectives with the
policies and 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. 


--------------------------------------------------------- Letter :11.1

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. 

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


WORLD HEALTH ORGANIZATION
=========================================================== Appendix I

The World Health Organization (WHO) was created in 1948, and the
United States became a member that same year.  WHO's constitution
states that the enjoyment of the highest attainable standard of
health is one of the fundamental rights of every human being.  In
1977, the World Health Assembly, WHO's policy-making body, formulated
its "Health for All by the Year 2000" strategy, challenging
governments and WHO to attain a level of health that would permit all
people of the world to lead socially and economically productive
lives.  The objectives of WHO are pursued in part through technical
cooperation with member states and by directing and coordinating
international health work.  These objectives are complementary and
include advocating health; stimulating specific health action and
disseminating information; developing norms, standards, plans, and
policies; developing models for monitoring, assessing, and evaluating
programs and projects; training; promoting research; and providing
direct technical consultation and resource mobilization. 


   ORGANIZATIONAL STRUCTURE
--------------------------------------------------------- Appendix I:1

WHO has six regional offices located in Washington, D.C.; Alexandria,
Egypt; Brazzaville, Congo; Copenhagen, Denmark; New Delhi, India; and
Manila, Philippines.  It also has liaison offices in Addis Ababa,
Ethiopia; New York, Washington, D.C; and Lyon, France (the
International Agency on Research and Cancer).  WHO has 143 country
offices, which are often located within the national health ministry. 

WHO recently appointed an acting Deputy Director General to deal with
day-to-day management and policy issues in the absence of the
Director General.  The Director General has seven Assistant Directors
General and two Executive Directors who are responsible for managing
and administering the budgets of the major program divisions of WHO. 
Each of the six regional offices has a director, who is responsible
for managing the programs and budgets of the regional offices.  In
addition, at headquarters, over 30 directors of functional
departments are responsible for planning, monitoring, and evaluating
the program activities of WHO. 


   GOVERNANCE
--------------------------------------------------------- Appendix I:2

The World Health Assembly is composed of all 190 member states.  It
meets annually in May to decide the overall direction of the
organization and the general program for a specific period and adopt
the 2-year budget.  Most decisions are made by consensus, but a
two-thirds vote is required if called for on budget issues.  No
member has veto power.  The World Health Assembly elects the Director
General as well as the 32 member states who designate 1 person
technically qualified in the field of health to serve on the
Executive Board.  The board meets twice a year to review the work of
WHO in more detail and prepares issues for consideration by the World
Health Assembly.  About one-third of the members are replaced
annually.  The current U.S.  member of the Executive Board is the
Principal Deputy Assistant Secretary for Health, Department of Health
and Human Services.  The current U.S.  term on the Executive Board
will be completed in June 1997.  The United States will attend the
board meeting as a nonmember in 1998. 


   REPORTING MECHANISMS
--------------------------------------------------------- Appendix I:3

The Director General issues an annual report on the work of WHO.  The
report makes an annual assessment of world health status and needs
and recommends relevant priorities for international health action to
meet those needs.  It also reports on WHO's efforts and programs for
improving the world health situation. 


   MAJOR PROGRAM AREAS
--------------------------------------------------------- Appendix I:4

WHO's planning covers a 6-year period and provides a framework for
annual workplans.  The most recent plan, The Ninth General Program of
Work for 1996-2001, establishes the global health policy framework
for action by the world health community (international organizations
of the U.N.  system, including WHO; nongovernmental organizations;
bilateral and multilateral donor and development agencies; banks; and
countries).  The four major orientations of the global health policy
include integrating health and human development in public policies,
ensuring equitable access to health services, promoting and
protecting health, and preventing and controlling specific health
problems. 

WHO encourages and assists member states to provide a vast number of
functions to achieve its objectives.  The functions include technical
cooperation, consensus development, information dissemination and
other support focused on, but not limited to, prevention and control
of infectious diseases, including eradication of diseases where
possible; promotion of maternal and child health; environmental
health, including promotion of safe water and improved sanitation;
occupational health; promotion of improvements in health systems,
with particular reference to equity of access; occupational health;
and reproductive health, nutrition, and health problems of a
noncommunicable nature (e.g., cancer and cardiovascular disease). 


   FINANCIAL RESOURCES
--------------------------------------------------------- Appendix I:5

WHO's budget, maintained on a biennial basis, is the largest of the
U.N.  specialized agencies.  WHO's regular budget comes from assessed
contributions from member states, and its scale of assessments is
fixed according to the U.N.  scale of contributions adopted by the
General Assembly.  (See tables I.1 through I.3.) Extrabudgetary
contributions come from various donor countries and institutions for
specific health initiatives or programs. 



                               Table I.1
                
                              WHO's Budget

                         (Dollars in millions)

                                                 1992-   1994-   1996-
Type of funding                                     93      95      97
----------------------------------------------  ------  ------  ------
Regular budget                                  $734.9  $822.1  $842.6
Extrabudgetary contributions                     756.7  1,149.  993.7\
                                                             2       a
======================================================================
Total                                           $1,491  $1,971  $1,836
                                                    .5      .3      .3
----------------------------------------------------------------------
\a This amount was estimated as of January 1995. 

Source:  WHO. 



                               Table I.2
                
                  Distribution of WHO's Regular Budget

                         (Dollars in millions)

                                                 1992-   1994-   1996-
Location                                            93      95      97
----------------------------------------------  ------  ------  ------
Headquarters\a                                  $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. 



                               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. 


   PERSONNEL
--------------------------------------------------------- Appendix I:6

As of January 1, 1996, WHO had 3,828 employees:  1,363 professional
and 2,465 general services staff.  However, WHO has not met its
target for the recruitment of women to professional and higher graded
posts.  In 1993, the Executive Board set a target date of September
30, 1995, for reaching the 30-percent goal for women to occupy all
professional and higher graded posts.  However, only three of eight
offices--the Americas, Europe, and headquarters--reached the goal by
that date.  As of December 1995, WHO employed 758 men and 284 women,
or about 27.3 percent of its staff, in the professional and higher
grade categories. 

Because of budgetary constraints, WHO has taken a number of steps to
downsize the organization.  For example, WHO has established a
reduction-in-force committees for staff in professional and general
services category posts and reduction-in-force procedures.  In early
1996, WHO abolished 207-1/2 regular budget positions.  About 43 of
the posts were unoccupied.  About 39 received termination notices, 33
mutually agreed to leave, and 9 retired.  Other solutions, such as
reassignment or placement into half-time posts, were provided for the
remaining staff.  Tables I.4 and I.5 provide data on WHO staff
levels. 



                               Table I.4
                
                      Number of WHO Staff Members

                                                 1992-   1994-   1996-
Type of staff                                       93      95      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

                                                 1992-   1994-   1996-
Location                                            93      95      97
----------------------------------------------  ------  ------  ------
Headquarters                                     1,552   1,565   1,371
Regions                                          2,184   1,896   1,713
Countries                                          782     812     744
======================================================================
Total                                            4,518   4,273   3,828
----------------------------------------------------------------------
Source:  WHO. 


   COLLABORATION WITH OTHER
   INTERNATIONAL ORGANIZATIONS
--------------------------------------------------------- Appendix I:7

WHO has official relations with over 180 nongovernmental
organizations.  Along with other institutions, especially with the
U.N.  Children's Fund (UNICEF), WHO promotes the involvement of
relevant socioeconomic development sectors in health in line with its
Health for All strategy.  UNICEF-WHO joint actions in the areas of
child survival, the sick child initiative, safe water and sanitation,
breastfeeding, and safe motherhood are some examples that call for
intersectoral action and help put health in the center of sustained
development policies and programs. 

Progress has been made in strengthening collaboration at country and
regional levels between WHO and the World Bank and other regional
development banks:  the African Development Bank, the Asian
Development Bank, the European Bank for Reconstruction and
Development, the Inter-American Development Bank, and the Islamic
Development Bank.  WHO advises and supports member states and the
banks on their health and health-related policies and the allocation
of use of their financial and technical resources to implement those
policies. 

Recommendations for action and World Bank and WHO partnership
principles were agreed to at the World Bank/WHO Review Meeting in
November 1994.  During 1995, all of WHO's regional offices organized
follow-up regional review meetings with the World Bank's regional
representatives.  Collaboration is aimed at ensuring that health
aspects are taken fully into consideration in development of projects
financed by the World Bank and that WHO is fully involved in the
early stage in planning and throughout the implementation and
evaluation phases at all levels--country, regional, and global. 

WHO has continued to collaborate with the Association of South-East
Asian Nations on advocacy measures against the Human Immunodeficiency
Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) and
pharmaceutical products.  A memorandum of understanding with the
South Asian Association for Regional Cooperations was prepared in
1995.  Collaboration also continued with the League of Arab States
and the Organization of Islamic Conference. 

The WHO working group on continental Africa was established in 1994
to facilitate WHO's contribution to the implementation of the U.N. 
"New Agenda for the Development of Africa in the 1990s" strategy. 
WHO is promoting awareness of the Treaty Establishing the African
Economic Community and has assisted the Secretariat of the
Organization of African Unity in drafting a health protocol for the
treaty. 


   U.S.  PARTICIPATION IN WHO
--------------------------------------------------------- Appendix I:8

The United States is active in virtually every aspect of the work and
functioning of WHO.  As a founding member of WHO, the United States
has helped to define its role in international health work.  The
United States has a greater number of its citizens on the staff of
WHO--143 as of January 1996--compared with other member states:  the
United
Kingdom (57), France (57), Russian Federation (41), Germany (41),
Japan (36), Canada (35), Italy (30), and Brazil (28).  However, the
number of U.S.  staff is still below the recruitment range, which is
193 to 262. 

Many of the top scientific and administrative positions of the
Secretariat are held by U.S.  citizens.  Senior posts filled by U.S. 
citizens include the Assistant Director General for Communicable
Diseases, Director of the Action Program on Essential Drugs, Director
of the Division of Emerging and Other Communicable Diseases
Surveillance and Control, and the External Relations and Information
Officer in Washington, D.C.  In addition, of the 1,100 WHO
collaborating centers, more than 162 are located at U.S.  institutes,
many at National Institutes of Health and the Centers for Disease
Control and Prevention. 


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

U.S.  Agency for International Development (USAID)

White House Office of Science and Technology Policy

White House Council for Environmental Quality


PAN AMERICAN HEALTH ORGANIZATION
========================================================== Appendix II

The International Sanitary Bureau, the predecessor of the Pan
American Health Organization (PAHO), was created in 1902 during the
first international meeting devoted to the health problems of the
Western Hemisphere.  The bureau was essentially a source for
information on the countries' sanitary conditions.  The bureau was
later charged with conducting and promoting scientific studies on any
deadly disease outbreak in the North, South, and Central Americas and
the Caribbean, offering assistance in promoting and protecting the
health of the countries' populations and encouraging seaport
sanitation.  In 1923, the bureau was entrusted with elaborating the
Pan American Sanitary Code.  The code, which was adopted a year later
by delegates of 18 countries, changed the organization's name to the
Pan American Sanitary Bureau and broadened its functions and
responsibilities. 

International health authorities understood that an international
organization with a broad health program was essential to cope with
the health problems of a world made increasingly smaller by faster
transportation.  The XII Pan American Sanitary Conference created the
Pan American Sanitary Organization--which later became PAHO--and
established the Pan American Sanitary Bureau as its operative arm. 
In 1949, an agreement with WHO established the relationship between
the two organizations, with the bureau serving as WHO's regional
office for the Americas. 

PAHO's mission is to foster and coordinate the efforts of the
countries in the Western Hemisphere to fight disease, lengthen life,
and promote the physical and mental health of their populations.  To
fulfill these mandates, PAHO cooperates with member countries in (1)
identifying immediate and long-term health threats and developing
approaches to overcome them; (2) making the latest scientific and
technical information in health available; (3) providing assistance
for developing and improving national and local health services; (4)
promoting research and development of technology; (5) awarding grants
and fellowships and organizing seminars and training courses; and (6)
supporting national activities and programs that address public
health problems.  PAHO also works with member countries' ministries
of health, social security agencies, and other national health
institutions in the health, education, environment, and agriculture
sectors. 


   ORGANIZATIONAL STRUCTURE
-------------------------------------------------------- Appendix II:1

PAHO's Secretariat is headed by a director who is elected every 4
years by the Pan American Sanitary Conference.  The Secretariat staff
is composed of health authorities from member states who are
primarily, but not exclusively, from countries in the Western
Hemisphere.  The Secretariat is responsible for carrying out the
policies and programs approved by the governing bodies of the
organization.  PAHO has 8 scientific and technical centers and 28
field offices.  One of its field offices is located in El Paso,
Texas. 


   GOVERNANCE
-------------------------------------------------------- Appendix II:2

The policies of PAHO are set by its governing bodies--the Pan
American Sanitary Conference, the Directing Council, and the
Executive Committee.  The conference and the council also serve as
the Regional Committee for the Americas of the WHO.  The conference
meets every 4 years to elect the Director of the Pan American
Sanitary Bureau, establish PAHO's general policies and the bureau's
mandates, and serve as a forum for debating major national and
international health issues.  The Directing Council's makeup mirrors
that of the conference.  Among other responsibilities, the council
reviews and approves PAHO's biennial program budget and considers
important policy issues.  The Executive Committee is made up of
representatives from nine member governments chosen by the conference
or the council for staggered 3-year terms.  The committee meets twice
yearly to approve the provisional agendas for the conference and the
council and review policy issues that will be presented to those
bodies. 


   REPORTING MECHANISMS
-------------------------------------------------------- Appendix II:3

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


   MAJOR PROGRAM AREAS
-------------------------------------------------------- Appendix II:4

In September 1994, the Pan American Sanitary Conference approved five
strategic and programmatic orientations for PAHO for 1995-98.  The
five orientations are health in human development, health systems and
services development, health promotion and protection, environment
development and protection, and disease prevention and control. 

PAHO's member states have asked PAHO to undertake activities that are
outside the scope of the WHO charter but are consistent with PAHO's
constitution.  One of these responsibilities is a veterinary public
health program, a mandate received from member countries.  As a
member of the inter-American system, PAHO is frequently called on to
carry out assignments unique to the region, such as its
responsibilities in carrying out negotiations leading to the Health
Initiative of the Americas, which was part of the plan of action of
the Summit of the Americas held in Miami, Florida, in December 1994. 


   FINANCIAL RESOURCES
-------------------------------------------------------- Appendix II:5

The largest portion of PAHO's funds comes from assessments paid
directly by member countries.  These assessments are calculated based
on a country's population and national income.  The remainder of the
organization's regular budget comes from WHO.  PAHO also receives
extrabudgetary resources from various U.N.  agencies, other
international bodies for which it acts as an executing agency,
foundations, and bilateral donor countries, as shown in tables II.1
and II.2.  About 82.9 percent of PAHO's budget is allocated for its
program costs. 



                               Table II.1
                
                             PAHO's Budget

                         (Dollars in millions)

                                                 1992-   1994-   1996-
Type of funding                                     93      95      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  63.0\a
======================================================================
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 $11 million for payments due
before 1996.  According to PAHO officials, the borrowed funds will be
repaid when a surplus of assessments contributions is available, but
when this will occur is unknown. 


   PERSONNEL
-------------------------------------------------------- Appendix II:6

As of December 1, 1995, PAHO had a total of 686 employees--
271 professional and 415 general services staff.  Women make up 59
percent of the total number of employees and 34 percent of the total
professional positions.  PAHO employs about 109 U.S.  citizens--
49 professional and 60 general services staff.  Senior posts filled
by U.S.  citizens include the Deputy Director and Chiefs of Budget,
Finance, Administration, Publications and Editorial Services, Public
Information, and the Pan American Center for Human Ecology and
Health. 


   COLLABORATION WITH OTHER
   INTERNATIONAL ORGANIZATIONS
-------------------------------------------------------- Appendix II:7

PAHO collaborates with a number of organizations.  Some of PAHO's
current collaborative efforts include

  -- vaccinations with UNICEF, the U.N.  Development Program (UNDP),
     USAID, and Rotary International;

  -- efforts to reduce maternal and child mortality and other
     programs to improve children's health with UNICEF at the
     regional and country levels;

  -- radiology and nuclear medicine with the International Atomic
     Energy Agency;

  -- air and water pollution issues with the U.N.  Environment
     Program and the U.S.  Environmental Protection Agency;

  -- food safety and animal health coordination with the Food and
     Agriculture Organization;

  -- the Joint U.N.  Program on the HIV and AIDS with WHO, UNDP,
     UNICEF, the U.N.  Educational, Scientific, and Cultural
     Organization (UNESCO), U.N.  Population Fund, and the World
     Bank;

  -- health conditions of refugees with the U.N.  High Commissioner
     for Refugees; and

  -- natural disaster response with the Red Cross. 

Since 1994, PAHO has participated as a regular member in the World
Bank's consultative groups meetings.  PAHO also participated at the
Inter-American Development Bank's annual board meeting, sponsored the
first Inter-American Conference on Society, Violence, and Health and
cosponsored by the Inter-American Development Bank; UNICEF; UNDP;
UNESCO; USAID; the Organization of American States; and the
Inter-American Dialogue, a think tank in Washington, D.C.  It also
played a key role in 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. 


INTERNATIONAL LABOR ORGANIZATION
========================================================= Appendix III

The International Labor Organization (ILO) was established in 1919
under the Treaty of Versailles as an autonomous institution
associated with the League of Nations.  An agreement establishing the
relationship between ILO and the United Nations was approved in 1946,
and ILO became the first specialized agency associated with the
United Nations.  Today, ILO continues to operate under its own
constitution. 

The primary objectives of ILO are promoting democracy and human
rights, fighting unemployment and poverty, and promoting equality and
adequate protection for all categories of workers.  Among its
activities, ILO formulates international policies and programs to
help improve working and living conditions; creates international
labor standards to serve as guidelines for national authorities in
putting these policies into action; carries out an extensive program
of technical cooperation to help governments in making these policies
effective in practice; and engages in training, education, and
research to help advance these efforts.  ILO is unique among world
organizations in that worker and employer representatives have an
equal voice with government representatives in formulating policies. 


   ORGANIZATIONAL STRUCTURE
------------------------------------------------------- Appendix III:1

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


   GOVERNANCE
------------------------------------------------------- Appendix III:2

ILO's policy-making and legislative body is the International Labor
Conference, which is composed of the entire membership and meets
every June.  The conference approves the biennial budget.  ILO's
Executive Board is the Governing Body, which is composed of 56
members (28 government delegates, 14 worker delegates, and 14
employer delegates).  The Secretariat is headed by a Director General
appointed by the Governing Body.  The Director General is responsible
to the Governing Body for managing the Secretariat.  The United
States has a permanent seat in the Governing Body and the U.S. 
representative to the Governing Body is the Deputy Under Secretary of
Labor for International Affairs.  The Governing Body usually makes
decisions on a consensus basis, and no member has veto power. 


   MAJOR PROGRAM AREAS
------------------------------------------------------- Appendix III:3

ILO focuses broadly in three areas:  promoting democracy and human
rights, fighting unemployment and poverty, and protecting working
people.  ILO's budget documents contain a wide array of programs
within its institutional focus, including international labor
standards and human rights, employment, enterprise and cooperative
development, training, industrial relations and labor administration,
multinational enterprises and social policy, working conditions and
the environment, sectoral activities, social security, statistics,
development and technical cooperation, equality for women, employers
activities, and workers activities.  Within these programs, ILO
employs such tools as technical meetings, research, dissemination of
information, standard setting, technical advisory services, and field
projects. 


   FINANCIAL RESOURCES
------------------------------------------------------- Appendix III:4

ILO's regular biennial budget is divided into about 40 major
programs.  In the 1996-97 biennium budget, four of the major programs
are allocated over half of ILO's program funds.  These programs are
enterprise and cooperative development, training, working conditions
and environment, and development and technical cooperation.  Of the
over $227 million in extrabudgetary funds for the 1996-97 biennium,
over $64 million is expected to come from U.N.  sources, such as
UNDP.  Tables III.1 and III.2 show ILO's budgetary information for
1992-97. 



                              Table III.1
                
                              ILO's Budget

                         (Dollars in millions)

                                                 1992-   1994-   1996-
Type of funding                                     93      95      97
----------------------------------------------  ------  ------  ------
Regular budget                                  $405.7  $466.5  $579.5
                                                                    \a
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. 



                              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. 


   PERSONNEL
------------------------------------------------------- Appendix III:5

In March 1996, 72 U.S.  citizens comprised 11.4 percent of the
professional staff.  Although the United States contributes about 25
percent of ILO's regular budget, ILO considers 15-percent employment
of U.S.  citizens to be a desirable target.  According to an ILO
official, more than 15 percent may not be feasible, given the desire
of other countries to have some representation on ILO's staff.  U.S. 
citizens hold several senior positions within ILO, including Deputy
Director General, Director of Personnel, the Chiefs of the Equality
and Human Rights Coordination Branch; Public Information; Information
Technology and Communications; Publications; and Chief Librarian. 
Table III.3 shows the total number of ILO staff members between 1992
and 1995. 



                              Table III.3
                
                      Number of ILO Staff Members

Type of staff                             1992    1993    1994    1995
--------------------------------------  ------  ------  ------  ------
Professional                               712     707     712     694
General services                         1,077   1,075   1,094   1,118
======================================================================
Total                                    1,789   1,782   1,806   1,812
----------------------------------------------------------------------
Note:  Professional staff at ILO headquarters decreased 13 percent,
from 569 in 1992 to 495 in 1995.  General services staff at ILO
headquarters decreased 11 percent, from 732 in 1992 to 662 in 1995. 

Source:  ILO. 


   COLLABORATION WITH OTHER
   INTERNATIONAL ORGANIZATIONS
------------------------------------------------------- Appendix III:6

Within the U.N.  system, ILO coordinates its programs with funds,
programs, and specialized agencies, including UNDP, the International
Maritime Organization, UNESCO, UNICEF, and the U.N.  Industrial
Development Organization.  In addition, ILO coordinates with the
World Bank, the International Monetary Fund (IMF), and the World
Trade Organization (WTO).  A 1992 Joint Inspection Unit Report,
United Nations Cooperation With Multilateral Financial Institutions,
cited the ILO-World Bank liaison arrangement as a constructive
example of an effective approach to organizational cooperation. 
According to a World Bank official, interagency cooperation was good,
but it was ad hoc and, particularly at the field level, dependent on
personal relationships and contacts. 

ILO officials stated that ILO and IMF did not have a consistent
dialogue underway or a systematic way to collaborate.  The two
organizations disagreed on approaches to structural adjustment for
economies in transition or undergoing a balance of payments crisis. 
However, in April 1996, ILO circulated a memorandum announcing a new
agreement between IMF and ILO to foster collaboration on a systematic
basis.  Both ILO and IMF appear to be committed to creating a new
collaborative relationship that recognizes the differences between
the two organizations.  The differences stem, at least in part, from
the organizations' differing mandates. 

Until December 1996, ILO's relationship with WTO was informal but, in
ILO's view, close at the working level.  For example, a
representative of WTO attended meetings of ILO's Working Party on the
Social Dimensions of the Liberalization of Trade as an observer. 
However, at the December 1996 WTO Ministerial meeting in Singapore,
WTO's member states adopted the WTO Singapore Ministerial
Declaration, which called for continued collaboration with ILO. 
WTO's members states also renewed their 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
------------------------------------------------------- Appendix III:7

U.S.  participation in ILO is guided by national interests as defined
by the President's Committee on ILO.  The Committee is chaired by the
Secretary of Labor and consists of the Secretaries of State and
Commerce; the National Security Advisor; the President of the
American Federation of Labor and Congress of Industrial
Organizations; and the President of the U.S.  Council for
International Business, which includes the U.S.  Chamber of Commerce
and the National Association of Manufacturers.  The State Department
addresses the financial issues related to U.S.  government membership
and ILO management issues as well as U.S.  foreign policy issues. 
The Department of Labor addresses most of the technical issues
related to working conditions.  Additionally, the Department of
Commerce addresses the issues which arise in the ILO's Subcommittee
on Multinational Enterprises, Committee on Legal Issues and
International Labor Standards. 

On the basis of the work of the President's Committee on ILO, the
President's 1997 budget request for ILO sets out U.S.  interests and
immediate objectives for ILO.  U.S.  interests include preserving and
strengthening workers' rights, improving working conditions, and
creating employment.  Specific goals include safeguarding the
mechanisms used in applying ILO's conventions, particularly the human
rights conventions; promoting a linkage between adherence to human
rights labor standards and increased access to international trade;
supporting the program to eliminate child labor; and promoting
technical assistance programs in areas of foreign policy interests. 
The U.S.  government is actively seeking reductions in ILO's budget. 


U.N.  CONFERENCE ON TRADE AND
DEVELOPMENT
========================================================== Appendix IV

The first U.N.  Conference on Trade and Development (UNCTAD) in 1964
led to its establishment later that year as the principal entity
within the U.N.  General Assembly in the field of trade and
development.  Its mandate is to promote international trade,
particularly that of the developing countries to accelerate their
economic development.  UNCTAD's functions are policy analysis,
intergovernmental deliberations, consensus building and negotiation,
monitoring, implementation and followup, and technical cooperation. 


   ORGANIZATIONAL STRUCTURE
-------------------------------------------------------- Appendix IV:1

UNCTAD has a permanent Secretariat located in Geneva that is headed
by the Secretary General, who is appointed by the U.N.  Secretary
General and confirmed by the U.N.  General Assembly.  UNCTAD's
Secretary General reports to the U.N.  Secretary General.  Under a
reorganization, UNCTAD's recently appointed Secretary General has
reduced the number of divisions within the Secretariat from nine to
four.  The new divisions are (1) Globalization and Development; (2)
Services Infrastructure for Development and Trade Efficiency; (3)
Investment, Enterprise Development, and Technology; and (4)
International Trade in Goods and Services, and Commodities.  UNCTAD
does not have a field structure of permanent country offices. 


   GOVERNANCE
-------------------------------------------------------- Appendix IV:2

UNCTAD's conference, the organization's highest policy-making body,
meets every 4 years.  The Trade and Development Board is the
executive body of UNCTAD and normally meets once a year.  Its
membership is composed of every member of the conference that wishes
to be a member; the board currently has 138 members.  The board is
assisted in its work by the Working Party on the Medium-Term Plan and
the Program Budget.  The working party has 19 elected members.  The
United States is an elected member of the working party. 


   MAJOR PROGRAM AREAS
-------------------------------------------------------- Appendix IV:3

The 1996 UNCTAD conference declared that UNCTAD has a comparative
advantage in addressing trade-related development issues and that
UNCTAD should continue to facilitate the integration of developing
countries and those countries in transition in the international
trading system.  The conference outlined the focus of UNCTAD's
analytical and deliberative work for the next 4 years. 


   FINANCIAL RESOURCES
-------------------------------------------------------- Appendix IV:4

UNCTAD's core operating expenses are funded through the U.N.  regular
budget.  UNCTAD does not receive direct assessments or voluntary
contributions to fund its regular budget.  However, it receives
extrabudgetary funds from other sources, such as bilateral donors,
trust funds, and funds from UNDP, as shown in table IV.1.  UNCTAD
officials said that UNCTAD, as an entity of the U.N.  General
Assembly, may not borrow money.  The United States pays 25 percent of
the regular U.N.  budget. 



                               Table IV.1
                
                            UNCTAD's Budget

                         (Dollars in millions)

                                         1992-
                                            93       1994-95     1996-
                                        budget        budget        97
                                      expendit  appropriatio    budget
Type of funding                            ure             n  estimate
------------------------------------  --------  ------------  --------
Regular budget                          $100.1        $113.6  $124.1\a
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. 


   PERSONNEL
-------------------------------------------------------- Appendix IV:5

UNCTAD currently employs 19 U.S.  citizens, or about 4 percent of
UNCTAD's staffing level for 1996-97.  The total number of UNCTAD
staff posts is shown in table IV.2. 



                               Table IV.2
                
                      Number of UNCTAD Staff Posts

                                                 1994-   1994-   1996-
Type of staff                                       95      95     97\
----------------------------------------------  ------  ------  ------
Professional                                       288     258     258
General services                                   222     196     193
======================================================================
Total                                              510     454     451
----------------------------------------------------------------------
Source:  UNCTAD. 

In December 1995, the U.N.  Office of Internal Oversight Services
issued a report on UNCTAD, which noted that the head offices of the
nine divisions within UNCTAD were large and top heavy.  The report
added that most divisions appeared to be overstaffed at the
professional and general services levels.  The report attributed the
staffing problem to the existence of nonperforming personnel who were
accommodated in separate units or by expanding the size of the head
offices within the divisions.  These personnel, according to the
report, were the result of a mismatch of staff capabilities at a time
of changing program demands. 

In response, the UNCTAD Secretary General announced in April 1996
plans to create a leaner organizational structure.  His plans
included a 25-percent reduction at the senior level and staffing
changes to reflect current staff skill requirements.  According to
the State Department, during the 1996 UNCTAD Conference, the UNCTAD
Secretary General also announced plans to cut professional and
general services staff by 6 percent in 1996-97.  State Department
officials noted that the success of these plans will depend on how
well they are implemented. 


   COLLABORATION WITH OTHER
   INTERNATIONAL ORGANIZATIONS
-------------------------------------------------------- Appendix IV:6

Various aspects of UNCTAD's work overlaps with that of other
international organizations, particularly the U.N.  economic
commissions, the International Trade Center, WTO, and the World Bank. 
UNCTAD's approach to coordination with these organizations has been
on a project-by-project basis (e.g., a debt management program with
UNDP and the World Bank and a manual, Blueprint for Green Accounting,
with the World Bank).  The U.N.  Office of Internal Oversight
Services' December 1995 report was critical of the level of
coordination between UNCTAD and other international organizations. 
In particular, the report called for better integration of UNCTAD's
work with other parts of the U.N.  system.  According to UNCTAD, the
General Assembly's Committee for Program and Coordination, of which
the United States is a member, has primary responsibility for
ensuring that proper coordination takes place within the U.N. 
Secretariat and with U.N.  Secretariat entities. 

UNCTAD has recently attempted to better coordinate with WTO and the
International Trade Center and cooperate better with the World Bank. 
For example, the 1996 UNCTAD Conference participants agreed to
coordinate UNCTAD's technical cooperation programs more closely with
WTO and the International Trade Center, and UNCTAD and WTO have
agreed to take some steps to more closely coordinate their activities
in support of developing countries that wish to accede to WTO.  Also,
as part of a U.N.  systemwide Special Initiative on Africa, UNCTAD,
WTO, and the International Trade Center have developed a plan of
action for increasing Africa's export-oriented production and
improving of export diversification and markets.  According to World
Bank officials, in the fall of 1995, the Secretary General of UNCTAD
met with World Bank officials and called for closer collaboration
between the two institutions.  Bank officials described the action as
improving the atmosphere between the two organizations and thus an
important first step. 


   U.S.  PARTICIPATION IN UNCTAD
-------------------------------------------------------- Appendix IV:7

The State Department and the Office of the U.S.  Trade Representative
are the lead agencies for UNCTAD within the U.S.  government. 
According to a State Department official, an informal interagency
working group meets as needed in relation to meetings of the Trade
and Development Board or UNCTAD's quadrennial conference to approve
guidance for the meeting or comment on a policy paper.  Members of
the group include the Office of the U.S.  Trade Representative, the
Departments of Agriculture, Labor, Commerce, Justice, State, and
Treasury; and the Security and Exchange Commission. 

The United States believes UNCTAD should have a single purpose--to
help developing countries in their integration into the global
economic system.  To accomplish this goal, U.S.  officials state that
UNCTAD must focus on a small number of priority activities that
provide practical assistance to developing countries.  An additional
U.S.  goal for UNCTAD is to make UNCTAD complementary to, not
competitive with, WTO. 


U.N.  POPULATION FUND
=========================================================== Appendix V

In 1966, the U.N.  General Assembly authorized the United Nations to
provide technical assistance in the population field.  The U.N. 
General Assembly established a special fund for population activities
in 1967, which was later named UNFPA.  Currently, UNFPA is the
largest internationally funded provider of population assistance to
developing countries.  All contributions to UNFPA are voluntary. 

UNFPA's role is to build the capacity to respond to the needs in
population and family planning; promote awareness of population
factors, such as population growth, fertility, mortality, age
structure, spatial distribution, and migration; assist governments in
developing population programs and projects and provide financial
assistance for their implementation.  UNFPA provides financial and
technical assistance to developing countries at their request. 


   ORGANIZATIONAL STRUCTURE
--------------------------------------------------------- Appendix V:1

UNFPA is a subsidiary component of the United Nations and is subject
to the direction of the U.N.  General Assembly.  The governing body
of UNFPA is the UNDP/UNFPA Executive Board, which is composed of 36
member states elected by the U.N.  Economic and Social Council.  The
United States is currently a member of the board.  UNFPA's chief
executive is the Executive Director, who is appointed by the U.N. 
Secretary General normally for a 4-year term.  The Executive Director
manages UNFPA under the direction of the board and is fully
accountable to it for all aspects of UNFPA's operations. 

The Executive Board provides general policy guidance and direction
for UNFPA and has overall responsibility for ensuring that UNFPA
resources are employed with maximum effectiveness and efficiency in
assisting countries in their population activities and programs.  The
board also has responsibility for financial and administrative
policies relating to UNFPA's work program, fundraising methods, and
annual budget.  UNFPA submits its own budget estimates and operates
under the financial regulations approved by the board.  Each year,
the U.N.  Economic and Social Council receives a report from the
board outlining decisions on UNFPA matters.  The U.N.  Economic and
Social Council forwards this report to the General Assembly for its
consideration. 

UNFPA has 4 regions--Africa, Arab States and Europe, Asia and the
Pacific, and Latin America and the Caribbean--and has 100 field
offices--15 in the Arab States, 44 in sub-Saharan Africa, 23 in Asia
and the Pacific; and 18 in Latin America and the Caribbean.  Of the
100 field offices, 66 are headed by a resident UNFPA representative,
and 34 are headed by the country resident UNDP representative, who is
concurrently the UNFPA representative.  At the end of 1995, UNFPA was
implementing 2,479 projects--1,910 country and 569 intercountry. 
UNFPA's projects are largely implemented by member organizations of
the U.N.  system, nongovernmental organizations, and national
governments themselves.  UNFPA's own role in project implementation
is mainly to provide procurement assistance in support of
government-implemented projects, procure equipment and supplies for
UNFPA implemented activities, and contract for personnel services. 


   MAJOR PROGRAM AREAS
--------------------------------------------------------- Appendix V:2

In l994, the United Nations convened the International Conference on
Population and Development in Cairo.  UNFPA and the Population
Division of the U.N.  Department for Economic and Social Information
and Analysis constituted the Secretariat for the conference and were
heavily involved in the 3 years of preparatory activities leading up
to the conference.  The l83 countries attending the conference
adopted by consensus the International Conference on Population and
Development Program of Action, which included recommendations for
stabilizing the world's population. 

In the months after the conference, UNFPA examined the policy and
program implications of the action plan, particularly as they related
to UNFPA's policy orientations, program focus, and operational
strategies.  UNFPA identified those components of the action plan for
which it has a comparative advantage and formulated a mission
statement to serve as the basis of its activities over the next 20
years.  The mission statement proposes that UNFPA assistance be used
to (1) help ensure universal access to sexual and reproductive
health, including family planning to all couples and individuals, by
2015; (2) support population and development strategies that develop
the capacity to do population programming; and (3) promote awareness
of population and development issues and advocate for the
mobilization of the resources and political will necessary to
accomplish UNFPA's work. 

Currently, about two-thirds of UNFPA's funds are for reproductive
health, including family planning.  Activities range from support for
contraceptive research and production to training, infrastructure,
logistics, and expansion and improvement of service delivery.  Other
priority areas include information and education activities,
population data collection and analysis, research on demographic and
socioeconomic relationships, policy formulation and evaluation, and
programs to improve the situation of women.  Special efforts are also
undertaken in the areas of AIDS control and prevention and population
and the environment. 

Since the International Conference on Population and Development in
1994, UNFPA has revised its approach for the allocation of resources
to country programs.  The conference laid out specific longer term
goals in three major areas:  access to reproductive health; mortality
reduction in women and children; and universal education, especially
for girls. 

UNFPA's revised system for allocating resources categorizes countries
into three groups according to their needs for specific types of
assistance and circumstances with regard to the progress they have
made in meeting the conference's goals.  For example, countries in
the highest priority group must have the greatest distance from
achieving the goals of the conference and low levels of development. 
Under the previous system of allocation, the countries in this group
received 51 percent of program resources.  Under the new allocation
system, the share should go up to at least 67 percent.  Within each
group of countries, the actual level and type of resources made
available would primarily reflect UNFPA's comprehensive assessment of
the country's actual needs and capacities. 


   FINANCIAL RESOURCES
--------------------------------------------------------- Appendix V:3

UNFPA is a voluntarily funded organization.  It receives funds from
donor countries in support of programs in reproductive health,
including family planning, population and development, and advocacy. 
The Executive Board is responsible for approving each year the
program expenditure, which is based on income projections, prior
commitments, and foreseeable needs.  If the funds are not spent
during a given calendar year, the remaining funds are carried over to
the next year.  Tables V.1 and V.2 show UNFPA's budgetary information
for 1992 through 1997. 



                               Table V.1
                
                             UNFPA's Budget

                         (Dollars in millions)

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



                               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. 


   PERSONNEL
--------------------------------------------------------- Appendix V:4

In February 1996, UNFPA had 188 professional posts reserved for
international staff; 166 posts were occupied and 22 were vacant.  At
that time, 107 of the posts were in headquarters and 81 were in the
field.  U.S.  citizens held 20 of these posts.  Tables V.3 and V.4
provide details on UNFPA's overall staffing and the distribution of
staff between headquarters and the field. 



                               Table V.3
                
                      Number of UNFPA Staff Posts

                                                 1992-   1994-   1996-
Type of staff                                       93      95      97
----------------------------------------------  ------  ------  ------
Professional                                       293     304     329
General services                                   519     533     590
======================================================================
Total                                              812     837     919
----------------------------------------------------------------------
Source:  UNFPA. 



                               Table V.4
                
                     Location of UNFPA Staff Posts

                                                 1992-   1994-   1996-
Location                                            93      95      97
----------------------------------------------  ------  ------  ------
Headquarters                                       257     244     244
Field                                              555     593     675
======================================================================
Total                                              812     837     919
----------------------------------------------------------------------
Source:  UNFPA. 


   COLLABORATION WITH OTHER
   INTERNATIONAL ORGANIZATIONS
--------------------------------------------------------- Appendix V:5

UNFPA has developed an array of mechanisms and relationships for
coordinating its programs.  Coordination is essential for UNFPA to
perform its mission, particularly with other U.N.  agencies and the
World Bank.  UNFPA is primarily a funding agency for country-level
activities.  UNFPA must identify the expertise of executing
agencies--primarily other U.N.  agencies and recipient
governments--and seek collaboration in implementing its own program. 
Additionally, UNFPA has the lead role in monitoring and following up
on the International Conference on 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 frequent contacts and regular collaboration to no
contacts or common activities. 

Despite extensive collaboration between UNFPA and the World Bank,
particularly in Asia and the Pacific and Africa, coordination at the
operational level is on a project basis.  There is no formal
agreement or memorandum of understanding on collaboration.  A UNFPA
document stated that UNFPA wants to institutionalize relations at the
division and country levels to a greater degree than before and
thereby avoid the fluctuations in relations that tend to occur.  A
World Bank document states that the bank prefers establishing
collaboration on a project and country basis. 


   U.S.  PARTICIPATION IN UNFPA
--------------------------------------------------------- Appendix V:6

Although the United States has stressed the importance of population
objectives within the overall context of sustainable development, it
has not issued a policy detailing U.S.  objectives for UNFPA. 
However, officials at USAID and State clearly indicated that U.S. 
support for the work of UNFPA and the International Conference on
Population and Development's Program of Action was a high priority. 
USAID and State Department officials stated that the U.S.  national
interests in UNFPA's program stem from U.S.  objectives to (1)
minimize the negative consequences of rapid population growth, such
as political crises associated with economic stagnation, pressures
from migration, pressures on the world food supply, and environmental
degradation and (2) maximize the positive consequences of slower
population growth and smaller family size, such as better health for
women and children, trade and economic opportunities for the United
States, improved environmental quality, and a better chance for
political institutions to be able to deal with challenges and move
toward democracy.  USAID officials state that the agency regards
UNFPA programs as generally complementary to the activities supported
under the bilateral U.S.  population assistance program, which
provides assistance in a more limited number of countries than UNFPA. 
A USAID document indicated that USAID's objectives incorporate
principles from the conference's action plan.  The document also
states that USAID should maintain a close working relationship with
UNFPA in the population sector. 

U.S.  support for UNFPA has been shaped by various provisions in the
Foreign Assistance Act of l961, as amended, as they apply to U.S. 
bilateral programs in population and family planning.  In l985, the
Congress passed an amendment to the Foreign Assistance Act, which
prohibited the United States from providing assistance to any
organization that supported or participated in the management of a
program of coercive abortion or 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. 




(See figure in printed edition.)Appendix VI
COMMENTS FROM THE DEPARTMENT OF
STATE
=========================================================== Appendix V




(See figure in printed edition.)Appendix VII
COMMENTS FROM THE U.S.  AGENCY FOR
INTERNATIONAL DEVELOPMENT
=========================================================== Appendix V



(See figure in printed edition.)




(See figure in printed edition.)Appendix VIII
COMMENTS FROM THE DEPARTMENT OF
HEALTH AND HUMAN SERVICES
=========================================================== Appendix V

at the end of this appendix. 



(See figure in printed edition.)



(See figure in printed edition.)


The following is GAO's comment on the Department of Health and Human
Services' letter dated January 15, 1997. 

GAO COMMENT

1.  Our report recognizes and provides a number of examples of the
importance of WHO's programs and normative functions.  The additional
examples provided by the Department have been considered and have
reinforced our conclusion. 




(See figure in printed edition.)Appendix IX
COMMENTS FROM THE DEPARTMENT OF
LABOR
=========================================================== Appendix V



(See figure in printed edition.)




(See figure in printed edition.)Appendix X
COMMENTS FROM THE WORLD HEALTH
ORGANIZATION
=========================================================== Appendix V



(See figure in printed edition.)




(See figure in printed edition.)Appendix XI
COMMENTS FROM THE PAN AMERICAN
HEALTH ORGANIZATION
=========================================================== Appendix V

appears at the end of the appendix. 



(See figure in printed edition.)



(See figure in printed edition.)



(See figure in printed edition.)


The following is GAO's comment on the Pan American Health
Organization's letter dated November 8, 1996. 

GAO COMMENT

1.  We recognize that PAHO and the other four organizations have
strategic priorities and objectives incorporated in their workplans. 
However, when faced with budgetary constraints, any organization,
governmental or nongovernmental, should identify lower priority
programs and activities so that they can be appropriately adjusted in
line with available resources.  Our report does recognize, and PAHO
has acknowledged, that the organization recently conducted reviews of
some of its programs and activities to address the issues we
presented in this report. 




(See figure in printed edition.)Appendix XII
COMMENTS FROM THE INTERNATIONAL
LABOR OFFICE
=========================================================== Appendix V

end of this appendix. 



(See figure in printed edition.)


The following is GAO's comment on the International Labor
Organization's letter dated November 8, 1996. 

GAO COMMENT

1.  With the use of the currency adjustment rates provided by ILO, we
calculated ILO's real growth based on the projected inflation and
changes in the exchange rate.  We estimated a 2-percent decline in
real terms in ILO's budget.  The apparent 24-percent dollar increase
between the 1994-95 and 1996-97 ILO budgets and the corresponding
increase in the U.S.  assessment are due primarily to changes in the
U.S.  dollar-Swiss franc exchange rate (i.e., the 25-percent
strengthening of the Swiss franc relative to the dollar used in
formulating the ILO budget). 




(See figure in printed edition.)Appendix XIII
COMMENTS FROM THE U.N.  CONFERENCE
ON TRADE AND DEVELOPMENT
=========================================================== Appendix V

the end of this appendix. 



(See figure in printed edition.)


The following is GAO's comment on the U.N.  Conference on Trade and
Development's letter dated November 16, 1996. 

GAO COMMENT

1.  At the time of our fieldwork, the two studies referred to by
UNCTAD had not been completed. 




(See figure in printed edition.)Appendix XIV
COMMENTS FROM THE U.N.  POPULATION
FUND
=========================================================== Appendix V

at the end of this appendix. 



(See figure in printed edition.)



(See figure in printed edition.)


The following is GAO's comment on the U.N.  Population Fund's letter
dated November 11, 1996. 

GAO COMMENT

1.  Our report recognizes and provides a number of examples of
collaboration between UNFPA with other organizations.  The additional
examples provided by UNFPA have been considered and have reinforced
our conclusion that the organization supports U.S.  population goals. 


*** End of document. ***