WHO is a specialized agency of the UN, as provided for in the Charter of the United Nations. A goal-oriented organization with policies, program, and budget defined through well-developed mechanisms, WHO consists of three constituent bodies:

• The World Health Assembly, which is the highest decision-making body, is held in May each year and is attended by delegations from WHO's 191 member states and two associate members. Its main tasks are to decide on major policy matters and to approve the biennial program budget.

• The Executive Board consists of 32 persons, acting in their personal capacity, highly qualified in the field of health and designated for a 3-year term by as many member states, which are chosen by the Health Assembly on the basis of equitable geographical distribution. The board, which normally meets twice a year, gives effect to the decisions and policies of the Assembly, while advising it and preparing its agenda. • The Secretariat serves to carry out the decisions of the World Health Assembly and the Executive Board; it is the entire staff of WHO headed by the director-general, who is appointed as its chief technical and administrative officer for a 5-year term by the World Health Assembly on the nomination of the Executive Board.

In general, all technical activities that are of universal applicability—such as biological and epidemiological standardization, the overall assessment of the efficacy of methods and materials, and promoting the control of disease—are the responsibility of the headquarters in Geneva (Figure 2). WHO's highly decentralized structure enables it to respond directly to the needs of its membership, upon request, through its six regions, each consisting of a regional committee and a regional office. The regional offices, with their own directors, are responsible for formulating policies of a regional character and for monitoring regional activities. In many countries there is a resident WHO representative who is the main intermediary for support of WHO and who participates with the government in

planning and managing national health programs. The location of the six regional offices and the member states covered are shown in Figure 3.

Some 40% of WHO's 4300 staff members, including PAHO, work in countries all over the world, either in field programs or as WHO representatives; 30% are in the six regional offices and 30% at headquarters in Geneva.

WHO's normative, i.e., standard-setting, functions also include preparation and updating of the International Classification of Diseases, assignment of generic names for pharmaceuticals, and, since 1957, evaluating the safety for human consumption of selected food additives and contaminants in food and establishing acceptable daily intakes for these substances through the Joint FAO (Food and Agriculture Organization)/WHO Expert Committee on Food Additives.

The committee's reports, as well as those of a similar FAO/WHO group responsible for evaluating the safety of pesticide residues, are used in the formulation of national food legislation intended to protect consumers from hazardous additives or contaminants and by the Codex Alimentarius Commission—another joint FAO/WHO body—in establishing international food standards. (Food legislation is one of the many topics regularly covered by one of WHO's half-dozen specialized international periodicals, the quarterly International Digest of Health Legislation.) Codex originated at a time— the early 1960s—when international efforts were being made to increase world trade by reducing tariff barriers, as well as nontariff barriers resulting from differing food regulations. Consistent with a dynamic system that is still changing to deal with ever-changing circumstances, the international community has decided to use health-related Codex standards, guidelines, and recommendations as a reference in implementing relevant aspects of the trade agreements administered by the World Trade Organization (WTO) since 1995.

While the member making the largest contribution to the WHO regular budget is assessed at a maximum 25%, members making the smallest each pay 0.01%. Apart from its regular budget—US$842 654 000 for the biennium 1998-1999—WHO receives voluntary contributions from both governmental and nongovernmental sources. In recent years the total amount of these contributions has been roughly equivalent to regular budget levels. They include contributions for fostering research in tropical diseases and human reproduction, improving community water supply, expanding immunization, preventing and controlling diarrheal diseases, leprosy, malaria, and yaws, and preparing a credible emergency health response to disasters and natural catastrophes.

Working with Others

From its beginning, WHO set out to work not through its small staff alone but with and through others. Many thousands of individual researchers

Where Rex Live

WHO African Region WHO Region of the Americas

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