contents · despite an investment loss of us$ 13.5 million, and after administrative costs of us$...

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Contents Director-General’s Foreword .................................................................................................................. 2

Global Oversight Committee (GOC) Chairman’s Report ......................................................................... 3

Certification of the Financial Statements for the year ended December 2015 .................................... 16

Letter of Transmittal ............................................................................................................................. 17

Opinion of the External Auditor ............................................................................................................ 18

Statement I: Statement of Financial Position ....................................................................................... 20

Statement II: Statement of Financial Performance .............................................................................. 21

Statement III: Statement of Changes in Net Assets/Equity .................................................................. 22

Statement IV: Statement of Cash Flow ................................................................................................. 23

Statement V: Comparison of Budget and Actual Amounts .................................................................. 24

1 Basis of preparation and presentation ..................................................................................... 25

2 Significant accounting policies .................................................................................................. 26

3 Supporting information to the statement of financial position ............................................... 29

4 Supporting information to the statement of financial performance ........................................ 41

5 Supporting information to the statement of comparison of budget and actual amounts ....... 44

6 Related party and other senior management disclosures ........................................................ 45

7 Annex ........................................................................................................................................ 46

Membership .......................................................................................................................... 46 7.1

Fund Balance Reconciliation ................................................................................................. 49 7.2

Claims Processing .................................................................................................................. 50 7.3

Analysis of claims by category .............................................................................................. 52 7.4

Major cases >US$ 50,000 ...................................................................................................... 52 7.5

Organization's Contributions ................................................................................................ 53 7.6

Statement of First Tier and Second Tier Contributions ........................................................ 54 7.7

Contributions Received and Claims Paid .............................................................................. 55 7.8

Insured Persons ..................................................................................................................... 59 7.9

Composition of Global Oversight Committee (GOC) ............................................................ 62 7.10

Composition of Global Standing Committee ........................................................................ 63 7.11

Composition of Interim Global Standing Committee ........................................................... 63 7.12

Composition of Regional Surveillance Committees .............................................................. 64 7.13

Surveillance meetings & Briefing/Visits ................................................................................ 65 7.14

Composition of Medical Review Committee ........................................................................ 66 7.15

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Director-General’s Foreword

I have the honour to present the annual report for the year 2015 which includes financial statements, accounting policies and notes prepared in compliance with International Public Sector Accounting Standards (IPSAS) and WHO’s financial regulations and rules. Financial reporting is a critical element of governance and of sound management, the improvement of which are both important aspects of the WHO reform process. A sound Staff Health Insurance is not only about having good financial results and strong governance, It is also about providing participants with a high level of service and good access to treatment. In last year’s report I informed you that I had requested an external study to examine the existing administrative arrangements of the scheme and that this study concluded that whilst there was an overall good level of client satisfaction, certain aspects of administration could be improved. A roadmap was initiated in 2015 and certain measures were implemented, including a new 24/7 emergency service which was put in place that allows all staff and participants, wherever they are in the world, to have access to emergency assistance. Further improvements are planned for 2016. The actuarial estimate of future total liabilities continues to be only partially funded. Based on the current contribution rates and cost estimates, full funding will be reached by 2038. Dr Margaret Chan

Director-General Geneva, 1 April 2016

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Global Oversight Committee (GOC) Chairman’s Report

Since 1st January 2012, WHO has applied the International Public Sector Accounting Standards and in application of Paragraph 25.4.8 of the WHO International Public Sector Accounting Standards Manual, the financial statements of the Staff Health Insurance Fund (SHI) are reported separately from the rest of WHO’s financial statements. The SHI Fund financial statements identify separately the following SHI accounting entities (referred to in this report as “participating entities”): • World Health Organization (WHO) • Trust Fund for the Joint United Nations programme on HIV/AIDS (UNAIDS) • International Drug Purchase Facility (UNITAID) • International Agency for Research on Cancer (IARC) • International Computing Centre (ICC) • African Programme for Onchocerciasis Control (APOC, which closed in December 2015) • Pan American Health Organization (PAHO) Highlights of revenue, expenses, statistics, operations, administration and governance are included in order to provide a complete picture of the SHI Fund as at 31 December 2015. The statutory components of the financial report have been audited by the Organization’s External Auditor, the Republic of the Philippines Commission of Audit, whose opinion is included in the Financial Report.

Overall Results for 2015

I am pleased to report once again that the overall result for 2015 is positive. Contributions totalled US$ 120.5 million (US$ 118.8 million in 2014), with operational contributions of US$ 103.4 million (US$ 95.2 million in 2014), and claims of US$ 83.1 million (US$ 82.5 million in 2014). This resulted in a net operational surplus of US$ 20.4 million (US$ 12.7 million in 2014), despite the operational deficit for retired staff of almost US$ 7.4 million. This is shown in both Table 1 and Note 4.1.

In US$'000CONTRIBUTIONS

COLLECTEDCLAIMS PAID

SURPLUS / DEFICIT

Activ e Staff and Eligible Family Members (ex c. App C) 65,806 38,254 27,553

Retired Staff/Surv iv ors and Eligible Family Members 37,429 44,807 (7,378)

Temporary Staff (Appendix C) 195 9 186

103,430 83,069 20,360

Earmarking 25% of Activ e Staff Contributions for Retired Staff 21,935 Surplus/(Deficit) on Organization Share for Retirees carried ov er (5,527) Second-Tier Contributions 1,098 Prior Year adjustments (406) (429) Current Year adjustments 547 Total 120,530 83,187

Table 1

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The US$ 5.5 million deficit on Organization Share for Retirees carried over relates to all entities excluding PAHO.

Claims increased slightly in 2015 compared to 2014, with higher hospitalization costs paid (particularly in both HQ and UNAIDS). It is notable that there was an increase in the number of major claims (>US$ 50,000) in 2015, compared to 2014 (as mentioned in Note 7.5). However, the average length of hospital stay remained at 4 days in 2015.

In accordance with SHI Rule 470.4, a fixed percentage of active staff contributions (both staff and Organization shares) is set aside each year as a provision for future retired staff. The current percentage is 25%, and represents US$ 21.9 million, which is included within other income. In 2015 again, this amount covered the retirees’ operational deficit, as can be seen in Figure 12 under Note 7.1.

Despite an investment loss of US$ 13.5 million, and after administrative costs of US$ 5.1 million, the overall result was US$ 16.9 million. This positive result can be explained by the increase in contributions, offset by the challenging investment performance. This balance has been booked to the participating entities to reduce their unfunded liabilities, as shown in both Statement II: Statement of Financial Performance, and Note 4.7.

The latest contributions, claims, and headcount are all factored into the latest SHI actuarial liability, and AON Hewitt have informed the SHI that there was a favourable variance in 2015, compared to the previous actuarial valuation.

Active Staff (except Appendix C) After deduction of the 25% provision for future retired staff, the remaining 75% of contributions was sufficient to cover claims of active staff in all offices except AMRO/PAHO. AMRO/PAHO’s deficit (US$ 1.1 million), largely due to the higher cost of health care in the United States of America, was offset by a second tier contribution payable by staff and the Administration of AMRO/PAHO on a one-third/two-third basis under the provisions of the SHI Rule 395. This compares with a deficit of US$ 0.3 million in both 2014 and 2013. The contributions/claims relationship is shown in Figure 1.

0.0

5.0

10.0

15.0

20.0

25.0

Figure 1: Active Staff (except App C) Contributions and Claims by Office for 2015

Contributions Claims Second Tier ContributionsUS$ millions

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For all other offices (excluding AMRO/PAHO) combined, there was a net overall surplus of US$ 28.7 million for active staff (i.e. contributions exceeded claims) after a deduction of 25% of contributions as earmarking for retired staff. This compares with a figure of US$ 28.4 million in 2014 and US$ 25.3 million in 2013.

The statement of first and second tier contributions is presented in Note 7.7 of this report, and the surplus/deficit history is shown in Figure 2.

Figure 2: Surplus/deficit of fixed-term active staff (excl. App C) in all offices

0.0

2.0

4.0

6.0

8.0

10.0

12.0

2007 2008 2009 2010 2011 2012 2013 2014 2015

HQ/UNAIDS/UNITAID/ICC/ IARC SURPLUSin US$ millions

0.0

2.0

4.0

6.0

8.0

10.0

12.0

2007 2008 2009 2010 2011 2012 2013 2014 2015

AFRO SURPLUSin US$ millions

(3.0)

(2.0)

(1.0)

0.02007 2008 2009 2010 2011 2012 2013 2014 2015

AMRO/PAHO DEFICITin US$ millions

0.0

1.0

2.0

3.0

2007 2008 2009 2010 2011 2012 2013 2014 2015

EURO SURPLUSin US$ millions

0.0

1.0

2.0

3.0

2007 2008 2009 2010 2011 2012 2013 2014 2015

EMRO SURPLUSin US$ millions

0.0

1.0

2.0

3.0

2007 2008 2009 2010 2011 2012 2013 2014 2015

SEARO SURPLUSin US$ millions

0.0

1.0

2.0

3.0

2007 2008 2009 2010 2011 2012 2013 2014 2015

WPRO SURPLUSin US$ millions

0.0

0.1

0.2

0.3

0.4

0.5

2007 2008 2009 2010 2011 2012 2013 2014 2015

APOC SURPLUSin US$ millions

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Retired Staff

Claims paid in respect of retired staff exceeded contributions received by US$ 7.4 million (compared with US$ 15.6 million in 2014 and US$ 18.0 million in 2013). This category has been consistently in deficit for several years, and AMRO/PAHO retirees alone account for a deficit of US$ 10.5 million in 2015. The contributions/claims relationship is shown in Figure 3.

Table 2 shows that the proportion of claims covered by contributions, as can also be derived from Table 13 in Note 7.8. The surplus/deficit history is shown in Figure 4.

Table 2

Figure 4: Surplus/deficit of retired staff

0.0

5.0

10.0

15.0

20.0

25.0

Figure 3: Retired Staff Contributions and Claims by Office for 2015

Contributions ClaimsUS$ millions

Retired Staff PercentageAll : 83.5%All ex cluding AMRO/PAHO 111.1%AMRO/PAHO 37.4%

(20.0)(18.0)(16.0)(14.0)(12.0)(10.0)(8.0)(6.0)(4.0)(2.0)

0.02007 2008 2009 2010 2011 2012 2013 2014 2015

RETIRED STAFF and DEPENDANT DEFICIT in US$ millions

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Fund Balance and Liabilities

The SHI engaged Aon Hewitt Corporation to assess the financial impact of the adoption of International Public Sector Accounting Standard 25 for the After Service Health Insurance.

This valuation has been conducted in accordance with generally accepted actuarial principles and practices. In addition, the accounting valuation results are based on the actuary’s understanding of the requirements of International Public Sector Accounting Standard 25.

The 31 December 2015 valuation results and the International Public Sector Accounting Standard 25 disclosures are split by regional office. The defined benefit obligation and service cost are allocated to the regional offices.

The Fund balance at 31 December 2015 is US$ 723.9 million (an increase of 2.4% over 2014). As can be seen from Note 7.2, the latest actuarial Defined Benefit Obligation for ASHI per IPSAS 25 is estimated at US$ 2,012.0 million as at 31 December 2015 (in accordance with both SHI Rules 470.2 and 470.3). An amount of US$ 29.9 million has been set aside to pay four months of combined in-service and after-service claims for WHO (SHI Rule 470.1), leaving an unfunded deficit of US$ 1,318.0 million. This deficit represents 64% of the total liability, and is shown in the accounts of participating entities.

Figure 5: Fund Balance and trends in Liabilities (in US$ millions)

As can be seen from Figure 5, the liability for current retirees (Rule 470.2) had been steadily growing until 2012 when the liability for future retirees (Rule 470.3) was added in application of IPSAS.

It is also worth noting that the current Fund balance is insufficient to cover the liability for current retirees (Rule 470.2) itself.

Overall, the Defined Benefit Obligation has increased in 2015. This can be explained by a fall in the discount rate in the Euro-zone, partially offset by favourable claims experience during 2015. Further information on the actuarial valuation (including assumptions used) is contained in Note 3.10.

0.0100.0200.0300.0400.0500.0600.0700.0800.0900.0

1,000.0

2007 2008 2009 2010 2011 2012 2013 2014 2015

FUND BALANCE

0.0200.0400.0600.0800.0

1,000.01,200.01,400.01,600.01,800.02,000.02,200.0

2007 2008 2009 2010 2011 2012 2013 2014 2015

LIABILITY TRENDS DEFINED BENEFIT OBLIGATION (470.2

and 470.3)

(1,400.0)(1,200.0)(1,000.0)

(800.0)(600.0)(400.0)(200.0)

0.0200.0

2007 2008 2009 2010 2011 2012 2013 2014 2015

UNFUNDED LIABILITY

0.0

10.0

20.0

30.0

40.0

50.0

2007 2008 2009 2010 2011 2012 2013 2014 2015

LIABILITY TRENDSOUTSTANDING CLAIMS (470.1)

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Investment performance

The SHI Fund investments yielded -1.9% in 2015 (2.3% in 2014), which represented a net loss of US$ 13.5 million (compared to a gain of US$ 14.5 million in 2014).

Global fixed income and equity valuations were impacted during 2015 by a growing risk aversion in financial markets caused by concerns about the scale of the economic slowdown in China, ongoing quantitative easing by central banks in Japan and Europe, a sharp decline in oil prices, and a depreciation of emerging-market currencies. The US dollar strengthened against developed and emerging-market currencies which impacted the valuation of non US dollar holdings in US dollar terms. Overall, global long term bond valuations reduced by 4.1% and global equities valuations by 0.7%.

The SHI investment portfolio is structured with a long term time horizon to match the long term nature of its future expenditure, and so some years of lower performance are to be expected. The negative 2015 investment return figures should be viewed in the context of the positive returns in recent years:

2014 2.3% 2013 5.6% 2012 8.7% 2011 0.3% 2010 5.7%

The equity and fixed income investments are managed by external fund managers, whose appointment and performance is closely managed by the WHO Treasury unit and monitored by the independent expert advisors in the Advisory Investment Committee.

During 2015, the external management of the fixed income portfolios was subjected to a Request for Proposals (RFP) competitive tendering process, and three managers were selected to replace the existing two managers.

No adjustments were made to the strategic proportions of funds invested in the three asset classes, with fixed income securities remaining at around 67%, equities at around 25% and cash at 8%.

Table 3 provides a summary of the SHI investments at 31 December 2015, and the investment returns during 2015 (based on the average balances throughout the year).

Table 3

US$ millions % Return WeightRecommendation effective

2013

Co-mingled cash 60.3 0.6% 8% 0% to 10%Fix ed Income 483.7 -2.3% 67% 55% to 75%

Equities 177.3 -1.6% 25% 25% to 35%

Total Investments 721.3 -1.9% 100% 100%

Other Net Assets (eg Receiv ables) 2.5 0.0% 0% -

Total Fund Balance 723.9 -1.9% 100% 100%

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Actuarial valuation of the SHI liability

Following the funding valuation as of 31 December 2013, SHI was set a goal of reaching fully-funded status in 2037. This target included AMRO, but excluded PAHO. Including PAHO, full-funding will be reached in 2038.

Sensitivity Analysis

It is worth noting that the funding valuation is particularly sensitive to various assumptions, and in particular medical inflation, investment returns and discount rates. An analysis for three hypothetical, adverse scenarios illustrates the risk exposure of the plan:

1. Actual investment returns are 1.0% less than expected in the baseline scenario. 2. Assumed and actual medical cost increases are 1.0% per year higher than in the baseline scenario. 3. All discount rates permanently fall by 1.0%. Table 4 below summarizes the key results of the sensitivity analysis. The table shows that small changes in assumptions can cause large variations in long-term results when compounded over time:

Governance

The revised SHI Governance has been in place for almost three years and involves three committees: the Global Oversight Committee, the Global Standing Committee and the Regional Surveillance Committees.

Elections of former staff representatives who are participants in the SHI under paragraph 60 of the SHI Rules

In 2015, elections of former staff representatives who are participants in the SHI under paragraph 60 of the SHI Rules took place for seats on the Global Oversight Committee and the Global Standing Committee as per SHI Rule 491.5 and 501.2 (b). The term is for a period of 4 years beginning 1 September 2015. The following former staff were elected:

Ann Van Hulle as Member and Clas Sandström as Alternate for the Global Oversight Committee; Marjory Dam and Jean-Paul Menu as Members and Francoise Hery-Persin and Carol Collado as Alternates for the Global Standing Committee.

ScenarioProjected Year that Full

Funding is ReachedProjected Funded % at

1 January 2043

Baseline (ex cluding PAHO) 2037 125%

Baseline (including PAHO) 2038 124%

-1.0% Return on Inv estments 2043 105%

+1.0% Medical Trend Rates Not reached by 2055 59%

-1.0% Discount Rates 2044 103%

Table 4

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The Global Oversight Committee

The Global Oversight Committee (GOC) of the WHO SHI met twice in Geneva during 2015 on 27 to 29 April 2015 and 2 to 3 November 2015.

The Committee’s role is to oversee the SHI and advise the Director-General on SHI operations and management, finance and investments, audit and control, benefits and best practices, rules and Governance.

The Global Standing Committee and the Interim Global Standing Committee

The Global Standing Committee met 11 times during 2015 and reviewed a total of 63 cases from all regions.

The Committee’s role is to decide on cases referred to it in accordance with the SHI Rules, and to recommend to the Global Oversight Committee any proposed amendments to the SHI Rules and practices of the SHI.

The Interim Global Standing Committee’s role is to transact emergency business when the Global Standing Committee itself is not in session. Fortunately, there was no emergency business to attend to in 2015 to merit a meeting of the Interim Global Standing Committee.

The Regional Surveillance Committees

In each region, a surveillance committee is responsible for keeping under review the working of the SHI in the region, for deciding on cases referred to it in accordance with the SHI Rules, and for proposing to the Global Standing Committee any modifications in the rules or practices of the Insurance that they may consider advisable in the light of their experience. Decision made at the end of 2015

Since the implementation of the Governance in September 2013, the work of the SHI committees has been regularly assessed. In November 2014, the Global Oversight Committee recognized that there were still discrepancies between the Regions regarding the number of meetings, the number of cases treated in the RSCs or transferred to the Global Standing Committee and that it was very difficult to ensure a harmonized interpretation of the Rules with 7 different Committees (6 regional and one global). In addition to the above, the fact that the SHI Rules had been streamlined in 2015 meant that there were less cases that needed review by the RSCs. In light of this, the Global Oversight Committee commissioned a group to work with the Regional Offices with the objective to make proposals regarding the future of RSCs to strengthen the Governance through a unique Committee, with representation from all Regions. The group concluded that the establishment of a stronger Global Standing Committee with representatives from Staff Committees and Administration from all Regions, and the creation of a sub-committee to the Global Standing Committee for AMRO/PAHO would be a better option than keeping the RSCs. After agreement over the proposal from both the Staff Committees and the Regional Directors, the Global Oversight Committee advised the Director-General, who agreed to the disbandment of the RSCs as of 1 January 2016.

https://sharepoint.who.int/sites/shi/SHI%20Document%20Library/JM7_0_4_PRES_opening.ppt#307,2,Slide%202

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Administrative Matters

Computer Systems (HIIS) The project of upgrading the HIIS core technologies and databases (in order to keep abreast with industry technical standards and ensure that the HIIS back-office application remains viable and fully supported) was completed. In addition to this, the Direct Payment Advice was made available electronically. On-line Claims Submission Pilot The SHI team worked together with the IT Department in HQ to create this project and so far it has been a success story. Over 600 staff used the pilot for on-line claims submission. Their feedback has been extremely positive. This pilot has allowed staff members working in duty stations (where it would otherwise take up to 2 months for claims to reach SHI) to scan their claims electronically, complete a form and send it to SHI immediately. The only delay encountered was the time it took the claims team to process the on-line claims. As part of the new SHI IT project, a stronger IT portal will be developed during 2016. This should enable the extension of on-line claims submission to all staff and former staff who wish to be included. Self-service Portal for SHI Work began in 2015 to identify the best system for SHI to use to be able to launch by the end of 2016 a portal which should enable participants (staff members and former staff) not only to submit their claims electronically, but also to: view the status of their claim; print standard attestations; view their available credits; and print copies of their SHI Reimbursement Advices. SHI Rules The Director-General approved proposals made at the fifth meeting of the Global Oversight Committee to amend the SHI Rules. The proposed changes were the result of a working group of the Global Standing Committee. Four main changes were proposed and will be implemented as of 1 January 2016: 1. New Format for the SHI Rules – with a simplified version and a separate set of rules for staff on temporary appointments of 60 days or less and paid on a daily basis; 2. Dental Services – extension of the unused credit from the prior two years to be available after exhaustion of the current year’s credit to the prior three years, making a maximum possible accumulation of US$ 6,000 over a four-year period; 3. Optical Services – extension of unused credit from the prior two years to be available after exhaustion of the current year’s credit to the prior three years, making a maximum possible accumulation of US$ 1,000 over a four-year period; 4. Direct Payments and Letters of Guarantee – currently Direct Payments and Letters of Guarantee to health care providers are for 80% for former staff and temporary staff on contracts of less than 3 months. As of entry into force of the revised SHI Rules, these may be made at 100%. The retiree/temporary staff member will pay their share (20%) directly to SHI rather than to the health care provider. This should facilitate greater access to treatment, and will simplify the understanding of the billing and reimbursement system for all concerned. SHI Newsletter The second SHI Newsletter was issued for 2015 in English, French and Spanish and distributed to all participants. As last year, it included an executive summary of the SHI report.

Briefings Regular monthly briefings were provided to new staff, as well as monthly video conferences with regional offices and their SHI teams and BFOs. The SharePoint created in 2014 for regional SHI teams and HQ was updated periodically. A pre-retirement briefing was provided to future retirees. There were several country visits to Africa, and visits to the regional offices of AFRO, EMRO, SEARO and AMRO/PAHO by the SHI team in HQ. Regional briefing packages were tested and will be implemented during the course of 2016 in all regions.

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Staffing Staffing remained relatively stable during 2015, other than the fact that the SHI Medical Adviser recruited in June 2014 retired in September and was replaced with a short term Medical Adviser, pending recruitment of a fixed term staff member. At the fifth meeting of the Global Oversight Committee in November 2015, permission was given for the SHI to recruit another fixed term general service staff member as well as to keep a staff on a short term contract. It was also agreed that a review should be made of regional SHI staffing to ensure efficiency and harmonization of work and that post descriptions should be similar globally. The SHI Secretariat will work more on this during the course of 2016. Claims processing time By the end of the year, claims processing turnaround time was 1 week in HQ, AFRO, and AMRO/PAHO. Virtually all regions are showing improvements every month, and they are meeting the processing target time of 15 days. No region is reporting a delay of more than 20 days, which is remarkable compared to the experience of previous years. More details can be found in Note 7.3.

New format for SHI cards and emergency number New cards were dispatched to participants from April 2015 and are valid for 5 years for former staff and their eligible family members. It is worth noting that these used to have to be renewed every year. The cards are also valid up to the end of contract (but no longer than 5 years) for staff members and their eligible family members. An external insurance company was contracted to manage the operations of the 24-hour/7 day-a-week call service in case of emergencies outside of office working hours. So far, there has been positive feedback and fortunately very few people have had to use the service. As at December 2015, there had been an average of 5 calls per month, and 5 calls during the whole of 2015 which could be classified as real emergencies. We will continue with this service and hope to expand the languages provided during the course of 2016.

Hospital Conventions Recognition of SHI by healthcare providers remains a challenge and is a top priority. Although SHI regularly signs new conventions, it is not practical to conclude them with health care providers in every country where there is a WHO/PAHO/UNAIDS presence by either staff or former staff. SHI is working with the WHO Heads of Country Offices to try improve the situation. Many more conventions were signed during the course of 2015, and it is hoped that even more will be signed in 2016.

Operational budget In 2015, the administrative expenses represented US$ 5.1 million and are split as per Table 5.

The SHI at Headquarters is part of the Insurance unit and comes under the responsibility of the Head SHI, who reports to the Coordinator, Insurance and Pension Services (IPS) and the Comptroller respectively.

in US$'000 2015 2014 %

Staff costs 4,675 4,184 12%

Travel 59 32 80%

Other operating costs (including actuarial valuation costs) 377 303 25%

TOTAL 5,111 4,519 13%

Table 5

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Figure 6 contains the staff positions which are funded from the SHI budget, and are reported in the Statement of Financial Performance.

Figure 6

There was a 12% increase in total staff costs reflecting salary costs of HQ and Regional staff processing claims. However, this was still within budget for the biennium (particularly due to a regional staff cost underspend in 2014).

Travel costs increased in 2015 for many good reasons. The Coordinator IPS and the Head SHI visited PAHO to discuss the administration of the SHI in the entire region, and more specifically, the possibility of using the same IT system for claims administration, the RFP for the third party administrator of claims in the USA and staffing, finance and general administrative matters. In addition the SHI Secretariat visited, EMRO, SEARO and several country offices in Africa in order to brief staff, work on harmonization of procedures and negotiate agreements/conventions with health care providers. The Coordinator IPS and SHI Finance Officer attended a meeting in Rome with other UN Organizations to discuss the ASHI.

Other operating costs have increased significantly in 2015, mainly due to the introduction of the emergency helpline service, and commencement of the approved HIIS upgrade. As before, both travel and other operating costs were contained within the biennium budget allocated. Further details are available in Note 4. The comparison of budget and actual expenses for the period ended 31 December 2015 is shown in both Statement V and Note 5.

Since 2005, SHI Rule 460.5 states that any administrative expenses are charged, up to a maximum of 6% of total premiums collected and other sources of income. From Table 6, it can be seen that the current administrative expenses fall well below this percentage, despite the additional staff costs. As stated before, these figures cover not only HQ but also Regional Office staff costs for claims processing.

Coordinator, P.05 (40%)

1.7 x SHI Clerk, G.04

Administrative Officer, P.04

Administrative Assistant, G.06

SHI IT Product Specialist P.03reporting to IT

SHI TSY Officer, P.02 (50%)reporting to TSY

Operational Supervision:

Medical Officer, P.04

Finance Officer, P.03

3.5 x SHI Assistant, G.05

8.1 x SHI Assistant, G.06

2007 2008 2009 2010 2011 2012 2013 2014 2015

Total Income (in US$'000) 89,702 50,132 145,741 121,708 107,677 150,006 143,906 131,524 113,004

Administrative expenses (in US$'000) 1,593 1,838 1,938 2,532 3,415 3,989 4,271 4,519 5,111

Adm. Exp. / Income (in % ) 1.8% 3.7% 1.3% 2.1% 3.2% 2.7% 3.0% 3.4% 4.5%

Limit put in place in 2005 as per para 460.5 (in %) 6% 6% 6% 6% 6% 6% 6% 6% 6%

Table 6

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Risks and Challenges

Every Health Insurance scheme has its risks and challenges, the WHO SHI is no different. The SHI Secretariat is working on solutions to mitigate the main risks and challenges to the scheme, as highlighted in Table 7.

Challenge Risk On-going solutionsNew SHI cards were made available during 2015 which contain an emergency number (available 24/7 in 3 languages).Engagement with health care providers to have agreements/conventions commenced in 2014. 2015 saw several missions to countries to establish more conventions. SHI hopes to establish even more during 2016 and continues to work with the country representatives on this matter.New SHI rules have been issued which aim to be clearer to understand.Pamphlets summarizing benefits have been updated.The SHI Intranet site is regularly updated.The Extranet site for former staff is regularly updated.Information Notes are sent out to participants when needed.The annual SHI Newsletter is issued to participants.A new Internet site is planned to be available in 2016 for all participants, and be more user-friendly.Regular briefings, country visits, regional office visits, briefing packages (videos) and sharepoint sites have been created for use by the regions.

IT systems

The IT system needs to be robust andsustainable and able to protect allinformation, particularly due to itsconfidential nature. An IT system that is notfit for purpose poses one of the greatest riskto the SHI. Incorrect financial reporting, lossof data and breach of confidentiality wouldbe catastrophic and would mean the end ofthe SHI being internally managed.

The GOC recommended to the Director-General an upgrade to the HIIS which was done during the course of 2015. In addition the GOC recommended the addition of an on-line claims processing system with a self-service portal. The former was piloted in 2015 with great success and is now being migrated to a more stable system with the self-service portal being developed in parallel in the new system. Both should be available to all participants by the end of 2016 and should provide a sustainable platform for the SHI for several years.The SHI Secretariat is visiting all regional offices with an aim to harmonize processes. Briefing packages are being prepared, a sharepoint site has been createdMonthly video-conferences with the regional offices are held to discuss issues.A global SHI briefing/workshop will be held in HQ during 2016 for all SHI staff globally.Work will be undertaken to ensure that there is harmonization in job descriptions, standard office procedures and recruitment.

Table 7

Lack of information on how SHI works can lead to many problems (i.e. the participant embarking on expensive treatment that is not reimbursable; submitting claims out of date; and not being reimbursed etc).

Access to information

Inconsistencies of processes leads to confusion, lack of trust and inefficiencies.Harmonization of processes

This is one of the biggest challenges facing the SHI today. It is a global plan, active in over 180 countries. The risk of a participant not having access to treatment could have serious implications for their health.

Access to treatment

15

On behalf of the GOC, I am very pleased with the progress made to improve the service level, communication, and sustainability of the SHI Fund.

The GOC will continue to monitor the performance and the long term financing of SHI very closely, and will make any recommendation to the Director-General, as appropriate.

Dr Hans Troedsson

Assistant Director-General - GMG Geneva, 1 April 2016

Challenge Risk On-going solutionsThe SHI Secretariat has a staff member who spends 50% of his time auditing and controll ing claims. Rigorous controls and checks are made at every stage of claims processing.The claims team are given regular briefings and trainings on fraud control.Visits to regional offices are made to audit SHI claims.The SHI HIIS has built-in controls, and it is expected that the new IT systems will have even better controls.

Overuse of benefitsFrom a cost containment perspective, the financial risk of overuse of benefits must also be considered.

Indicators for overuse of benefits are being explored by the SHI Secretariat, in order to control this risk.A dedicated Finance Officer and Finance Assistant are in place to ensure that the SHI accounts are in compliance with International Public Sector Accounting Standards (IPSAS).Regular actuarial reviews are made, as well as both internal and external financial audits.

Service level

Failure to reimburse participants in a timelymanner leads to frustration, unhappiness andcan lead to financial hardship. This isparticularly important when reimbursingclaims for former staff, who normally live ona reduced income.

The SHI Secretariat has strived to reimburse all participants within 15 days. For the most part, this has been achieved.

The financial risk of fraud cannot be under-estimated, and all SHI staff must remain vigilant.

Detection of fraud

Inproper financial controls and planning will most definitely lead to the demise of the SHI Fund.

Financing

Table 7 continued

16

Certification of the Financial Statements for the year ended December 2015

The accounts for the SHI have been established and maintained in accordance with International Public Sector Accounting Standards. The financial statements for the year ended 31 December 2015, together with the notes to the statements and supporting schedules, have been reviewed and approved. Nicholas R Jeffreys Claude Hennetier Rossier Comptroller Coordinator, Insurance and Pension Services 1 April 2016

17

Letter of Transmittal

18

Opinion of the External Auditor

20

Statement I: Statement of Financial Position As at 31 December 2015

(In thousands of United States dollars)

Notes 31 December 201531 December

2014

ASSETSCurrent assets

Cash and cash equiv alents 3.1 62,015 A1 18,663 Short-term inv estments 3.2 20,535 A2 24,111 Accounts receiv able - current 3.3 12,517 A3 3,321 Receiv able from participants 3.4 175 A6 296 Inter-entity receiv able 3.5 60,342 A5 29,093

Total current assets 155,584 75,484

Non-current assetsAccounts receiv able - non-current 3.6 1,308,275 A9 1,241,178 Long-term inv estments 3.2 632,812 665,978

Total non-current assets 1,941,087 1,907,156

TOTAL ASSETS 2,096,671 1,982,640

LIABILITIESCurrent liabilities

Financial liabilities 3.2 54,358 L1 33,679 Other current liabilities 3.7 396 L6 717 Deferred rev enue 3.8 35 L6 88 Prov ision for outstanding claims 3.9 29,931 L12 30,097

Total current liabilities 84,720 64,580

Non-current liabilitiesLong-term liabilities 3.10 2,011,952 L11 1,918,060

Total non-current liabilities 2,011,952 1,918,060 TOTAL LIABILITIES 2,096,671 1,982,640

NET ASSETS - -

NET ASSETS/EQUITYNet assets/reserves

Reserv es - N1 - TOTAL NET ASSETS/EQUITY - - TOTAL LIABILITIES AND NET ASSETS/EQUITY 2,096,671 1,982,640

21

Statement II: Statement of Financial Performance For the year ended 31 December 2015


Notes 2015 2014

REVENUEContributions collected 4.1 120,530 118,831

TOTAL REVENUE 120,530 118,831

EXPENSEClaims paid 4.1 83,187 80,107 Amounts w ritten-off 4.2 427 (42) Staff costs 4.3 4,675 4,184 Trav el 4.4 59 32 Other operating costs 4.5 377 303

TOTAL EXPENSE 88,724 84,584

Finance rev enue/(ex pense) 4.6 (14,917) 12,966 Amounts booked to participating entities 4.7 16,888 47,213

NET SURPLUS/(DEFICIT) FOR THE YEAR - -

22

Statement III: Statement of Changes in Net Assets/Equity For the year ended 31 December 2015


There is no reported change in net assets/equity, due to the policy of booking any surplus back to the participating entities to reduce their unfunded liabilities. This policy will continue whilst there is an overall unfunded liability for the SHI.

23

Statement IV: Statement of Cash Flow For the year ended 31 December 2015


2015 2014

CASH FLOWS FROM OPERATING ACTIVITIES Surplus or deficit - - Non-cash movements

(Increase)/decrease in accounts receiv able - current (9,196) (996) (Increase)/decrease in receiv able from participants 120 247 (Increase)/decrease in accounts receiv able - non-current (67,097) (282,531)

Increase/(decrease) in prov ision for outstanding claims (166) 6,658

Increase/(decrease) in other current liabilities (321) (237)

Increase/(decrease) in deferred rev enue (53) (31) (Increase)/decrease in Inter-entity receiv able (31,248) 8,066 Increase/(decrease) in long-term liabilities 93,891 323,085

Net cash flows from operating activities (14,069) 54,263

CASH FLOWS FROM INVESTING ACTIVITIES (Increase)/decrease in short-term inv estments 3,576 (12,386) (Increase)/decrease in long-term inv estments 33,166 (46,575) Increase/(decrease) in financial liabilities 20,679 12,108

Net cash flows from investing activities 57,421 (46,852)

Net increase/(decrease) in cash and cash equivalents 43,352 7,410

Cash and cash equivalents at beginning of year 18,663 11,252

Cash and cash equivalents at end of year 62,015 18,663

Statement V: Comparison of Budget and Actual Amounts For the year ended 31 December 2015


EXPENSESOriginal

Biennium Budget

ChangeFinal

Biennium Budget

2014 Expense

2015 Expense

Biennium Expense

Balance NotesPercentage

Implementation

Staff costs 9,528 (3) 9,526 4,184 4,675 8,859 667 5.1 93%Trav el 115 - 115 32 59 91 24 5.2 79%Other operating costs 610 285 895 303 377 680 215 5.3 76%Total budgeted ex penditure 10,253 282 10,536 4,519 5,111 9,629 906 91%Claims paid - - - 80,107 83,187 163,294 - 5.4 -Amounts w ritten-off - - - (42) 427 385 - 5.5 -Total non-budgeted ex penditure - - - 80,065 83,614 163,679 - -Total 10,253 282 10,536 84,584 88,724 173,309 906 -

24

25

1 Basis of preparation and presentation The Financial Statements of the SHI have been prepared on the accrual basis of accounting in accordance with International Public Sector Accounting Standards. Where International Public Sector Accounting Standards do not address a particular issue, the appropriate International Financial Reporting Standard (IFRS) has been applied.

These Financial Statements were prepared under the assumption that the SHI is a going concern and will continue in operation and will meet its mandate for the foreseeable future (International Public Sector Accounting Standards 1).

These financial statements are presented in United States dollars and all values are rounded to the nearest thousands ($’000).

Functional currency and translation of foreign currencies The functional and reporting currency of the SHI is the US$. Foreign currency transactions are translated into US$ at the prevailing United Nations Operational Rates of Exchange (UNORE). The UNORE are set once a month, and revised mid-month if there are significant exchange rate fluctuations relating to individual currencies. Assets and liabilities in currencies other than US$ are translated into US$ at the prevailing UNORE month-end closing rate. Resulting gains or losses are accounted for in the Statement of Financial Performance. The non US$ denominated assets and liabilities in the investment portfolios are translated into US$ at the month-end closing rate used by the custodian.

Materiality and the use of judgments and estimates Materiality 1 is central to SHI’s financial statements. The SHI process for reviewing accounting materiality provides a systematic approach to the identification, analysis, evaluation, endorsement and periodic review of decisions taken involving the materiality of information, spanning a number of accounting areas. The financial statements include amounts based on judgments, estimates and assumptions by management. Changes in estimates are reflected in the period in which they become known.

Financial Statements2

In accordance with International Public Sector Accounting Standards 1, a complete set of financial statements has been prepared as follows:

• Statement of Financial Position• Statement of Financial Performance• Statement of Changes in Net Assets• Statement of Cash Flow• Comparison of budget and actual amounts• Notes, comprising a summary of significant accounting policies and other relevant information.

1 Omissions or misstatements of items are material if they could, individually or collectively, influence the decisions or assessments of users made on the basis of the financial statements. 2 The financial statements are rounded to the thousands of US dollars. Comparative figures have been adjusted, as a result rounding differences may occur.

26

2 Significant accounting policies SHI applies the World Health Organization accounting rules and has adopted the International Public Sector Accounting Standards since January 2012.

A financial accounting valuation of the WHO After Service Health Insurance plan is performed annually in application of International Public Sector Accounting Standards 25.

Cash and Cash Equivalents 2.1

Cash and cash equivalents are held at nominal value and comprise cash at banks, collateral deposits, commercial papers, money market funds and short-term bills and notes. All investments that have a maturity of three months or less from the date of acquisition are included as cash and cash equivalents. This includes cash and cash equivalents held in the portfolios managed by external investment managers.

Financial instruments 2.2

Financial assets or financial liabilities at fair value through surplus or deficit are financial instruments that meet either of the following conditions: 1) they are held for trading; or 2) they are designated by the entity upon initial recognition as at fair value through surplus or deficit. Financial instruments in this category are measured at fair value and any gains and losses arising from changes in the fair value are accounted for through surplus or deficit and included within the Statement of Financial Performance in the period in which they arise. All derivative instruments, such as interest rate swaps, currency forward contracts, futures or options are classified as held for trading.

Bank Deposits and other receivables are non-derivative financial assets with fixed or determinable payments that are not quoted in an active market. Accrued income related to interest, dividends and pending cash to receive from investments are included here. Bank deposits and other receivables are stated at amortized cost calculated using the effective interest rate method, less any impairment. Interest income is recognized on the effective interest rate basis, other than for short-term receivables where the recognition of interest would be immaterial.

Other financial liabilities include accrued expenses and payables relating to investments and are recognized initially at fair valued, and subsequently measured at amortized cost using the effective interest method other than for short-term liabilities where the recognition of interest would be immaterial.

The Financial instruments are allocated between current and non-current. This is based on the investment time horizons of each of the investments and is shown in the Statement of Financial Position. All of the financial instruments in the investment portfolios other than those classified in the categories detailed above are classified as non-current due to the long-term investment horizon of the portfolios.

27

Accounts Receivable 2.3Accounts receivable are recorded at their net estimated realizable value. Accounts receivable is classified as non-current if receivable is due after one year from the reporting date.

Any write-off of SHI receivables will be in accordance with World Health Organization accounting rules, and will be properly escalated to the appropriate Management level.

Accrued Liabilities 2.4Accrued liabilities are financial liabilities in respect of goods or services that have been received by the SHI during the reporting period and which have not yet been invoiced.

Provisions and Contingent Liabilities 2.5Provisions are recognized for future liabilities and charges where the SHI has a present legal or constructive obligation as a result of past events and it is probable that the SHI will be required to settle the obligation.

Other commitments, which do not meet the recognition criteria for liabilities, are disclosed in the notes to the financial statements as contingent liabilities when their existence will be confirmed only by the occurrence or non-occurrence of one or more uncertain future events which are not wholly within the control of the SHI.

Revenue 2.6The main sources of revenue for the SHI include but are not limited to: Non-exchange revenue • Contributions. Revenue is from contributions collected from both active and retired staff. Where payment terms are in the current accounting year, revenue is recognized in the current period. Where payment terms specify payment after the year end (as in the case of both Leave Without Pay and Extension periods concluding after the year end), the amount is reported as deferred revenue. • Finance revenues. Revenue is from both income on externally managed investments, and interest on cash and cash equivalents. Where SHI does not control the resource, the revenue and amount receivable is not recorded until the cash is received.

Expenses 2.7Expenses are decreases in economic benefits or service potential during the reporting period in the form of outflows or consumption of assets or incurrences of liabilities that result in decreases in net assets/equity. Expenses are recognized when claims are due (delivery principle) and not when cash or its equivalent is paid.

28

Short-Term Benefits 2.8Short-Term Benefits are benefits paid in the current period or less than 12 months thereafter for service rendered in the current period. They include salaries, bonuses and leave expected to be paid within 12 months after the end of the related service period, and many other benefits.

In accounting for Short-Term Benefits:

- no actuarial valuation is needed; and - an entity recognizes the undiscounted cost of benefits as they are earned.

The portion of the SHI covering active staff is a short-term benefit for which SHI should record an annual expense equal to the cost of medical benefits for active staff and their dependents, reduced by all contributions made by active staff.

Post-employment Benefits 2.9Post-employment Benefits are benefits paid after separation for service rendered, such as pensions, post-employment health care, and post-employment life insurance.

In accounting for Post-employment Benefits:

- an actuarial valuation is generally needed to determine a discounted liability; - an entity accrues a liability and an expense as employees render service; - actuarial gains and losses (unexpected changes in liabilities) may be amortized using the corridor

method or recognized immediately in the Statement of Financial Position. Under the corridor method, accumulated gains and losses up to a corridor of 10% of the greater of the market value of assets or the liability are not amortized. Amounts outside of this corridor are amortized over a period no longer than the average remaining service period of active employees expected to receive benefits under the plan.

The portion of the SHI covering retired staff is a defined benefit, post-employment benefit subject to all requirements for defined benefit plans contained in International Public Sector Accounting Standards 25, “Employee Benefits”.

Statement of Cash Flow 2.10The Statement of Cash Flow (Statement IV) is prepared using the indirect method.

Budget comparison 2.11SHI’s budget and accounting bases differ. Budgets within the SHI are approved on a modified cash basis rather than the full accrual basis of International Public Sector Accounting Standards. In addition, budgets are prepared on a biennial basis.

Amounts booked to participating entities 2.12Any surplus is booked back to the participating entities to reduce their unfunded liabilities. This policy will continue whilst there is an overall unfunded liability for the SHI.

29

3 Supporting information to the statement of financial position

Cash and cash equivalents 3.1Cash and cash equivalents are held by investment portfolios on behalf of the SHI. They include cash and other financial assets of which the acquisition date is less than three months of the maturity. A, B and C are different Fund managers.

Investments & financial instruments 3.2The overall investment portfolio for SHI is periodically reviewed by the World Health Organization Advisory Investment Committee to ensure that the level of returns, as well as the level of investment risk, is appropriate for the Fund. The long-term funds are managed by external fund managers who invest primarily in government and corporate bonds, and in equities. The fixed income portfolio of investments is hedged 50% US$, 30% CHF, 20% EUR to match the currencies of the Fund’s liabilities. During 2015, two actively managed portfolios were reorganized as a result of the Request for Proposal for the fixed income portfolios. Three managers (A, B, and C) were selected (which include one existing manager) and at the start of the new mandates at the end of September 2015, the portfolio size was rearranged to have an equal amount (around US$ 150.0 million) for each of the three portfolios. No allocation change was made to the equity portfolios, nor to the passively managed global bond fund.

In US$'000Long term

fixed income portfolio A

Long term fixed income portfolio B

Long term fixed income portfolio C

Long term global bond index fund

Equity portfolio

Externally managed

Staff Health Insurance portfolios

CASH AND CASH EQUIVALENTS 12,830 37,287 11,898 0 0 62,015

In US$'000Long term





Equity portfolio

Externally managed


INVESTMENTS UNDER CURRENT ASSETSCash and cash equiv alents 12,830 37,287 11,898 0 0 62,015 Short-term inv estments

Financial assets at fair v alue through surplus or deficit -- held for trading 4,490 307 620 - - 5,417 Bank deposits & receiv ables 8,538 1,109 5,471 - - 15,117

Total inv estments under current assets 25,858 38,702 17,989 0 0 82,550

INVESTMENTS UNDER NON-CURRENT ASSETSLong-term inv estments

Financial assets at fair v alue through surplus or deficit -- upon initial recognition 153,302 111,289 152,561 38,405 177,255 632,812 Total inv estments under non-current assets 153,302 111,289 152,561 38,405 177,255 632,812

FINANCIAL LIABILITIES UNDER CURRENT LIABILITIESFinancial liabilities

Financial liabilities at fair v alue through surplus or deficit for trading (3,631) (853) (714) - - (5,198) Pay ables and accruals (26,595) (1,089) (21,476) - - (49,160)

Total financial liabilities under current liabilities (30,226) (1,942) (22,189) - - (54,358) TOTAL INVESTMENTS - NET 148,934 148,049 148,361 38,405 177,255 661,004

30

Short-term investments

Short-term investments are held by investment portfolios on behalf of the SHI. These include financial assets at fair value through surplus or deficit held for trading, and bank deposits & receivables. “Financial assets at fair value through surplus and deficit” include fixed income securities and derivatives instruments held to cover projected liabilities and any unexpected cash requirements. Receivables include accrued income on investments and receivables from trade sales to settle.

Long-term investments

Long-term SHI investments are placed in accordance with the approved World Health Organization Investment Policy, and are invested in high-quality, medium-dated and long-dated, government, agency and corporate bonds, and global equities. As the investment horizon and objective of the externally managed portfolios are more than one year, the financial assets at fair value through surplus or deficit upon initial recognition in the portfolios are classified as long-term investments.

Financial liabilities

Financial liabilities disclosed under “Financial liabilities at fair value through surplus or deficit for trading” include derivative transactions such as foreign exchange forward contracts and interest rate swaps. Financial liabilities disclosed under “Payables and accruals” relate to other financial liabilities from investments including the trade purchases made before 31 December 2015 and settled after that date. Financial liabilities at the end of 2015 were higher than at the end of 2014 due to an increase in pending trades at the end of 2015.

In US$'000Long term





Equity portfolio

Externally managed


SHORT-TERM INVESTMENTS

Financial assets at fair v alue through surplus or deficit -- held for trading 4,490 307 620 - - 5,417

Bank deposits & receiv ables 8,538 1,109 5,471 - - 15,117

Total 13,028 1,416 6,091 - - 20,535

In US$'000Long term





Equity portfolio

Externally managed


LONG-TERM INVESTMENTS

Financial assets at fair v alue through surplus or deficit -- upon initial recognition 153,302 111,289 152,561 38,405 177,255 632,812

In US$'000Long term





Equity portfolio

Externally managed


FINANCIAL LIABILITIES

Financial liabilities at fair v alue through surplus or deficit for trading 3,631 853 714 - - 5,198

Pay ables and accruals 26,595 1,089 21,476 - - 49,160

Total 30,226 1,942 22,189 - - 54,358

31

Fair Value Hierarchy

The fair value hierarchy is the categorization of market pricing indicating the ease of realizing the value of investments held as shown below.

Most of the financial instruments held have quoted prices (unadjusted) in active markets and are classified as Level 1 valuations. Derivative instruments that are “over the counter” are classified as Level 2 because their fair value is observable either directly (i.e., as a price) or indirectly (i.e., derived from prices). The instruments shown under the Level 2 fair value measurement category consist of the derivative contracts in the externally managed portfolios. There were no instruments held at 31 December 2015 which would be classified as Level 3 valuation, for which the fair value is not based on observable market data.

Risk Management

The SHI investments are exposed to financial risks including credit risk, interest rate risk, foreign exchange risk and investment price risk. In accordance with the Financial Regulations, funds not required for immediate use may be invested. All investments are carried out within the framework of investment policies approved by the Director General. All portfolios are managed by external managers who manage funds in accordance with a defined mandate. The Advisory Investment Committee reviews regularly the investment policies, and the investment performance and risk for each investment portfolio. This Committee is comprised of external investment specialists and can make recommendations to the Director General.

Nature of financial instruments

Investments are categorised as follows:

- Long-term fixed income – comprising funds managed by external investment managers as defined in the approved Investment Policy – these are invested in high-quality medium-dated and long-dated, government, agency, and corporate bonds.

- Equities – Comprising either funds or pooled funds invested in global equities managed by external investment managers as defined in the approved Investment Policy.

Level 1 Level 2 Level 3 Total

Cash and cash equiv alents 11,472 - - 11,472

Short-term inv estmentsFinancial assets at fair v alue through surplus or deficit -- held for trading - 4,688 - 4,688

Long-term Inv estmentsFinancial assets at fair v alue through surplus or deficit -- upon initial recognition 632,812 - - 632,812

Financial LiabilitiesFinancial liabilities at fair v alue through surplus or deficit for trading - (5,178) - (5,178)

Total 644,284 (490) - 643,795

32

Credit Risk

The SHI investments are widely diversified to limit credit risk to any individual investment counterparty. Investments are placed with a wide range of counterparties using minimum credit quality limits and maximum exposure limits by counterparty (and by groups of related counterparties) established in investment mandates. These limits are applied both to the portfolios managed internally by the World Health Organization Treasury unit, and also to the portfolios managed by external investment managers. The Treasury unit monitors the total exposure to counterparties across all internally and externally managed portfolios to ensure that total counterparty exposures across portfolios are tracked and managed.

The credit risk and liquidity risk for cash and cash equivalents are minimized by investing only in major financial institutions which have strong investment grade credit ratings from primary credit rating agencies. The Treasury unit regularly reviews the credit ratings of the approved financial counterparties and takes prompt action in the event of any credit rating downgrade. The credit risk of the investments under externally managed portfolios are monitored by the managers and they are summarised as follows.

Due to the new investment guidelines of one of the two new managers, the following table shows the average credit rating of the top two ratings instead of the minimum credit rating. There are no past due nor impaired financial assets pertaining to SHI investments.

Average rating of the top 2 ratings Asset value

AAA 149,487

AA+ 29,255

AA 20,049

AA- 23,767

A+ 22,258

A 78,891

A- 27,705

BBB+ 34,525

BBB 33,566

BBB- 7,904

Total 427,406

Not rated 230,449

Grand total 657,856

33

Interest rate risk

The SHI fixed income investments are exposed to interest rate risk. Investment duration is a measure of sensitivity to changes in market interest rates, and the effective average duration of the investments of the SHI at 31 December 2015 was 6.3 years for the long-term investments.

Fixed income derivative instruments may be used by external investment managers to manage interest rate risk under strict investment guidelines. These interest rate instruments are used for portfolio duration management and for strategic interest rate positioning.

The interest rate swaps held in the SHI portfolios as at 31 December 2015 are summarised below.

Currency Local currency '000 US$'000 equivalent Pay/Receive Maturity

AUD 400 291 Pay Fix ed / Receiv e Float Jun 2026

EUR 3,000 3,259 Pay Fix ed / Receiv e Float Sep 2039

EUR 4,200 4,562 Pay Fix ed / Receiv e Float Mar 2026

EUR 4,000 4,345 Pay Float / Receiv e Fix ed Mar 2021

JPY 150,000 1,247 Pay Fix ed / Receiv e Float Dec 2025

JPY 2,970,000 24,689 Pay Float / Receiv e Fix ed Mar 2018

JPY 350,000 2,910 Pay Float / Receiv e Fix ed Jun 2035

MXN 13,400 776 Pay Float / Receiv e Fix ed Jul 2021

MXN 59,500 3,445 Pay Float / Receiv e Fix ed Oct 2019

MXN 19,900 1,152 Pay Float / Receiv e Fix ed Sep 2017

MXN 9,700 562 Pay Float / Receiv e Fix ed Jul 2022

MXN 92,400 5,351 Pay Float / Receiv e Fix ed Oct 2017

GBP 1,850 2,727 Pay Fix ed / Receiv e Float Mar 2026

GBP 400 590 Pay Fix ed / Receiv e Float Mar 2040

GBP 7,900 11,644 Pay Fix ed / Receiv e Float Mar 2018

GBP 3,700 5,453 Pay Fix ed / Receiv e Float Sep 2018

GBP 1,200 1,769 Pay Float / Receiv e Fix ed Mar 2021

USD 12,400 12,400 Pay Fix ed / Receiv e Float Jun 2026

USD 23,800 23,800 Pay Fix ed / Receiv e Float Dec 2017

USD 40,100 40,100 Pay Fix ed / Receiv e Float Dec 2022

USD 5,150 5,150 Pay Fix ed / Receiv e Float Aug 2022

USD 3,900 3,900 Pay Fix ed / Receiv e Float Jan 2023

USD 2,150 2,150 Pay Fix ed / Receiv e Float May 2017

USD 8,500 8,500 Pay Fix ed / Receiv e Float Jun 2017

BRL 4,210 1,064 Pay Float / Receiv e Fix ed Jan 2016

SEK 4,900 771 Pay Float / Receiv e Fix ed Jan 2025

34

Forward foreign exchange contracts and other derivative financial instruments held within the externally managed investment portfolios

In accordance with the investment guidelines set up for each externally managed portfolio, the external investment managers use forward foreign exchange contracts, futures contracts and interest rate swap contracts to manage the currency and interest rate risk of groups of securities within each portfolio.

The forward foreign exchange contracts within the externally managed investment portfolios are summarised below.

A 1% appreciation (or a 1% depreciation) in the relative value of the U.S. Dollar against the above forward foreign exchange contracts would result in an increase (or decrease) in the unrealized loss on these contracts by less than US$ 0.1 million.

Futures contracts

The futures contracts held within the externally managed portfolios are summarised below.

Local currency '000 US$'000 equivalent Local currency '000 US$'000 equivalent

AUD 13,399 9,731 CHF 132,943 132,985

BRL 1,412 353 EUR 1,985 2,165

CAD 14,438 10,394 INR 1,206 18

CZK 35,523 1,459

DKK 69,878 10,256

GBP 17,842 26,299

JPY 6,832,767 56,846

MXN 73,783 4,260

MYR 2,605 606

NOK 2,820 318

NZD 523 357

PLN 18,650 4,718

SGD 1,200 845

TWD 21,815 661

ZAR 11,814 760

Total 127,863 Total 135,168

Net sold amounts Net purchased amounts

Long position

Products Exchange No. of contracts

Australian 10 y r Gov ernment Bond Futures MAR 2016 ASX 13

Euro 5 y ear German Gov ernment Note (BOBL) Futures MAR 2016 EUREX 59

Euro French Gov ernment Bond (OAT) Futures MAR 2016 EUREX 18

Euro 30 y ear German Gov ernment Bond (BUXL) Futures MAR 2016 EUREX 8

Spanish 10 y r Gov ernment Bond (BONO) Futures MAR 2016 EUREX 3

Liffe Long Gilt Futures MAR 2016 LIFFE 8

US 5 y ear T-Note Futures MAR 2016 CBOT 110

US 10 y ear T-Note Futures MAR 2016 CBOT 244

Ultra US Treasury Bond Futures MAR 2016 CBOT 5

35

There are no options on futures contracts held within the externally managed portfolios.

Accounts receivable – current 3.3Total current accounts receivable amounted to US$ 12,517 thousand as at 31 December 2015. These include part of the entity share of the unfunded long-term liability for future healthcare costs, as determined by Aon Hewitt Corporation, professional actuaries.

Short position

Products Exchange No. of contracts

3 month Eurodollar Futures JUN 2016 IMM 5

3 month Eurodollar Futures SEP 2016 IMM 7

3 month Eurodollar Futures DEC 2016 IMM 5

3 month Eurodollar Futures MAR 2017 IMM 4

Euro 2 y ear German Gov ernment Note (Schatz) Futures MAR 2016 EUREX 76

Euro 5 y ear German Gov ernment Note (BOBL) Futures MAR 2016 EUREX 20

Euro 10y ear BUND MAR 2016 EUREX 76

Euro 10 y r Italian Gov ernment Bond (BTP) Futures MAR 2016 EUREX 10

Euro 30 y ear German Gov ernment Bond (BUXL) Futures MAR 2016 EUREX 1

US 30 y ear T-Bond Futures MAR 2016 CBOT 2

Note 1 : ASX refers to Australian Securities Ex change. IMM refers to the International Monetary

Market and CBOT refers to Chicago Board of Trade. IMM and CBOT are part of Chicago Mercantile

Ex change Group. EUREX refers to the Eurex Ex change.

Note 2: Some products are show n on both long and short positions because they are held

in tw o different ex ternally managed portfolios.

In US$'000 31 December 2015 31 December 2014ACCOUNTS RECEIVABLE - CURRENT

Unfunded SHI long-term liability duePan American Health Organization (PAHO) 9,740 -

Retirees (Organization Share) Staff Health Insurance contributions duePan American Health Organization (PAHO) 2,602 2,378

Retirees (Retiree Share) Staff Health Insurance contributions dueUnited Nations Joint Staff Pension Fund (UNJSPF) 117 -

2nd Tier contribution to cover Prior Year Regional DeficitInternational Computing Centre (ICC) - 818

Contribution to cover administrative expensesInternational Computing Centre (ICC) 58 52

General Operating Costs paid in advance - Regions - 70 Excess manual Staff Health Insurance claims recoverable from staff - 3 Total 12,517 3,321

36

Receivable from participants 3.4The total balance of receivables amounted to US$ 175 thousand at 31 December 2015, and is related to 20% of medical expenses to be recovered from participants following direct payments.

For active staff members and their participating family members, direct payment may be made to a health care provider for the full amount of an individual medical bill, where the full amount of the medical bill equals at least 15% of a staff member's net monthly salary (plus post adjustment for staff in the P&D categories). The staff member’s share of expenses (normally 20% + non-reimbursable expenses) is recovered from the next month salary/3 months’ salaries.

Inter-entity receivable 3.5This a net receivable to the SHI from the World Health Organization. The inter-entity receivable increased in 2015 because SHI funds previously held in externally managed fixed income portfolios and bank deposits were mainly invested in co-mingled WHO short-term investments.

Accounts receivable – non-current 3.6

Total non-current accounts receivable amounted to US$ 1,308,275 thousand as at 31 December 2015, representing the majority of the entity share of the unfunded long-term liability for future healthcare costs, as determined by Aon Hewitt Corporation, professional actuaries.

In US$'000 31 December 2015 31 December 2014

RECEIVABLES FROM PARTICIPANTSWorld Health Organization (WHO) 148 270 African Programme for Onchocerciasis Control (APOC) - 0 International Agency for Research on Cancer (IARC) - - International Computing Centre (ICC) 2 4 International Drug Purchase Facility (UNITAID) - 2 Trust Fund for the Joint United Nations Programme on HIV/AIDS (UNAIDS) 25 20

Total 175 296


ACCOUNTS RECEIVABLE - NON-CURRENTWorld Health Organization (WHO) 914,054 866,127 African Programme for Onchocerciasis Control (APOC) 8,051 10,606 International Agency for Research on Cancer (IARC) 37,663 34,894 International Computing Centre (ICC) 24,428 18,946 International Drug Purchase Facility (UNITAID) 3,150 2,358 Pan American Health Organization (PAHO) 265,539 260,106 Trust Fund for the Joint United Nations Programme on HIV/AIDS (UNAIDS) 55,390 48,142

Total 1,308,275 1,241,178

37

Unrecognized losses (for US$ 199,250 thousand) have been reflected under the application of the corridor method of accounting (as permitted under International Public Sector Accounting Standards), which smoothens the impact of short-term changes in actuarial assumptions on the corresponding unfunded After Service Health Insurance liability.

Following the closure of the African Programme for Onchocerciasis Control (APOC) as of 31 December 2015, the APOC share of the unfunded liability will transfer to the World Health Organization (Regional Office for Africa) in 2016.

Other current liabilities 3.7Total balance for other current liabilities as at 31 December 2015 is US$ 396 thousand. These amounts relate to various short-term liabilities as detailed below.

Deferred revenue 3.8Unrealized contributions (related to both Extensions and Leave Without Pay) worth US$ 35 thousand were received in 2015.

Provision for outstanding claims 3.9As at 31 December 2015, an amount of US$ 29,931 thousand has been estimated by Aon Hewitt Corporation, professional actuaries, for settlement of four months of combined in-service and after-service claims and administrative expenses for the SHI.


OTHER CURRENT LIABILITIESVoided claim pay ments (pending repay ment) 61 39 Inv estment Management Fees 274 379 General Operating Costs - Regions 60 300

Total 396 717


PROVISION FOR OUTSTANDING CLAIMSWorld Health Organization (WHO) 20,850 20,846 African Programme for Onchocerciasis Control (APOC) 44 278 International Agency for Research on Cancer (IARC) 340 905 International Computing Centre (ICC) 710 309 International Drug Purchase Facility (UNITAID) 97 52 Pan American Health Organization (PAHO) 5,885 6,471 Trust Fund for the Joint United Nations Programme on HIV/AIDS (UNAIDS) 2,005 1,237

Total 29,931 30,097

38

Long-term liabilities 3.10The Defined Benefit Obligations as of 31 December 2015 were determined by Aon Hewitt Corporation, professional actuaries, based on personnel data and past payment experience provided by SHI. At 31 December 2015, the Defined Benefit Liabilities amounted to US$ 2,011,952 thousand for After Service Health Insurance.

Following the closure of the African Programme for Onchocerciasis Control (APOC) as of 31 December 2015, the APOC share of the liability will transfer to the World Health Organization (Regional Office for Africa) in 2016.

In 2013, the SHI Governance approved that a full actuarial study should only be undertaken every 3 years, with lighter studies in interim years. It must be noted that the actuarial valuation as of 31 December 2015 is a light study, whereby all assumptions have been updated with the exception of census data (which has been rolled forward from the 2014 study).

Below are the disclosures required for After Service Health Insurance as at 31 December 2015 under International Public Sector Accounting Standard 25.


LONG-TERM STAFF LIABILITIESWorld Health Organization (WHO) 1,522,580 1,461,668 African Programme for Onchocerciasis Control (APOC) 17,052 18,972 International Agency for Research on Cancer (IARC) 61,230 57,100 International Computing Centre (ICC) 31,132 26,063 International Drug Purchase Facility (UNITAID) 5,664 4,483 Pan American Health Organization (PAHO) 269,395 253,635 Trust Fund for the Joint United Nations Programme on HIV/AIDS (UNAIDS) 104,900 96,139

Total 2,011,952 1,918,060

US$'000

Reconciliation of Defined Benefit ObligationDefined Benefit Obligation at 31 December 2014 2,245,834

Serv ice Cost for 2015 105,310 Interest Cost for 2015 64,649 Actual After Serv ice Gross Benefit Pay ments in 2015 (44,807) Actual After Serv ice Non-Aetna Admin Ex penses in 2015 (2,626) Actual After Serv ice Aetna Admin Ex penses in 2015 (556) Actual Contributions by After Serv ice Participants in 2015 12,476 Plan Amendments - Changes in Accounting Methods - Actuarial (Gain)/Loss (169,079) Unrecognized Gain/(Loss) (202,841) Unrecognized Prior Serv ice (Credit)/Cost 3,592

Defined Benefit Obligation at 31 December 2015 2,011,952

39

US$'000

Reconciliation of Assets

Assets at 31 December 2014, Net of 470.1 Reserv e 676,882 Actual Total SHI Gross Benefit Pay ments for 2015 (84,682) Actual Total SHI Non-Aetna Administrativ e Ex penses for 2015 (5,111) Actual Total SHI Aetna Administrativ e Ex penses for 2015 (922) Actual Total SHI Participant Contributions during 2015 42,500 Actual Total SHI Non-Aetna Organization Contributions during 2015 83,963 Actual Aetna Ex penses (Directly Paid by PAHO) during 2015 922 Net HQ Transfer to/from AMRO/PAHO for 2015 - (Increase)/Decrease in 470.1 Reserv e during 2015 166 Ex pected Return on WHO-Administered SHI Assets for 2015 34,930 Gain/(Loss) on Plan Assets during 2015 (54,712)

Assets at 31 December 2015, Net of 470.1 Reserve 693,936

US$'000Reconciliation of Funded StatusDefined Benefit Obligation (DBO) ex cluding Unrecognized Gain/(Loss)

Inactiv e 947,719 Activ e 1,263,483

Total DBO ex cluding Unrecognized Gain/(Loss) 2,211,201

ASHI Plan AssetsGross SHI Plan Assets Administered by WHO (723,867) Offset for WHO 470.1 Reserv e 29,931

Net ASHI Plan Assets Administered by WHO (693,936)

(Surplus)/Deficit 1,517,265 (Reimbursement Right) - Unrecognized Gain/(Loss) (202,841) Unrecognized Prior Serv ice (Credit)/Cost 3,592

Net (Asset)/Liability Recognized in Statement of Financial Position 1,318,015 Current (Asset)/Liability 9,740 Noncurrent (Asset)/Liability 1,308,275

US$'000Annual Expense for Calendar Year 2015

Serv ice Cost 105,310 Interest Cost 64,649 Ex pected Return on Assets (36,413) Ex pected Return on Reimbursement Right - Amortization of (Gain)/Loss 14,783 Amortization of Prior Serv ice Cost (789) Ex pense before One-Time Ev ents 147,539 Curtailments - Settlements - Special Termination Benefits -

Total Expense Recognized in Statement of Financial Performance 147,539

40

The major assumptions and methods used in the last valuation are described below.

Discount Rate by Office Region of Staff Member - Europe - Non-UNAIDS 1.5% - Europe - UNAIDS 2.9% - Other Countries 4.8% - The Americas - AMRO 4.5% - The Americas - PAHO 4.5% Expected Rate of Return on Assets - WHO (Excluding PAHO) 4.8% - PAHO 3.2% Medical Cost Increases by Nationality Region of Staff Member - Europe - Initial Increase 3.6%

- Long-term Increase 2.9% - Year Long-term Increase Reached 2034

- Other Countries - Initial Increase 6.0% - Long-term Increase 4.8% - Year Long-term Increase Reached 2040

- The Americas - Initial Increase 5.0%/7.0% - Long-term Increase 4.5%/4.0% - Year Long-term Increase Reached 2040/2040

General Inflation by Office Region of Staff Member - Europe 1.4% - Other Countries 2.5% - The Americas 2.5%

US$'000Medical Sensitivity Analysis2015 Serv ice Cost plus Interest Cost

Current Medical Inflation Assumption Minus 1% 130,746 Current Medical Inflation Assumption 169,959 Current Medical Inflation Assumption Plus 1% 224,343

31 December 2015 Defined Benefit ObligationCurrent Medical Inflation Assumption Minus 1% 1,822,578 Current Medical Inflation Assumption 2,211,201 Current Medical Inflation Assumption Plus 1% 2,721,252

US$'000Funded Status and Actuarial (Gain)/Loss for Calendar Year 2015

Defined Benefit Obligation 2,211,201 (Net Plan Assets) (693,936) (Surplus)/Deficit 1,517,265 (Reimbursement Right for PAHO 470.1 Reserv e) -

(Gain)/Loss on Defined Benefit Obligation (169,079) (Gain)/Loss on WHO- and PAHO-Administered ASHI Assets 54,549

US$'000Expected Accounting Contributions during 2015

Contributions by /for Activ e Staff, Net of Claims/Admin Costs 50,281 Contributions by WHO/PAHO for Inactiv es 29,198 Net HQ Transfer to/from AMRO/PAHO -

Total 79,479

41

4 Supporting information to the statement of financial performance

Contributions collected & Claims paid 4.1The revenue of the SHI consists of a first tier of contributions received in respect of both active and retired staff (of which one third is paid by the participants and two-thirds by WHO).

A region, or any other office administered by WHO, shall be required to add a second tier of contributions to the SHI throughout the year following any calendar year in which the claims reimbursed to its active staff total more than 75% of the first tier contributions. The amount by which these claims exceed the 75% ceiling is defined as the regional deficit. It is this amount that must be recovered by the SHI through the second tier of contributions. Historically, this has been applicable to the Regional Office for the Americas, as can be seen in Note 7.7. The 2015 results include a prior year contribution recalculation adjustment worth US$ 400 thousand, with regards to a second tier contribution expected from the International Computing Centre (ICC) as a result of its 2013 regional deficit.

A decision was made in 2011 to ensure long-term sustainability and full funding of the SHI. In order to increase the funding level of the SHI liability, rates of contributions have been increased as from 2012. An increase of 4% per year (compounded rate) in the rates of contributions and lump sum rates is currently being applied. The situation is monitored closely on a yearly basis by the SHI Governance, and the rates will be reviewed and revised as and when necessary.

SHI’s main purpose is to provide for the reimbursement of a major portion of the expenses for medically recognized health care incurred by staff and other participants to the SHI. SHI therefore recognizes expenses related to the reimbursements of claims submitted by its participants (both active and retired staff, and their recognized family members).

Contributions collected were higher in 2015 than in 2014 (US$ 118,831 thousand), mainly reflecting the rate increase approved by the SHI Governance. Claims increased in 2015 compared to 2014 (US$ 80,107 thousand), with higher hospitalization costs paid (particularly in both HQ and UNAIDS).

In US$'000CONTRIBUTIONS

COLLECTEDCLAIMS PAID

SURPLUS / DEFICIT

Activ e Staff and Eligible Family Members (ex c. App C) 65,806 38,254 27,553

Retired Staff/Surv iv ors and Eligible Family Members 37,429 44,807 (7,378)

Temporary Staff (Appendix C) 195 9 186

103,430 83,069 20,360

Earmarking 25% of Activ e Staff Contributions for Retired Staff 21,935 Surplus/(Deficit) on Organization Share for Retirees carried ov er (5,527) Second-Tier Contributions 1,098 Prior Year adjustments (406) (429) Current Year adjustments 547 Total 120,530 83,187

42

Amounts written-off 4.2The Director-General approved the write-off of US$ 418 thousand in relation to the remaining second tier contribution recalculated as being due from the International Computing Centre (ICC) as a result of its 2013 regional deficit. The remainder of the amounts written-off relate to the unsuccessful recovery from participants of 20% of medical expenses following direct payments.

Staff costs 4.3Total staff costs reflect salary costs of HQ and Regional staff processing claims. There was a 12% increase in 2015, though this is still within budget for the biennium (particularly due to a regional staff cost underspend in 2014).

Travel 4.4Travel costs increased in 2015 due to high-level missions to PAHO, EMRO, SEARO and many country offices in Africa to brief staff, discuss administrative matters and to enhance or establish agreements with major medical networks. However, overall biennium costs were contained within the budget allocated.

Other operating costs 4.5Other operating costs have increased significantly in 2015, mainly due to the introduction of the emergency helpline service (US$ 25 thousand), and commencement of the approved HIIS upgrade (US$ 49 thousand). However, overall biennium costs were contained within the budget allocated.

In US$'000 31 December 2015 31 December 2014STAFF COSTS

HQ 3,655 3,565 Regional Offices 1,020 619

Total 4,675 4,184

43

Finance revenue/(expense) 4.6SHI Fund investments yielded -1.9% in 2015, compared to 2.3% in 2014. Global fixed income and equity valuations were impacted during 2015 by a growing risk aversion in financial markets caused by concerns about the scale of the economic slowdown in China, ongoing quantitative easing by central banks in Japan and Europe, a sharp decline in oil prices, and a depreciation of emerging-market currencies. These factors created volatility in bond prices, and given that fixed income investments are held at fair value, the bond price reductions have led to a negative result for finance revenues in 2015. However, the market prices of these long term bonds will recover in future years as economic global circumstances normalize.

Amounts booked to participating entities 4.7Any surplus is booked back to the participating entities to reduce their unfunded liabilities. This policy will continue whilst there is an overall unfunded liability for the SHI.

In US$'000 31 December 2015 31 December 2014FINANCE REVENUE/(EXPENSE)

Income on Equity Inv estments (Ex t. Managed) (2,696) 6,325 Income on Fix ed Income Inv estments (Ex t. Managed) (11,366) 7,938 Income on Cash Inv estments (Ex t. Managed) 1 5 Interest on Cash and cash equiv alents 601 226 Inv estment Income/(Ex pense) (13,459) 14,494 Ex change (Gain)/Loss (130) (104) Inv estment Management Fees (1,328) (1,424)

Total (14,917) 12,966

44

5 Supporting information to the statement of comparison of budget and actual amounts

The original 2014/15 biennium budget was approved by the Director-General on 20 November 2013 following the first SHI Global Oversight Committee Meeting.

Staff costs 5.1The budget includes staff costs for the SHI unit in Headquarters, and for claims processing in the Regional Offices. Following the communication of final standard salary costs, the staff costs budget was updated. There was an overall 7% underspend against the biennium budget mainly due to prior year adjustments in the regional costs.

Travel 5.2The travel underspend against the biennium budget can be explained by less duty travel than planned (mainly from the Secretariat), cheaper travel costs for approved duty travel, and cost-sharing of some travels by country offices. It is important to note that video-conferencing is used to enable colleagues from the Regions to participate in the Global Standing Committee meetings.

Other operating costs 5.3The original budget was subsequently amended to include consulting fees for the feasibility study, and the external audit. Also, the cost of the approved HIIS upgrade has since been included. There was an underspend against the biennium budget mainly related to reduced consulting fees, and delays concerning the HIIS upgrade.

Claims paid 5.4There is no approved budget available for claims paid in 2015. The nature of the SHI operation is such that only one very large claim is needed to distort the outcome, plus this amount is largely dependant on other variables such as headcount. Therefore, it is difficult to forecast accurately.

Amounts written-off 5.5There is no approved budget available for amounts written-off in 2015.

45

6 Related party and other senior management disclosures

The only staff member considered to be “key management personnel” is the Chairman of the SHI Global Oversight Committee (GOC). There are no other ungraded staff working for the SHI.

As the Chairman is receiving all entitlements and benefits which are funded by WHO and not SHI, these are disclosed in WHO’s financial statements and not in the SHI’s financial statements.

46

7 Annex

Membership 7.1The insured population of active staff (excluding temporary staff App C), retired staff and eligible family members totalled 37,903, which represents an increase of 3.2% compared to the 2014 figures (36,726 insured persons at the end of 2014). The trends in membership are given in Figure 7.

As far as paying members are concerned (i.e. active paying members to retired members and survivors) the ratio of active staff to retired staff has moved from 1.50 in 2007 to 1.96 in 2015.

A breakdown of information on active staff (and their dependants) by Region is provided in Figures 8 and 9. As will be seen, Headquarters, UNAIDS, UNITAID, ICC, IARC, EURO, and AMRO/PAHO together represented 45% of insured active staff, i.e. just under half of insured active staff are in areas where the cost of health care is high. AFRO and APOC3 accounted for 31% and the other regional offices together represented 24%.

A breakdown of information on retired staff (and their dependants) by Region is provided in Figures 10 and 11. Headquarters, UNAIDS, UNITAID, ICC, IARC, EURO, and AMRO/PAHO together represented 65% of insured retired staff, i.e. well over half of insured retired staff are in areas where the cost of health care is high. AFRO and APOC accounted for 17% and the other regional offices together represented 18%.

3 The African Programme for Onchocerciasis Control (APOC) closed in December 2015.

2007 2008 2009 2010 2011 2012 2013 2014 20150

5,000

10,000

15,000

20,000

25,000

30,000

35,0001 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

Figure 7: Trends in Membership

Retired Staff & Survivors Active Staff (exc App C) - Paying Members

Dependants of Retired Staff & Survivors Dependants of Active Staff (exc App C)

47

Active Staff (except Appendix C)

For active staff (exc. App C), both first and second-tier contributions are include in Figure 9. The bubble size is based on the value of claims.

HQ19%

UNAIDS9%

UNITAID0%

ICC2%

IARC2%

AFRO31%

APOC0%

AMRO/PAHO9%

EMRO11%

EURO4%

SEARO7%

WPRO6%

Insured Persons - 2015

Figure 8: By Office

0.0

5.0

10.0

15.0

20.0

25.0

0.0 5.0 10.0 15.0 20.0

Contributions (US$ millions)

Claims (US$ millions)

Surplus/Deficit - 2015

HQ

UNAIDS

UNITAID

ICC

IARC

AFRO

APOC

AMRO/PAHO

EMRO

EURO

SEARO

WPRO

Figure 9: By Office

Deficit

Surplus

48

Retired Staff

Figure 11 demonstrates that the deficit for retired staff continues to be mainly generated by both PAHO and HQ regions. The bubble size is based on the value of claims.

HQ31%

UNAIDS1%

UNITAID0%

ICC0%

IARC2%

AFRO15%APOC

2%

AMRO/PAHO28%

EMRO4%

EURO3%

SEARO8%

WPRO6%

Figure 10: By Office

Insured Persons - 2015

0.0

5.0

10.0

15.0

20.0

25.0

0.0 5.0 10.0 15.0 20.0 25.0

Contributions(US$ millions)

Claims (US$ millions)

Surplus/Deficit - 2015

HQ

UNAIDS

UNITAID

ICC

IARC

AFRO

APOC

AMRO/PAHO

EMRO

EURO

SEARO

WPRO

Figure 11: By Office

Deficit

Surplus

49

However, the mechanism to earmark 25% of active staff contributions for the retired staff deficit is working, as can be seen in Figure 12.

Fund Balance Reconciliation 7.2

-25.0

-20.0

-15.0

-10.0

-5.0

0.0

5.0

10.0

15.0

20.0

25.0

2007 2008 2009 2010 2011 2012 2013 2014 2015

US$ millions

Deficit - Retired Staff 25% Earmarked Contributions Net of 25% Earmarked Contributions minus Deficit - Retired Staff

Figure 12: 25 % Earmarked Contributions Mechanism - historic trend

In US$'000 Notes 31 December 2015 31 December 2014

FUND BALANCE RECONCILIATIONActuarial requirement for future costs of retired staff and surv iv or dependants (Rule 470.2) 947,719 955,274 Actuarial requirement for future costs of activ e staff (Rule 470.3) 1,064,233 962,786 Long-term liabilities 3.10 2,011,952 1,918,060 Prov ision for outstanding claims 3.9 29,931 30,097 Total Liability 2,041,883 1,948,157 less Accounts receiv able - current (unfunded SHI long-term liability due element) 3.3 (9,740) - less Accounts receiv able - non-current 3.6 (1,308,275) (1,241,178) Fund Balance 723,867 706,979 % Unfunded Liability /Total Liability 64% 64%

50

Claims Processing 7.3The number of claims processed in 2015 for all offices was 143,466, as shown in Tables 8 and 9. This has increased by 2.0% compared to 2014.

With regards to the AMRO/PAHO claims data, this does not seem to be comparable to other claims data. This is probably because of AETNA and CVS statistics (both are USA third party administrators for medical expenses and medicaments respectively). SHI will continue to work with PAHO to ensure comparability in future.

No. claims % % 15 vs 14HQ 21,544 15% 3.6%IARC 1,999 1% 0.0%ICC 880 1% 17.5%UNITAID 428 0% (26.5%)UNAIDS HQ 2,360 2% 8.3%UNAIDS Field Staff 2,461 2% (9.5%)Direct payments 6,200 4% 0.0%HQ - processed claims 35,872 25% 1.8%AFRO 7,351 5% 14.3%AMRO/PAHO 78,975 73% 1.3%EMRO 5,361 4% 6.5%EURO 2,512 2% 8.3%APOC 279 0% (28.6%)SEARO 5,309 4% (0.4%)WPRO 7,807 5% (1.7%)Regions - processed claims 107,594 93% 2.0%Grand Total 143,466 100% 2.0%

2015

Number of claims paid in 2015Table 8

No. claims % No. claims % No. claims % No. claims % No. claims % % 15 vs 07 %15 vs 14HQ - processed claims 32,516 24% 36,363 23% 34,143 22% 35,222 25% 35,872 25% 10.3% 1.8%Regions - processed claims 105,241 96% 124,799 95% 124,356 95% 105,435 93% 107,594 93% 2.2% 2.0%Grand Total 137,757 100% 161,162 100% 158,499 100% 140,657 100% 143,466 100% 4.1% 2.0%

2015

Table 9Number of SHI claims paid as from 2007

2007 2012 20142013

51

By the end of the year, claims processing turnaround time was 1 week in HQ, AFRO, and AMRO/PAHO, as shown in Figures 13 and 14. Virtually all regions are showing improvements every month, and they are meeting the processing target time of 15 days. No region is reporting a delay of more than 20 days, which is remarkable compared to the experience of previous years. The processing time is measured from the time of submission of a claim to the time it is validated for payment via bank transfer.

0

5

10

15

20

25

30

35

40

45

50

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Days

2015

Figure 13 - Average Claims Processing Days

HQ / IARC

AFRO

AMRO/PAHO

EMRO

EURO

SEARO

WPRO

TARGET

0

2

4

6

8

10

12

14

16

18

20

HQ / IARC AFRO AMRO/PAHO EMRO EURO SEARO WPRO

Days

Region

Figure 14 - Average Claims Processing Days in Dec 2015

TARGET

52

Analysis of claims by category 7.4The 2015 breakdown of expenses per category showed an increase in hospitalization:

1. Hospitalization (accommodation + medical care) represented the largest item of expenditure – 41.3% of total expenses

2. Medication – 16.6% of total expenses 3. Physicians' fees – 14.8% of total expenses 4. Dental care – 8.1% of total expenses 5. Domiciliary and Institutional nursing care – 3.3% of total expenses. Table 10 shows the distribution of claims and the variations between these five categories:

Claims increased slightly in 2015 compared to 2014, with higher hospitalization costs paid (particularly in both HQ and UNAIDS). It is notable that were a greater number of major claims (>US$ 50,000) in 2015, compared to 2014 (as mentioned in Note 7.5). However, the average length of hospital stay remained at 4 days in 2015.

Major cases >US$ 50,000 7.5In 2015, among the 243 major cases (>US$ 50,000) which total US$ 26.2 million, there are:

• 93 AMRO/PAHO cases worth US$ 10.1 million, representing 39% of the AMRO/PAHO claims; and

• 150 cases for HQ and ROs (excl. AMRO/PAHO) worth US$ 16.2 million, representing 29% of HQ and Regions claims.

For AMRO/PAHO, retirees represented 70% of major cases. For HQ and ROs (excl. AMRO/PAHO), retirees represented 69% of major cases. The above figures partly explain the large deficit for retirees.

As an overall comparison, there were 228 major cases (>US$ 50,000) in 2014, worth US$ 23.6 million.

In US$'000 Hospitalizations Medication Physicians Dental careDom/Inst

Nursing careOthers TOTAL

Active Staff (exc. App C) 15,718 5,221 5,956 3,932 270 7,156 38,254% 41.1% 13.6% 15.6% 10.3% 0.7% 18.7% 100.0%

Temporary (App C) Staff 1 1 4 0 0 3 9% 10.3% 13.2% 46.5% 0.0% 0.0% 29.9% 100.0%

Retired Staff 18,580 8,578 6,330 2,769 2,464 6,086 44,807% 41.5% 19.1% 14.1% 6.2% 5.5% 13.6% 100.0%

2015 GRAND TOTAL 34,299 13,800 12,290 6,701 2,734 13,245 83,069% 41.3% 16.6% 14.8% 8.1% 3.3% 15.9% 100.0%

2014 GRAND TOTAL 31,822 14,320 12,444 7,483 3,073 13,368 82,510% 38.6% 17.4% 15.1% 9.1% 3.7% 16.2% 100.0%

VARIANCE 2,477 (520) (153) (782) (339) (123) 560% 2.7% (0.7%) (0.3%) (1.0%) (0.4%) (0.3%) 0.0%

Table 10

53

Organization's Contributions 7.6The Organization's share of contributions both for active and retired staff is two-thirds (the participants' share being one-third), as shown in Figure 15.

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

in US$ millions

Figure 15: Contributions Sharing Organization Share Staff Share

54

Statement of First Tier and Second Tier Contributions for Active Staff 7.7and Eligible Family Members (exc. App C)

In US$'000 INCOME * CLAIMS BALANCE

FIRST TIER

Headquarters 22,539 15,578 6,961

Regional Office for Africa 11,744 2,658 9,086

Regional Office for the Americas 7,611 8,741 (1,130)

Regional Office for Europe 2,817 1,165 1,652

Regional Office for South-East Asia 2,841 850 1,991

Regional Office for the Eastern Mediterranean 4,347 1,706 2,641

Regional Office for the Western Pacific 3,009 1,082 1,927

African Programme for Onchocerciasis Control (APOC) 363 57 305

International Agency for Research on Cancer (IARC) 1,271 602 669

International Computing Centre (ICC) 1,740 1,264 477

International Drug Purchase Facility (UNITAID) 587 236 352

Trust Fund for the Joint United Nations Programme on HIV/AIDS (UNAIDS) 6,938 4,316 2,622

Total 65,806 38,254 27,553

REGIONAL OFFICE FOR THE AMERICAS

Opening Balance 1,470

Deficit during the y ear 7,611 8,741 (1,130)

Second-Tier Contributions receiv ed during the y ear (SHI Rule 395) 1,098

Second-Tier Contributions receiv ed for prior y ears (SHI Rule 395) -

Closing Balance 1,437

* Ex cluding 25% of contributions collected w hich hav e been earmarked for retired staff.

55

Contributions Received and Claims Paid 7.8

Table 11

Table 12

PAYING MEMBERS SPOUSES CHILDREN SECONDARY

DEPENDANTSSTUDENTS

18-25HEADQUARTERS 7,811 3,980 3,196 249 342 15,578 22,539 6,961UNAIDS 2,095 740 761 100 620 4,316 6,938 2,622UNITAID 109 41 63 0 22 236 587 352ICC 569 267 361 17 50 1,264 1,740 477IARC 329 88 112 0 72 602 1,271 669AFRO 1,648 445 526 3 35 2,658 11,744 9,086APOC 18 22 17 0 0 57 363 305AMRO/PAHO 4,146 1,597 2,016 511 471 8,741 7,611 (1,130)EMRO 748 371 363 119 105 1,706 4,347 2,641EURO 645 334 138 6 43 1,165 2,817 1,652SEARO 371 261 155 45 18 850 2,841 1,991WPRO 537 234 161 110 41 1,082 3,009 1,927

GRAND TOTAL 19,025 8,380 7,869 1,159 1,820 38,254 65,806 27,553

* Excluding 25% of contributions collected which have been earmarked for retired staff.

CONTRIBUTIONS RECEIVED AND CLAIMS PAID DURING 2015BY OFFICE LOCATION AND CATEGORY

ACTIVE STAFF MEMBERS AND THEIR DEPENDANTS(EXCEPT TEMPORARY STAFF APP C)

(EXPRESSED IN US$'000)

CLAIMS PAID CLAIMS TOTAL

CONTRIBUTIONS TOTAL *

SURPLUS/ DEFICITOFFICE

DUTY STATION Physicians Medication Hospitalizat. Radiology Laborat. Dental care Optical Psych. Physio. Dom/Inst Nursing care Others TOTAL %

HEADQUARTERS 2,697 1,540 6,904 619 641 1,346 382 577 382 97 392 15,578 40.7%

UNAIDS 597 486 2,208 132 159 360 94 104 82 27 67 4,316 11.3%

UNITAID 64 22 53 8 16 35 7 21 6 2 1 236 0.6%

ICC 117 72 877 19 29 79 25 19 22 0 5 1,264 3.3%

IARC 81 52 230 17 16 101 37 30 24 1 14 602 1.6%

AFRO 167 382 1,393 113 110 224 152 6 20 19 71 2,658 6.9%

APOC 4 10 27 2 3 5 6 0 0 0 0 57 0.2%

AMRO/PAHO 1,731 1,882 2,515 499 397 934 132 239 250 63 101 8,741 22.9%

EMRO 140 274 576 57 64 330 127 18 37 41 41 1,706 4.5%

EURO 166 114 382 36 36 261 62 52 26 1 29 1,165 3.0%

SEARO 76 182 213 34 49 104 126 9 12 16 30 850 2.2%

WPRO 117 206 341 58 59 153 90 27 8 3 20 1,082 2.8%

Grand Total 5,956 5,221 15,718 1,594 1,579 3,932 1,240 1,103 870 270 771 38,254 100%

% 15.6% 13.6% 41.1% 4.2% 4.1% 10.3% 3.2% 2.9% 2.3% 0.7% 2.0% 100%

CLAIMS PAID DURING 2015 BY OFFICE LOCATION AND CATEGORYACTIVE STAFF MEMBERS AND THEIR DEPENDANTS

(EXCEPT TEMPORARY STAFF APP C)(EXPRESSED IN US$'000)

56

Table 13

Table 14

RETIREES SURVIVORS SPOUSES CHILDREN SECONDARY DEPENDANTS

STUDENTS 18-25

HEADQUARTERS 14,272 2,970 4,612 289 126 139 22,409 19,792 (2,617)

UNAIDS 418 1 27 45 0 2 494 418 (76)

UNITAID 39 0 0 0 0 0 39 8 (31)

ICC 9 0 4 0 0 0 13 0 (13)

IARC 321 5 32 0 0 1 359 760 401

AFRO 676 72 311 15 0 6 1,080 3,471 2,391

APOC 48 6 12 1 0 1 70 289 219

AMRO/PAHO 9,834 48 6,061 217 303 299 16,763 6,266 (10,497)

EMRO 404 156 225 13 19 11 828 1,452 624

EURO 151 16 48 1 0 6 224 847 624

SEARO 798 146 372 7 0 5 1,329 2,323 995

WPRO 712 108 283 9 39 49 1,201 1,802 601

GRAND TOTAL 27,683 3,528 11,989 599 488 520 44,807 37,429 (7,378)

CONTRIBUTIONS RECEIVED AND CLAIMS PAID DURING 2015BY OFFICE LOCATION AND CATEGORY

RETIRED STAFF MEMBERS AND THEIR DEPENDANTS(EXPRESSED IN US$'000)

CLAIMS TOTAL

CONTRIBUTIONS TOTAL


CLAIMS PAID

DUTY STATION Physicians Medication Hospitalizat. Radiology Laborat. Dental care Optical Psych. Physio. Dom/Inst Nursing care Others TOTAL %

HEADQUARTERS 3,412 2,549 10,581 827 628 1,209 288 241 471 1,715 489 22,409 50.0%

UNAIDS 69 62 251 18 21 29 7 13 9 5 8 494 1.1%

UNITAID 11 20 1 1 2 1 0 0 2 0 1 39 0.1%

ICC 3 1 6 1 2 0 0 0 1 0 0 13 0.0%

IARC 63 55 125 17 10 50 15 2 12 1 9 359 0.8%

AFRO 88 219 521 74 56 47 38 1 8 2 27 1,080 2.4%

APOC 5 26 23 4 4 2 5 0 1 0 0 70 0.2%

AMRO/PAHO 2,439 4,706 5,604 689 533 1,078 129 159 462 625 338 16,763 37.4%

EMRO 54 254 310 24 28 74 34 1 11 27 12 828 1.8%

EURO 25 43 28 2 2 70 25 3 17 0 9 224 0.5%

SEARO 79 346 605 29 54 100 62 1 19 17 17 1,329 3.0%

WPRO 84 297 525 30 31 109 31 0 7 71 15 1,201 2.7%

Grand Total 6,330 8,578 18,580 1,715 1,370 2,769 635 420 1,019 2,464 927 44,807 100%

% 14.1% 19.1% 41.5% 3.8% 3.1% 6.2% 1.4% 0.9% 2.3% 5.5% 2.1% 100%

(EXPRESSED IN US$'000)

CLAIMS PAID DURING 2015 BY OFFICE LOCATION AND CATEGORYRETIRED STAFF MEMBERS AND THEIR DEPENDANTS

57

Figure 16

Figure 17

With regards to the AMRO/PAHO claims data, this does not seem to be comparable to other claims data. This is probably because of AETNA and CVS statistics (both are USA third party administrators for medical expenses and medicaments respectively). SHI will continue to work with PAHO to ensure comparability in future.

(EXPRESSED IN US$'000)CLAIMS PAID UP TO 2015

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

2007 2008 2009 2010 2011 2012 2013 2014 2015

Claims Paid to Active Staff(exc App C) and dependants

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

45,000

50,000

2007 2008 2009 2010 2011 2012 2013 2014 2015

Claims Paid to Retired Staff and dependants

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

90,000

2007 2008 2009 2010 2011 2012 2013 2014 2015

Total Claims Paid to Active (exc App C) & Retired Staff and dependants

0

100

200

300

400

500

600

700

800in US$ Cost per Claim in 2015

Active Staff (exc App C) and dependants Retired Staff and dependants

0

1,000

2,000

3,000

4,000

5,000

6,000in US$ Cost per Claimant in 2015

Active Staff (exc App C) and dependants Retired Staff and dependants

58

Table 15

Table 16

PAYING MEMBERS SPOUSES CHILDREN SECONDARY

DEPENDANTSSTUDENTS

18-25

HEADQUARTERS 3,462 3,827 1,589 3,605 1,248 2,757 3,989 1,232UNAIDS 2,530 1,568 712 4,345 5,125 1,717 2,761 1,044UNITAID 2,100 1,869 1,235 58 5,552 1,773 4,416 2,643ICC 2,285 2,304 1,498 8,351 4,984 2,045 2,816 771IARC 1,432 928 460 4,251 1,027 2,169 1,142AFRO 647 291 107 693 130 287 1,270 983APOC 598 895 274 74 475 2,998 2,523AMRO/PAHO 3,637 2,852 3,023 5,441 2,980 3,338 2,906 (432)EMRO 769 626 258 2,046 895 542 1,382 840EURO 1,302 1,545 337 732 1,163 1,001 2,420 1,419SEARO 540 520 222 1,484 253 427 1,428 1,001WPRO 871 664 252 1,178 437 603 1,677 1,074

GLOBAL PER CAPITA 1,883 1,518 635 3,003 1,544 1,293 2,224 931

* Excluding 25% of contributions collected which have been earmarked for retired staff.

CLAIMS TOTAL

CONTRIBUTIONS TOTAL *

CLAIMS PAIDSURPLUS/

DEFICIT

CONTRIBUTIONS RECEIVED AND CLAIMS PAID PER CAPITA DURING 2015ACTIVE STAFF MEMBERS AND THEIR DEPENDANTS

(EXCEPT TEMPORARY STAFF APP C)(EXPRESSED IN US$)

OFFICE

RETIREES SURVIVORS SPOUSES CHILDREN SECONDARY DEPENDANTS

STUDENTS 18-25

HEADQUARTERS 9,864 11,600 6,704 3,214 20,985 1,880 8,750 7,728 (1,022)UNAIDS 10,204 1,904 11,224 462 7,713 6,533 (1,180)UNITAID 39,051 0 19,525 4,199 (15,326)ICC #VALUE!IARC 3,058 1,014 1,107 7 548 2,458 5,207 2,749AFRO 1,473 813 1,070 46 0 181 894 2,871 1,977APOC 881 246 284 47 529 443 1,840 1,397AMRO/PAHO 8,027 156 9,856 2,331 7,402 3,479 7,073 2,644 (4,429)EMRO 2,333 2,943 2,209 391 9,534 1,071 2,214 3,881 1,667EURO 819 897 723 116 1,057 777 2,943 2,166SEARO 2,559 1,401 1,549 334 461 621 1,934 3,382 1,448WPRO 3,030 2,406 1,980 485 6,503 3,535 2,600 3,901 1,301

GLOBAL PER CAPITA 6,532 3,903 5,369 924 8,561 2,166 5,385 4,499 (886)

(EXPRESSED IN US$)

CLAIMS TOTAL

CONTRIBUTIONS TOTAL


CLAIMS PAID

CONTRIBUTIONS RECEIVED AND CLAIMS PAID PER CAPITA DURING 2015RETIRED STAFF MEMBERS AND THEIR DEPENDANTS

59

Figure 18

Insured Persons 7.9

The Spouses category includes voluntary spouses in Figure 19.

(EXPRESSED IN US$)CONTRIBUTIONS RECEIVED AND CLAIMS PAID PER CAPITA UP TO 2015

-2,000

-1,000

0

1,000

2,000

3,000

4,000

5,000

2007 2008 2009 2010 2011 2012 2013 2014 2015

Contributions and Claims per CapitaActive Staff (exc App C) and dependants

Claims

Contributions

SURPLUS/DEFICIT

-3,000

-2,000

-1,000

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

2007 2008 2009 2010 2011 2012 2013 2014 2015

Contributions and Claims per CapitaRetired Staff and dependants

Claims

Contributions

SURPLUS/DEFICIT

Children < 2142%

Children aged 21-254%

Sec. Dependants1%

Spouses19%

Staff Members34%

Figure 19: Insured Persons (Active Staff exc App C) 2015 by Category

60

Table 17

Figure 20

DUTY STATION PAYING MEMBERS SPOUSES CHILDREN SECONDARY

DEPENDANTSSTUDENTS

18-25 TOTAL

HEADQUARTERS 2,256 1,040 2,012 69 274 5,651UNAIDS 828 472 1,069 23 121 2,513UNITAID 52 22 51 4 4 133ICC 249 116 241 2 10 618IARC 230 95 244 0 17 586AFRO 2,547 1,531 4,898 5 268 9,249APOC 30 25 61 0 5 121AMRO/PAHO 1,140 560 667 94 158 2,619EMRO 973 592 1,406 58 117 3,146EURO 495 216 408 8 37 1,164SEARO 687 501 698 30 73 1,989WPRO 616 352 638 93 95 1,794

TOTAL 10,103 5,522 12,393 386 1,179 29,583

NUMBER OF INSURED PERSONS AS AT 31 DECEMBER 2015ACTIVE STAFF MEMBERS AND THEIR DEPENDANTS

(EXCEPT TEMPORARY STAFF APP C)

(EXCEPT TEMPORARY STAFF APP C)

NUMBER OF INSURED PERSONS AS AT 31 DECEMBER 2015ACTIVE STAFF MEMBERS AND THEIR DEPENDANTS

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

Spouses

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000Paying Members

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

Children

0

500

1,000

1,500

2,000Secondary dependants

0

500

1,000

1,500

2,000

Students 18 - 25

61

Table 18

Figure 21

DUTY STATION RETIREES SURVIVORS SPOUSES CHILDREN SECONDARY DEPENDANTS

STUDENTS 18-25 TOTAL

HEADQUARTERS 1,447 256 688 90 6 74 2,561UNAIDS 41 0 14 4 0 5 64UNITAID 1 0 0 1 0 0 2ICC 0 0 0 0 0 0 0IARC 105 5 29 6 0 1 146AFRO 459 88 291 336 1 34 1,209APOC 55 25 44 31 0 2 157AMRO/PAHO 1,225 310 615 93 41 86 2,370EMRO 173 53 102 34 2 10 374EURO 185 18 67 12 0 6 288SEARO 312 104 240 22 1 8 687WPRO 235 45 143 19 6 14 462

TOTAL 4,238 904 2,233 648 57 240 8,320

NUMBER OF INSURED PERSONS AS AT 31 DECEMBER 2015RETIRED STAFF MEMBERS AND THEIR DEPENDANTS

NUMBER OF INSURED PERSONS AS AT 31 DECEMBER 2015RETIRED STAFF MEMBERS AND THEIR DEPENDANTS

0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

4,500

Paying Members

0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

4,500

Survivors

0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

4,500

Spouses

0

200

400

600

800

1,000

Children

0

200

400

600

800

1,000

Secondary dependants

0

200

400

600

800

1,000

Students 18 - 25

62

Composition of Global Oversight Committee (GOC) 7.10

Members Alternates

Chairman Dr H. TROEDSSON Mr N. JEFFREYS

Regional Director of Administration and Finance (DAF) Mr D. ALLEN Mr G. ANDERSON

Regional Director of Programme Management (DPM/DRD) Mr T. KASAI Mr W.J. CABORE

Designated by the Staff Dr T.B. USTUN Dr M.M. ROBINSON NICOLMr F. M'POUSSA MOKOUKA Ms P. VIDAL ESTEVEZ

Designated by the Retired Staff Mrs A. VAN HULLE-COLBERT Mr C. SANDSTROM

External Advisers Mrs C. BODIN N/AProf. T. ZELTNER N/A

Internal Advisers Ms F. MOURAIN-SCHUT Mrs J. McKEOUGHMrs F. NOCQUET Mr P. CRONINDr W. PLANCHAMP to 23.03.16Dr C. CROSS from 24.03.16

Observers CHAIR, GLOBAL STANDING COMMITTEE

Secretary Ms C. HENNETIER-ROSSIER Ms S. BELL-SHIERS

Other Ms J. HOLLANDMr S. SENANAYAKE

GLOBAL OVERSIGHT COMMITTEE

63

Composition of Global Standing Committee 7.11

Composition of Interim Global Standing Committee 7.12 The Global Standing Committee proposed the following names at its meeting SHI GSC/13/2 held on 13 November 2013:

Members Alternates

Chairman Dr S. RITTER VON XYLANDER to 06.06.15 Ms C. DEYNOUT Dr R. BALOCCO from 06.06.15

Advisers Dr T. LAMBRECHTS to 01.10.15Dr W. PLANCHAMP from 01.10.15Ms F. MOURAIN-SCHUT Mrs A. SCHEPENS

Administration VacantMs C. DEYNOUT Mrs D. D’AMICO

Dr C. PASSARELLIMr H. BAGUE Mr C. SAENZMr C. IACOBESCU Dr ARUN THAPADr K. TISOCKI Mr B. JORGENSEN

Designated by the Staff Dr S. RITTER VON XYLANDER to 06.06.15 Dr R. BALOCCO to 06.06.15Dr R. BALOCCO from 06.06.15 Dr A. BELLAH from 06.06.15Dr M. MATHAI Mr K. R. HOSSAINMrs M. METWALLY Dr K. NAHAPETYANDr S. MATIC Dr A. MATHUR

Designated by the Retired StaffMs M. DAM Ms F. HERY-PERSIN

Secretary Ms S. BELL-SHIERS Ms C. HENNETIER-ROSSIER

GLOBAL STANDING COMMITTEE

Dr S. BASSIRI

Dr R. MAYORGA SAGASTUME

Mrs C. COLLADODr J.P. MENU

Members Alternates

Chairman Dr S. RITTER VON XYLANDER Ms C. DEYNOUT

Administration Dr R. MAYORGA SAGASTUME Mr C. IACOBESCUVacant

Participants Dr R. BALOCCO

Designated by the Retired Staff

Dr M. MATHAI

INTERIM GLOBAL STANDING COMMITTEE

Dr J.P. MENU

64

Composition of Regional Surveillance Committees 7.13

Members Alternates

Chairman Dr K. MWINGA Dr M. EKEKE MONONO

Designated by the Regional Director Mr R.N. FONTES Dr J. NABYONGA

Designated by the Staff Dr M.M. NGARTELBAYE Ms M.T. DJEUSSI

Designated by the Retired Staff Mr J.P. NDOKAYO Mrs J. MAKAMONA

Secretary Mr A. RITCHIE Mr H. BAGUE

Members Alternates

Chairman Vacant Mr s. SHAUF

Designated by the Regional Director Dr M. MONTEIRO Dr A. BARCELODr S. LUCIANI Dr C. RUIZ MATUSDr L. REVEIZ Dr R. ESCALADA

Designated by the Staff Vacant VacantDr P. RAMON PRADO Vacant

Designated by the Retired Staff Dr M. BOYER Dr G. PERDOMO

Secretariat Mr C. SAENZ (NS Advisor) Mrs G. MARTINEZ

Members Alternates

Chairman Dr S. ARNAOUT Dr H. ASGHAR

Designated by the Regional Director Dr H. ATTA Mrs H. EL SHAZLYDr M. MALIK Mr T. KHORSHED

Designated by the Staff Dr J. AL-RAIBY Dr K. SAEED

Designated by the Retired Staff Mrs O. METWALLI Dr A. ABDELLATIF

Secretary Mr B. JORGENSEN

AMRO/PAHO

EMRO

AFRO

65

Surveillance meetings & Briefing/Visits 7.14

Members Alternates

Chairman Dr P. NAYAR Dr G.S. SENANAYAKE

Designated by the Regional DirectorDr R. DE JESUS Dr N. ABEYSINGHE

Designated by the Staff Mr D.C. PATHAK Mr R. SINGH

Designated by the Retired Staff Mr R. L. RAI Mr S. C. SAPRA

Secretary Mr R. CHELMINSKI

Members Alternates

Chairman Dr C. LEE

Designated by the Regional Director Dr J. MENDOZA ALDANA Ms T. DELA CRUZDr J. NAKAGAWA Ms M. LUCZON

Designated by the Staff Mr K. KHOW Ms P. KLEINITZ Ms M. PUA

Designated by the Retired Staff Ms L. MANUEL Ms L. RODRIGUEZ

Secretary Mr R. DURAISWAMI

EURO (No RSC)

WPRO

Dr S. MERCADO

Ms R. MACAPAGAL

SEARO

Dr N. RAINA Dr G. SETIADI

RegionStandard Meeting

of Surveillance Committees

Emergency/Ad hoc Meeting (usually held by email) of Surveillance Committees

Briefings/Visits

GSC (HQ) 11 None

20+(including visits to SEARO, PAHO,

EMRO and several countries in the African Region)

RSC AFRO 3 None 2RSC AMRO/PAHO 12 None 3RSC EMRO None 3 NoneRSC EURO None None NoneRSC SEARO None None NoneRSC WPRO 1 None None

Meetings of Global Standing CommitteeRegional Surveillance Committees & Briefings/Visits - 2015

66

Composition of Medical Review Committee 7.15

Members Alternates

Chairman Dr D. ENGELS Dr P.L.F. ZUBER

Designated by the Director-General Dr A. GRIEKSPOOR Dr S.A.L. HUGONNET

Designated by the Staff Dr I.D. IVANOV Dr M.O. LAMUNU

Secretary Ms C. HENNETIER-ROSSIER

MEDICAL REVIEW COMMITTEE

contents · despite an investment loss of us$ 13.5 million, and after administrative costs of us$...

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