LONDON -- Dr. Margaret Chan, director-general of the World Health Organization, travelled to Guinea earlier this month to join the country's president in celebrating the world's first Ebola vaccine.
After praising health workers in West Africa for their triumph over the lethal virus, Chan spent the night in the presidential suite at the beach-side Palm Camayenne hotel. The suite, equipped with marble bathrooms and a dining room that seats eight, has an advertised price of 900 euros (US$1,008) per night.
Some say such luxurious accommodations send the wrong message to the rest of WHO's 7,000 staffers -- and may hurt the cash-strapped health agency's fundraising efforts to fight diseases worldwide.
According to internal documents obtained by The Associated Press, the UN health agency routinely has spent about US$200 million a year on travel expenses, more than what it doles out to fight some of the biggest problems in public health, including AIDS, tuberculosis and malaria combined.
Last year, WHO spent about US$71 million on AIDS and hepatitis. It devoted US$61 million to malaria. To slow the spread of tuberculosis, WHO invested US$59 million. Still, some health programs do get exceptional funding -- the agency spends about US$450 million trying to wipe out polio every year.
WHO declined to say if it paid for Chan's stay at the Palm Camayenne in Conakry, but noted that host countries sometimes pick up her hotel tabs.
At a time when the health agency is pleading for more money to fund its responses to health crises worldwide, it has struggled to get its travel costs under control. Senior officials have complained internally that UN staffers break new rules aimed at curbing its expansive travel costs, booking perks like business class airplane tickets and rooms in five-star hotels with few consequences.
"We don't trust people to do the right thing when it comes to travel," Nick Jeffreys, WHO's director of finance, said during a September 2015 in-house seminar on accountability -- a video of which was obtained by the AP.
Despite WHO's numerous travel regulations, Jeffreys said the agency couldn't be sure its staffers always booked the cheapest fares or that their travel was even warranted.
Ian Smith, executive director of Chan's office, said the chair of WHO's audit committee said the agency often did little to stop misbehaviour.
"We, as an organization, sometimes function as if rules are there to be broken and that exceptions are the rule rather than the norm," Smith said.
Earlier that year, a memorandum was sent to Chan and other top leaders with the subject line "ACTIONS TO CONTAIN TRAVEL COSTS" in capital letters. The memo reported that compliance with rules requiring travel to be booked in advance was "very low." The document also pointed out that WHO was under pressure from its member countries to save money.
Travel would always be necessary, the memo said, but "as an organization we must demonstrate that we are serious about managing this appropriately."
In a statement to the AP, the UN health agency said "the nature of WHO's work often requires WHO staff to travel" and that costs were reduced 14 per cent last year compared to the previous year -- although the 2015 total was exceptionally high due to the 2014 Ebola outbreak in West Africa.
But staffers still are openly ignoring the rules.
An internal analysis in March, obtained by the AP, found that only two of seven departments at WHO's Geneva headquarters met their budget targets and concluded that the compliance rate for booking travel in advance was only between 28 and 59 per cent.
Since 2013, WHO has paid $803 million for travel. WHO's approximately US$2 billion annual budget is drawn from the taxpayer-funded contributions of its 194 member countries; the United States is the largest contributor.
After he was elected, U.S. President Donald Trump tweeted : "The UN has such great potential," but had become "just a club for people to get together, talk, and have a good time. So sad!"
WHO said Sunday that nearly 60 per cent of its travel costs were spent on sending outside experts to affected countries and for national representatives to attend WHO meetings.
During the Ebola disaster in West Africa, WHO's travel costs spiked to US$234 million. Although experts say on-the-ground help was critical, some question whether the agency couldn't have shaved its costs so more funds went to West Africa . The three countries that bore the brunt of the outbreak couldn't even afford basics such as protective boots, gloves and soap for endangered medical workers.
Dr. Bruce Aylward, who directed WHO's outbreak response, racked up nearly US$400,000 in travel expenses during the Ebola crisis, sometimes flying by helicopter to visit clinics instead of travelling by jeep over muddy roads, according to trip reports he filed.
Chan spent more than US$370,000 in travel that year, as documented in a confidential 25-page analysis of WHO expenses that identified the agency's top 50 spenders. Aylward and Chan were first and second. WHO declined requests for an interview with Chan; Aylward did not respond to a request for comment.
Three sources who asked not to be identified for fear of losing their jobs told the AP that Chan often flew in first class.
WHO said its travel policy, until February, permitted its chief "to fly first class." It said Chan now flies business class, at her request.
Devi Sridhar, a global health professor at the University of Edinburgh, described WHO's travel costs as "extremely high" but said the problems at WHO probably stretched across the whole United Nations.
"People know these UN jobs can be cushy and come with perks, that you get to travel business class and stay at nice hotels," she said, adding that the lack of scrutiny of UN finances was a problem.
Other international aid agencies, including Doctors Without Borders, explicitly forbid their staff from travelling in business class. Even the charity's president must fly in economy class. With a staff of about 37,000 aid workers versus WHO's 7,000 staffers, Doctors Without Borders spends about US$43 million on travel a year.
The U.S. Centers for Disease Control and Prevention would not provide its travel costs, but said staffers are not allowed to fly business class unless they have a medical condition. The UN children's agency UNICEF, which has about 13,000 staffers, said it spent US$140 million on global travel in 2016.
"When you spend the kind of money WHO is spending on travel, you have to be able to justify it," said Dr. Ashish Jha, director of the Global Health Institute at Harvard University. "I can't think of any justification for ever flying first class."
Jha warned that WHO's travel spending could have significant consequences for fundraising. Several weeks ago, WHO asked for about US$100 million to save people in Somalia from an ongoing drought. In April, it requested US$126 million to stop the humanitarian catastrophe in Yemen .
"If WHO is not being as lean as possible, it's going to be hard to remain credible when they make their next funding appeal," Jha said.
