World Health Organization criticise for consulting spend

The World Health Organization has come under fire for its use of private consultants, having allegedly paid Boston Consulting Group more than $11 million since the final quarter of 2020. An external auditor has suggested that the organisation changed criteria to help the strategy consulting giant win the work, while questioning the value for money of the services procured.

In mid-June, the World Health Organization (WHO) expressed concerns over the resurgence of Covid-19 infections in many African countries. The world health body says health systems are seriously unprepared for an increase in cases, while Matshidiso Moeti, WHO Regional Director for Africa, noted it was “crucial that we swiftly get vaccines into the arms of Africans at high risk of falling seriously ill and dying of Covid-19."

While the $11.72 million of the WHO’s annual $5.84 billion budget might not seem like that much, in the above context, every penny counts. Speaking to online news site Vox, which broke the story,  Adam Kamradt-Scott – the incoming Global Health Chair at the School of Transnational Governance in Florence, who studies the WHO – argued that if the amount were spent on “a health care system in a low-income country,” it would comprise “a significant portion of their funding.”

The WHO is a noted member of the Covax coalition – a network whose aim is to ensure all countries have equitable access to vaccines. Looking at how many Covid-19 vaccine doses that could buy from Pfizer, BioNTech or Moderna, Kamradt-Scott added, “If it’s money being wasted, that’s a lot of vaccines that could have been purchased.” According to Vox’s calculations, the amount spent on the firm it identified as Boston Consulting Group’s services could pay for about 600,000 Covid-19 vaccine doses.

As with many cases of a public services organisation spending money on private consultants, the WHO has previously defended its strategy as helping it save money in the long-run. Before the pandemic, for example, it was disclosed that the WHO spent a similar amount on advisory work to support its organisational reform. At that time, a spokesperson for the United Nations agency argued, the consulting companies had supported the WHO “in areas where we lack in-house expertise or want to tap the current best-in-class standards.”

In this case, however, the independent audit has put the value for money of the engagements under intense scrutiny. Looking at BCG’s record for negotiating on behalf of the WHO, in one of the nine purchase orders it brokered, BCG’s consultants got a 20% reduction on protective gowns, before the client and consultants placed an order and approved the quality of the gowns. However, soon after, an external PPE supplier supporting the WHO deemed the gowns low-quality, and cancelled the order.

Elsewhere, another case saw auditors flag a missed opportunity for savings, with noting the consultants “did not negotiate” on a price “which had better potential for saving.” In this instance, consultants negotiated a discount of 0.08% off N95 masks, for a savings of $9,750, while in the same month, the same supplier fulfilled another mask order with a discount that amounted to $303,200.

Meanwhile, the auditor also pointed toward the consulting firm’s erroneous use of the term “pro bono” regarding its work with the WHO. According to Vox, BCG characterised its PPE procurement work this way, even though only the cost of the first of three phases and a transition period was covered by the firm. The seven-month contract ultimately cost $7.3 million, of which $2.53 million was paid for by the WHO, leading the audit to conclude it was “of the view that calling this engagement pro bono is not correct.”

Perhaps most concerningly, however, the report found WHO staff had changed criteria to help BCG win work at the agency. In relation to a contract between December 2020 to May 2021, the organisation asked consultants for competitive proposals to help strengthen its “long-term supply chain vision.” However, while another firm won the highest score by the pre-specified criteria and should have won the contract, BCG was handed it. As a result, the authors noted, “WHO changed the evaluation criteria and re-evaluated the bids as per which Consultant A [BCG] scored higher and was awarded the consultancy.”

Responding to the findings, the WHO argued the contracts were awarded in the context of an unprecedented health emergency, but added it was taking the report seriously, and has “already begun implementing” changes “related to procurement.” A statement from BCG meanwhile claimed it had “rapidly mobilised teams to support worldwide efforts to fight the spread of the virus,” before asserting the company was “extremely proud of our work that contributed to saving lives in this unprecedented time.”

It is not the first time the world’s largest consulting brands have been scrutinised for their roles in the global pandemic response. For example, in 2020, senior members of BCG were reportedly paid over £6,000 per day to help improve the UK’s test and trace project – which according to critics remains unfit for purpose – while 1,000 consultants employed by Deloitte had also worked on the system, and more staff from top professional services firms like KPMG and EY were put on standby in the autumn to work on “back office” parts of the system on a short-term basis.