PHA-Exch> PHM and the World Health Assembly 2008

[Claudio Schuftan]

Prior to the 61st World Health Assembly (WHA), the Third World Network (TWN)
in collaboration with the People's Health Movement (PHM) and Health Action
International (HAI) called for a civil society meeting. The meeting was held
in Geneva on Sunday 18th May and discussed the civil society contribution
during the 61st (19-24 May 2008).

The workshop was participated by around 50 participants from civil society
organizations/networks, academic institutions and few official
representatives. The discussions can be concluded as follows:



n       *WHO new publication policy: adopted under pressure from "a
powerful" member state*

In this policy, all documents of a "controversial" nature must now be
cleared by the office of WHO's Director-General. The definition of what
exactly "controversial" means is unclear and thus the policy clearly carries
the danger of arbitrary censorship.

*A group of organizations and networks, with the leadership of the Third
World Network, has sent a letter to Dr Chan spelling out civil society
concern that a potential abusive censorship can result from the new policy
(refer to CIVIL SOCIETY LETTER TO WHO MEMBER STATES REGARDING WHO's
PUBLICATIONS POLICY)..*

n       *Global Call for Action for a revival of "Health for All"*

On the 30th anniversary of the Alma Ata Declaration, the People's Health
Movement launched a global call for action:

"Health for All" cannot be realized while *"the world's resources are
increasingly concentrated in the hands of a few who strive to maximize
profits. Neoliberal political and economic policies are made by a small
group of powerful governments, and by international institutions such as the
World Bank, the International Monetary Fund and the World Trade
Organization. These policies, together with the unregulated activities of
transnational corporations, have had severe effects on the lives and
livelihoods, on the health and well**‐**being of people in both the North
and the South"*. People's Charter for Health

*During WHA 2008, PHM launched a statement: Primary Health Care remains the
Best Tool to Achieve "Health for All". The statement was endorsed by civil
society organizations and networks (refer to PRIMARY HEALTH CARE REMAINS THE
BEST TOOL TO ACHIEVE "HEALTH FOR ALL").*

n       *WHO's Secretariat ignored an Assembly resolution *

Despite the victory of passing a resolution on *"Rational Use of Drugs" *at
the 60th WHA, WHO did not allocate funds to implement it. Our c*ivil society
workshop raised a question: whose decision is it to withdraw an action that
the WHO's secretariat had mandated member states to tackle? Civil society
representatives are aware of the budget limitations of WHO, however, such
limitations cannot overrule mandates given to the organization by its
governing body. Civil society asks for a transparent process of budget
allocation.*

n       *WHO is accused of silence and complicity in the cover up of the
health consequences of **Chernobyl***

Independent demands have risen for WHO to revise the 1959 Agreement with the
International Atomic Energy Agency so that WHO can undertake serious
scientific evaluations of nuclear disasters' consequences and also provide
needed assistance to affected populations.

*A Geneva-based group has prepared a resolution for the WHA in 2009. The
group  is working closely with the Special Rapporteur on the Right to Food
and will undertake legal action in which the most complete, up to date
scientific and medical evidence will be presented to senior WHO staff and
staff of the Department of Radiation; they will be informed that in any
future court case, they will be unable to claim that they did not know. *

n       *Global Health Partnerships: progress on developing draft policy
guidelines for WHO's involvement *

The participants welcomed the review of the risks and responsibilities
inherent to WHO's public-private partnerships.

*The workshop released a statement which called the member states to pay a
serious attention to:*

-        *the importance of using more descriptive title for the WHO
Guidelines in report EB 123/6. Suggested is: "Guidelines on
interaction with commercial enterprises to achieve health outcomes".
Such Guidelines exist as an annex to the January 2001 Executive Board
Report EB 107/20 entitled: "Working with the private sector to achieve
health outcomes", but have been totally ignored by the WHO leadership;
see these Guidelines
at:http://ftp.who.int/gb/archive/pdf_files/EB107/ee20.pdf. (refer to
**Global Health Partnerships: **progress** **on** developing draft
policy guidelines for WHO's involvement)***

n       *Influenza Virus: benefits of sharing *

We recall last year's scandal of WHO giving developing countries'
(Indonesiaamong others) virus samples to companies, for the
development of a vaccine
to which poor countries would have no access. This was in violation of WHO's
own guidance and also in violation of the Convention on Biological Diversity
which recognizes the sovereign rights of states over their biological
resources.

During WHA60 (May 2007), resolution 60.28 *linked virus sharing with benefit
sharing*. Instead, the rich countries are pushing for loose and informal
guidelines, while the *developing countries insist on standard material
transfer agreements*. Some progress over the year in terms of recognition of
the problem, of the need for fair benefit sharing ended in various proposals
from developing countries, and more transparency has been achieved in terms
of records of all viruses provided being kept in terms of who received them
and are using them. Still needed is to know which companies have obtained
them and what profit they are making. It is a test case which will set a
precedent.

n       *Primary Health Care, health systems and global economic order*

Discussions during the workshop referred many times to *the negative impacts
of the current global political and economic order in widening the equity
health gap within and between countries*.

Participants are of the opinion that the current economic crises,
represented partially by the rise in food prices, will further widen the
present inequity gap. It was also mentioned that it is high time for change,
as people across the world have had enough; while people cannot access food,
the international financial institutions remain protective of for profit
corporations. In these trying times, *WHO needs to fulfil its constitutional
mandate and take the leading role of coordinating efforts to make "Health
for All" a reality.*

 *The Anti-microbial resistance is a major threat to public health *

Participants referred the worrisome problem of microbial resistance to
antibiotics and the associated irrational use of drugs which is, to a great
extent, due to the direct-to-public advertisement of drugs.

Participants viewed that it is understood that Big Pharma is
profit-oriented, but WHO and its member states should protect the right of
the next generations to find treatments that work.

WHO must provide guidance in the area of drug promotion to the public and to
health professionals and governments must guarantee strict implementation.

n       *Access to medicines*

Participants acknowledged *two challenges: a) how to use flexibilities in
TRIPS and b) how to overcome the problem of innovation and market failure in
the medicines domain*. The current IPR system has not resulted in further
innovation.

The Thai experience showed the serious obstacles found in *using compulsory
licensing as one of the important flexibilities*. The use of the allowed
flexibilities is very much dependent on political and economic pressures
that manifest themselves as trade retaliation actions by rich countries,
withdrawal of foreign investment, threatened legal action, withdrawal of new
medical registration applications, IPR campaigns to undermine the image of
the country which used these flexibilities, very long approval processes,
delay in importation of generic products and threats from the patent
holders. These pressures always come from both governments and
pharmaceutical multinationals.

The group urged the WHO Secretariat to:

-        technically assist member states, and provide them with the needed
political support in the use of the flexibilities of the TRIPs agreement,

-        encourage the member states to increase their investment in
pharmaceutical research and production.
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