PHM-Exch> WHO: Members' pressure leads to more inclusive reform process

[Claudio Schuftan]

   From:    ssangeeta at myjaring.net

TWN Info Service
Third World Network

Below is a news report on discussions on WHO's reform that took place at the
WHO Executive Board that met on 25th May 2011. (excerpts)

We also have done an article on discussions on the reform that transpired
at the World Health Assembly and on the outcome. This article is available
at
http://www.twnside.org.sg/title2/intellectual_property/info.service/2011/ipr
.info.110506.htm


WHO: Members' pressure leads to more inclusive reform process
(SUNS #7163 Monday 6 June 2011)

Geneva, 1 Jun (K. M. Gopakumar and Sangeeta Shashikant) ­ Dissatisfaction
brewing among many Member States over the Secretariat's reform plan
culminated with Members reasserting their control over the reform process of
the World Health Organisation.

This took place at the 129th session of the WHO Executive Board on 25 May.
Earlier, the World Health Assembly (WHA) that met in Geneva on 16-24 May had
considered the WHO Director General's report titled "The Future of Financing
for WHO" (A64/4) that contains a broad, far-reaching reform agenda that is
likely to reshape the way in which the organization operates, is governed,
makes decisions and is financed.

The broad reform plan led to many Member States expressing their concerns
particularly over the lack of detail on the reforms proposed, the stress on
"donor-funding" to resolve the financial difficulties of the WHO, as well as
proposals such as the convening of the World Health Forum, which is aimed at
increasing the influence of the private sector and donors in setting the
health agenda in the WHO. They also emphasized that the WHO's reform process
must be driven by Members States themselves. However, these concerns were
skilfully side-stepped by Dr. Margaret Chan, WHO's Director-General with
promises of inclusiveness leading to the rapid adoption of the Secretariat's
resolution on the reform process which did not measure up to Member States'
expectations .

Member States' discontent with Dr. Chan's approach to reform continued to
brew, forcing the matter onto the agenda of the Executive Board (EB) that
met on 25 May after the conclusion of the WHA.

The Executive Board is composed of 34 members technically qualified in the
field of health and meets twice a year. The main functions of the Board are
to give effect to the decisions and policies of the World Health Assembly,
to advise it and generally to facilitate its work.]

Discussion at the EB saw a push by developed and developing countries for a
more transparent and Member State-driven process, resulting in the adoption
of a new decision EB 129(8) on WHO's reform for a healthy future. This new
decision sets out a more transparent and inclusive consultative process for
the finalisation of a reform plan in the next 6 months for consideration of
a special EB session that will be convened in November 2011.

The decision taken is as follows:

"The Executive Board,

"1. DECIDES to establish a transparent, Member State-driven and inclusive
consultative process, on WHO reforms, based on existing mechanisms,
comprising of the following steps:

"2. REQUESTS the Director-General to prepare by the end of June 2011, three
concept papers which will be further revised on an ongoing basis through the
consultative process, on the following issues: governance of WHO,
independent evaluation of WHO, and the World Health Forum, as outlined in
resolution WHA64.2;

"3. REQUESTS the Director-General to hold consultations of Member States at
WHO Headquarters, on these papers, and to create a platform for web-based
consultations by the end of July 2011;

"4. REQUESTS Regional Committees, based on the updated concept papers, to
engage in strategic discussions regarding the WHO reform process and report
on these discussions to the meeting outlined below;

"5. DECIDES to hold a special session of the Executive Board open to all
Member States in November 2011, following the Regional Committee meetings,
to discuss outcomes of the consultative process on the three papers, and
draft proposals prepared by the Secretariat or proposed by Member States on
other aspects of the reforms outlined in document A64/4.;

"6. URGES Member States to support, with possible funding, and actively
engage in the reform process;

"7. REQUESTS the Director-General to support the aforementioned elements of
the consultative process."

This decision is significant in that Member States pushed to regain control
of WHO's critical reforms which has hitherto been driven by the Secretariat.
It is also a major improvement over the Secretariat's resolution WHA 64.2
adopted during the WHA. The EB decision sets out a detailed process for
Member States' involvement including at the regional level, in driving all
aspects of WHO's reform. According to the decision, the special session of
the EB (open to all Member States) in November will discuss the entire
reform package.

On the other hand, the WHA 64.2 envisaged limited participation of Member
States including the EB in the reform process.

[WHA 64.2 endorses the Director-General's report (A64/4) and requests the EB
to establish an appropriate process to examine specific issues related to
WHO's governance identified in the Report. The resolution also further
requests the Director-General to present a concept paper for the World
Health Forum proposed to be held in November 2012, to the 130th session of
the Executive Board in January 2012; to develop an approach to independent
evaluation in consultation with Member States, and to present a first report
on the evaluation of the work of WHO to the 65th WHA in 2012; and to update
the 65th WHA on the progress through the 130th Executive Board meeting.

 Interestingly, the three concept papers to be prepared under the EB
decision
do not mention the financing of WHO.


Dr. Chan said that there was insufficient time to include the
issue of financing in the concept paper, but agreed to conduct consultations
beginning July and to address the issue in the concept paper. Dr. Chan also
said that the issue of finance and resource mobilisation is part of the
governance mechanism. The extent to which Dr. Chan will seek to address the
financial difficulties of WHO as part of the reform process is unclear. The
EB decision also lacks clarity on the utility of the independent evaluation
to the reform process as the independent evaluation will be undertaken in
parallel with other aspects of WHO's reform.

 Several Member States also raised again concerns over the private financing
of the reform as WHO
proposed that the development of the reform programme be partially funded by
the Bill and Melinda Gates Foundation (A64/4 Add. 1). The EB decision
attempts to address the issue by urging Member States to support the reform
process including possible funding.

 The WHO staff association representative said that while they supported the
reform, they sought clarification on the purpose and direction of reform,
adding that the staff was under severe stress. The staff association also
protested outside the EB meeting room, holding placards with slogans
questioning the accountability of WHO's top management. Some slogans were: "
WHO on Fire 800 staffs gone what is the vision and the implications for WHO
mandate" and "350 staffs to be fired where is the management
accountability".

Concerns raised at the WHA were also raised by several civil society
organizations in a letter to the EB members, prior to the EB meeting. In
particular, the letter expressed concern with the WHO's reform and the
potential conflict of interest involved in the reform process. The letter
requested "the Executive Board to provide guidance and design a process by
which the WHO secretariat might manage conflicts of interest as part of the
governance review process.

"This process should include a definition of individual and institutional
conflicts of interests as well as specific guidelines on how to
appropriately manage them; it should also require that WHO's institutional
policies for interaction with the commercial sector are clarified and widely
publicised. "Finally, we believe that in order to have a credible reform,
there is need for a broader discussion with Member States on the reform
process and objectives and the financing of the WHO, where these matters are
duly addressed, as are Member States contributions to, and their engagement
with, the WHO". +
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://phm.phmovement.org/pipermail/phm-exchange-phmovement.org/attachments/20110603/0b8d129f/attachment.html>