PHM-Exch> PHM Statement at Executive Board Meeting of WHO in Geneva on Priority Setting for WHO

[amit sen]

Thank you, Chair.
 
I am speaking on behalf of
Medicus Mundi International, among other organisations and coalitions represented
by the People’s Health Movement.
 
We are of the view that programme
and priority-setting are fundamental areas to the reform process and also
recall Dr. Chan calling it in November the  «hardest part of the reform». 
 
We have 3 points to raise about
document EB130/5Add.1:
 
1. Priority-setting should not be
driven by the availability of resources, but rather by themandate of the WHO.
The document portrays demand-led approach for priority-setting as a challenge,
while presenting development agencies as the solution, particularly in
low-income countries. This allows donor countries to interfere in the sovereign
domain of health policy making in developing countries. There is currently a
disconnect between priority-setting and the allocation of resources.
Country-driven priority setting is often neutralised by the multitude of
vertical diseasefocused programmes, driven by Global Public-Private
Partnerships (GPPPs) which influence resource allocation within WHO country
offices. The success of any new mechanisms for prioritisation will depend upon
addressing the distortions of resource allocation arising from tied donor funding.
 
2. Programme and priority-setting
requires a participatory process, rather than immediate identification of fixed
core priority areas to be applied to all countries. The seven core areas of
work may not reflect the actual priorities of many countries, particularly when
the methodology behind their selection is not clear. Member states should
focus, at this point in time, on the process and mechanism of priority-setting rather
than agreeing on specific priorities.
 
3. The document introduces the
concept of country groupings or “typologies”. While we welcome this approach,
we find that the five categories proposed are simplistic, and almost entirely based
on economic variables.  The concept of
country groupings could better be applied both across and within regions using more
representative criteria. Sub-regional groups can be identified, based on common
health situation and priorities, within every single region. Empowerment of
regional offices, and decreasing the level of centralisation in the WHO are prerequisites
for the success of such regional and sub-regional groupings, and for the entire
exercise of priority-setting.
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