PHM-Exch> WHO under siege from private sector

[Claudio Schuftan]

*WHO under siege from private sector  *

* *by Tom Fawthrop

It was symbolic of the crisis facing the United Nations’ World Health
Organisation that billionaire Bill Gates, the Chairman of Microsoft, was
the special guest-speaker addressing last year’s World Health Assembly
(WHA) of WHO member states.

This followed from Gates’ previous address at the 2005 edition of the WHA.
Commenting on the then unprecedented invitation extended to Gates to
deliver a keynote speech at the WHA, the People’s Health Movement (PHM)
viewed it as ‘part of an alarming trend of various UN organisations,
including WHO, kowtowing to global multinational corporations under the
guise of the “Global Compact” and so-called “Public-Private Partnerships”’.

‘It is time to either declare Microsoft a WHO member country, or stop the
shameful promotion of global corporations at important UN meetings,’ said a
PHM spokesperson.

The membership of the PHM is made up of doctors, public health specialists
and health activists committed to the principles of free universal health
systems.

While Gates was ostensibly invited to the 2011 WHA in his capacity as
co-chair of the Bill & Melinda Gates Foundation, activist groups say that
the line dividing his philanthropy from his links to pharmaceutical
interests and his company’s business strategy is very thin.

Many corporate giants have been adopted by WHO since 2010, as private
sector partners working together for ‘better global health’.

The origins of this public-private sector partnership process can be traced
to WHO’s chronic funding problems. Over 80% of its budget is based on
emergency services and voluntary contributions, as opposed to compulsory
financial commitments from member states.1

Hence, in the WHO search for extra resources, the private sector came up
with the Global Fund to Fight AIDS, Tuberculosis and Malaria. The
private-sector-funded Global Fund has emerged as a new player on the
increasingly fragmented field of world health alongside the World Bank, the
Gates Foundation, and other charities and non-governmental organisations
(NGOs).

Australian health researcher David Legge points out: ‘The reform proposals
that [WHO Director-General] Margaret Chan took to the WHA in 2011 had
clearly been discussed in advance with Bill Gates. They came up with a
package that included an evaluation of WHO and a proposal for a” World
Health Forum” to include  drug companies like Big Pharma, the development
banks, and big foundations. ‘ (ed- this is where the quote ends)

Naturally Chan needed to reassure member states that WHO, in ‘the interest
of safeguarding public health’, was ‘not afraid to speak out against
entities that are far richer, more powerful, and better connected
politically than health will ever be’, adding that ‘we need to maintain
vigilance against any real or perceived conflicts of interest’.

But the question is: have her actions in promoting public-private
partnerships, been at odds with her speeches on defending the basic mandate
of WHO to promote the public health interest on the global stage?

Whatever the role of the Director-General,* *the private sector package
presented by Chan has raised much concern among member states.

There is little doubt that Chan understands to some degree the conflict of
interest posed by private sector forces ranged against the WHO commitment
to public health systems, in contrast to their promotion of privatised
healthcare. The principle of partnership with the private sector has
created a dangerous blurring between dedication to public health on one
side, and the ambivalent role of philanthropy and the private sector. In
the case of the private sector Ms Chan seems to think that corporations
with good-are not only profiting from global health problems

But financially can be part of the solution.

Nowhere was this more evident than at the UN General Assembly special
meeting on non-communicable diseases (NCDs) held in New York in September.

The problems arising from WHO sharing the same bed with private
corporations became very obvious during the meeting. That’s because
non-communicable
diseases — such as heart disease, stroke, cancer, diabetes and emphysema —
are deeply entangled with important global industries, not only tobacco but
also food, pharmaceuticals, advertising, transportation and construction.
And NCDs are the planet’s biggest health problem, responsible for 63% of
all deaths each year, with incidence growing steeply in the rapidly
urbanising low-income nations of the world.

A *Washington Post* report queried: ‘What is the responsibility of rich
countries, and the pharmaceutical companies located in them, to improve
medical care in poor countries, where 40 percent of deaths from
non-communicable diseases occur before age 60?’

At a UN meeting in June billed as an opportunity for charities, NGOs and
the public to voice their views on the outcome document of the September
NCD summit, the tabled speakers included representatives of the
International Federation of Pharmaceutical Manufacturers and Associations,
the International Food and Beverage Alliance, and the World Federation of
the Sporting Goods Industry.

Among those attending the September meeting itself on behalf of ‘civil
society’ were industry representatives, according to the *BMJ* (British
Medical Journal). The journal also reported that GlaxoSmithKline,
Sanofi-Aventis and the Global Alcohol Consumers Group were included within
the official US delegation. And one well-attended breakfast for conference
delegates was hosted by PepsiCo.

Over 100 NGOs and medical groups signed a petition in July saying that
there needed to be a code of conduct with industry, as there was a ‘lack of
clarity of roles for the industry sector in UN health policy setting and
shaping’.

*‘Our position is that partnership isn’t the right word. It implies trust
and respect,’ said Patti Rundall, who helped run the campaign against
infant formula sales in Africa 30 years ago and today is working to limit
the marketing of processed food in the developing world. ‘The allegiance of
the food companies is to create profits. Their voluntary commitments are
only good for as long as they want to keep them,’ she said*.

The Davos-inspired assault on WHO

During the 1980s the World Bank effectively sidelined WHO as the primary
influence on health policies of governments of the South. The Bank’s
Structural Adjustment Programmes (SAPs) imposed major cuts to public health
services. At the same time privatisation of healthcare was assiduously
promoted.

Today key areas of public health and policymaking across the globe such as
prevention of disease, strengthening public health systems and primary
healthcare – the key terrain of WHO and the responsibilities of member
states – are being coveted by private interest groups led by the new
‘rulers of the world’ known as the World Economic Forum.

It is all part of the WEF’s Global Redesign Initiative to rebuild
institutions and mechanisms of global governance, according to Garance
Upham, a researcher on health issues.

Upham, who delivered a lecture at the International Association of Health
Policy – Europe conference held in Ankara, Turkey last year, explained that
the WEF advocates a new governance paradigm for dealing with global health
issues which requires a drastic reform of WHO.

The WEF, which holds its high-profile annual meetings in Davos,
Switzerland, argues that ‘T*he model of development characterised by donors
and recipients is dead ... In place we need to think about collective
responsibility. A world where an increasing number of stakeholders should
have a role in shaping and making policy is a given. Governance does not
equal governments alone.’*

Indeed WHO and public health is not only about governments. Other

stakeholders are doctors, nurses, patients and communities, but these
stakeholders are missing or marginalized in the Davos blueprint. The
Davos-distorted definition of ‘stakeholders’ is clearly set out in the
proposal to establish a World Health Forum (WHF), perhaps modeled on their
very own WEF.

The Davos group is advocating that private donors to global health
campaigns should enjoy more or less equal seating alongside WHO in
formulating policymaking and supervising global health initiatives. All
this is coming at a time of growing economic crisis, with many governments
only too eager to cut back on health budgets and their contributions to
WHO.

It perhaps comes as no surprise that, along with Tony Blair and Kofi Annan,
Peter Brabeck, a former CEO and current Chairman of Nestle, is a board
member of the WEF.

Upham argues that all this would downgrade WHO from its vital role in
intervening to control epidemics, supervising international health
standards and promoting primary healthcare, to a more humble role mediating
between major donors to the Global Fund, private medical charities like the
Gates Foundation and even certain drug companies.

Within this paradigm, Mr. Goslin argues, ‘health is an area in which
entrepreneurship can flourish. It is the mission of the [World Economic]
Forum’s Health Team to galvanise business to take action in global health.’

A response to this comes from public health academic A. Shukla, who writes:
‘Private involvement carries large overhead costs and simply needs to
deliver some form of profit. There is thus simply an insurmountable gap
between public interest and private privilege. Only through putting
pressure on the state will the excesses of the private sector in health be
eventually done away with.’

It is clear that public-private partnerships are a dangerous path for any
vulnerable UN agency to go down. A coalition of conflicting interests
usually results in one partner swallowing the other or bullying it into
submission.

A fundamental issue is at stake here: whether our world  health policy is
in the hands of health professionals, health ministries and grassroots
NGOs, or falls into the clutches of the unelected gnomes of Davos and their
business blueprints for ever greater control over the vital sector of
public health.


Tom Fawthrop is a journalist and filmmaker who attended the founding
conference of PHM –The Peoples Health Movement in 2000,and also
participated in their Cuenca Ecuador summit. He is director of *‘ Swimming
Against the Tide* ‘ a documentary on the Cuban health system. DVDs are
available from

<Eurekafilmsdocos at gmail.com>


Endnote

1. Some UN agencies such as the UN Development Porgramme (UNDP) receive
compulsory contributions from member states. But in the case of WHO, its
fixed contributions have been whittled down and it is now increasingly
dependent on voluntary contributions. See Delhi Statement, ‘Time to Untie
the Knots: The WHO Reform and the Need for Democratising Global Health’,
May 2011, available via

www.medico.de/en/themes/health/documents/time-to-untie-the-knots-the-who-reform-and-the-need-for-democratizing-global-health/1177
.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://phm.phmovement.org/pipermail/phm-exchange-phmovement.org/attachments/20120313/ba522cee/attachment.html>