PHM-Exch> PHM calls on WHO to develop a framework to guide its interaction with "stakeholders"

[Claudio Schuftan]

From: John Mahama <jmahama at gmail.com>


As Member States of the World Health Organisation prepare to commence the
65th World Health Assembly on 21st May 2012, PHM has called on WHO to
develop a framework to guide its interaction with all "stakeholders" in the
prevention and control of NCDs at global and national levels. Such a
framework will protect WHO from influence by any form of vested interest or
conflict of interest. The call is contained in a PHM Comment posted on the
Global Health Watch website (http://www.ghwatch.org/who-watch/wha65/ncd)
and shared below:


WHA Item 13.01 Non-Communicable Diseases (NCDs) Issues before the Assembly In
2011 two high levels meetings on NCDs were held: a Global Ministerial
Conference on Healthy lifestyles and NCDs in Moscow in April 2011; and High
Level Meeting of the UN General Assembly on Prevention and Control of NCDs
in New York in September 2011. The World Health Assembly is invited to note
the outcomes on these two meetings
A65/6<http://apps.who.int/gb/ebwha/pdf_files/WHA65/A65_6-en.pdf>and
provide further guidance.

The Political Declaration on NCDs that was endorsed at the New York HLM
called on WHO to present, before the end of 2012:

   - a comprehensive global monitoring framework, including a set of
   indicators, capable of application across regional and country settings,
   including through multisectoral process, to monitor trends and to assess
   progress made in the implementation of national strategies and plans on
   NCDs;
   - recommendations for a set of voluntary global targets for the
   prevention and control of NCDs.


   - options for strengthening and facilitation multi-sectoral actions for
   the prevention and control of NCDs through
partnership<http://apps.who.int/gb/ebwha/pdf_files/WHA65/A65_7-en.pdf>
   .


In relation to these three items, the WHO Secretariat developed documents
A65/6 <http://apps.who.int/gb/ebwha/pdf_files/WHA65/A65_6-en.pdf>, A65/6
Add.1 <http://apps.who.int/gb/ebwha/pdf_files/WHA65/A65_6Add1-en.pdf>, and
A65/7 <http://apps.who.int/gb/ebwha/pdf_files/WHA65/A65_7-en.pdf>, and the
Health Assembly is invited to note the reports, to share views and to
provide further guidance.

In addition, the WHA is invited to note reports on the implementation of
the Global NCDs Strategy
(A65/9<http://apps.who.int/gb/ebwha/pdf_files/WHA65/A65_9-en.pdf>)
and Action Plan
(A65/8<http://apps.who.int/gb/ebwha/pdf_files/WHA65/A65_8-en.pdf>
).
PHM Comment While there is rhetorical recognition of the larger scale
issues of trade and industry practices in this report it seems there is
very little action on this front. The implications of ISDS for tobacco
control and food regulation and the implications of ever tighter IP
protection for affordable access to medicines are self evident. But WHO has
completely avoided them. Furthermore, the significance of neoliberal
economic policies in widening inequalities have not been addressed.

WHA resolution WHA59.26<http://apps.who.int/gb/ebwha/pdf_files/WHA59-REC1/e/Resolutions-en.pdf>on
international trade and health highlights a number of crucial issues
in
relation to trade and health, and the WHO’s role in capacity strengthening
in this area. Global level action and coordination is needed to address
some of the trade related determinants of NCDs (WTO, Codex), including the
introduction of an international code on marketing of unhealthy foods, and
drinks (including alcohol) to children. Because the factors that shape NCDs
lie outside the reach of health policy, the most health gains in terms of
prevention will be made by influencing policies in domains such as trade,
food and pharmaceutical production, agriculture, urban development, and
taxation policies. Such approach to preventing NCDs should go beyond
education, housing and agriculture to also include the structural
determinants of health. We urge Member States to explicitly recognize the
role of trade policies in the spread of NCD risk factors and commit to
ensure that future trade treaties do not increase such risks.

A continuing concern in relation to NCDs is the sustained focus on
partnerships and engaging in multi-sector consultations. The private sector
– whilst a very important actor for policy implementation – appears to be
embedded throughout the processes . This is an important concern for food
and nutrition, but also alcohol. The continued failure by WHO to
distinguish between public interest NGOs (PINGOs) and Business interest
NGOs (BINGOs) compounds this issue. The UN High Level Meeting “civil
society hearing” which included representatives from the food and alcohol
industry was a case in point.

The WHO Director General, in her report to the WHA on progress on WHO
Reform and governance (A65/5), states that member states have agreed to the
following principle: “the development of norms, standards, policies and
strategies, which lies at the heart of WHO’s work, must continue to be
based on the systematic use of evidence and protected from influence by any
form of vested interest.” It is important for WHO to adopt this principle
in determining future policy and governance and action on NCDs.

Also in keeping with recommendations made in the WHO reform paper (A65/5):
WHO should also develop a framework to guide interactions with all
stakeholders on the prevention and control of NCDs, at both the national
and global levels.

WHO should provide technical support and expert advice to member states on
the implementation of fiscal, legislative and regulatory measures to
improve food and nutrition. This should involve technical support to
finance ministries on the administration of national food tax and
regulatory systems and administration, as well as the production of manuals
and toolkits.
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