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<div class=Section1>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'>Excuses for cross-posting<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'>From Alison Katz<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'>Open Letter to Dr Margaret
Chan, <o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'>Director-General, World Health
Organization<o:p></o:p></span></font></p>
<p class=MsoNormal style='margin-left:4.0in'><st1:place w:st="on"><st1:City
w:st="on"><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'>Geneva</span></font></st1:City></st1:place><span
lang=EN-GB style='mso-ansi-language:EN-GB'>, January 2007<o:p></o:p></span></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'>Dear Dr Chan, <o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'>You have taken office as Director-General
of the World Health Organization after two discouraging decades in which the
international health authority has been progressively subjected to pressure
from powerful minorities, separated from the people it serves and diverted from
its public health mission. <o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'>In short, WHO has fallen
victim to <span class=SpellE>neoliberal</span> globalization - as have most
social and economic institutions serving the public interest. <span
style='mso-spacerun:yes'> </span>A number of WHO staff, in senior and less
senior positions, have struggled against the worst excesses of this process,
but the damage has been extensive. In addition to the tragedy (and scandal) of continuing,
avoidable disease and death, WHO has lost friends among the people it serves and
has gained rich and powerful "partners" in search of new areas of influence.
<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'>Almost certainly, the world's
people will force a return to the goal of social and economic justice, and in
the area of health, to the promise of Alma Ata - which was itself explicitly
predicated upon a new international economic order. <o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'>"Health for All"
became WHO's slogan at the end <span class=GramE>of<span
style='mso-spacerun:yes'> </span>"</span>Les <span class=SpellE>Trentes</span>
<span class=SpellE>Glorieuses</span>" (1945-1975) - thirty years of genuine
progress towards a fairer - and therefore a healthier - world. <span
style='mso-spacerun:yes'> </span>This was the era of decolonization, when the
need for redistribution of power and resources, including the rights of peoples
to self determination and control over national resources, was widely recognized
and there was strong commitment to universal, comprehensive public services to
meet basic needs for health. <span class=GramE>A time of optimism, moral vision
and genuine progress.</span><span style='mso-spacerun:yes'> </span><span
style='mso-spacerun:yes'> </span><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'>Optimism was fully justified
because the world had (and still has) ample resources to ensure peace, security
and the wellbeing of all.<span style='mso-spacerun:yes'> </span>Health for All
is no utopia.<span style='mso-spacerun:yes'> </span>It was and is achievable
even if it is far more ambitious than the Millennium Development Goals which are
- quite literally - a set of half measures defined and delimited by the G8. <o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'>If thirty years is the length
of cycles of progress and backlash, with social progress for people always
overtaking, if only by a small margin, the backlash of powerful minorities to
maintain their privileges, we are embarking now on the new 30 year cycle of
progress. <span style='mso-spacerun:yes'> </span><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'><o:p> </o:p></span></font></p>
<p class=MsoNormal><span class=GramE><font size=3 face="Times New Roman"><span
lang=EN-GB style='font-size:12.0pt;mso-ansi-language:EN-GB'>And your five years
as Director-General (DG) of WHO coincides with that new cycle of progress.</span></font></span><span
lang=EN-GB style='mso-ansi-language:EN-GB'> <o:p></o:p></span></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'>Before I leave, I would like
to comment on some of the excellent points you have made in various speeches<a
style='mso-footnote-id:ftn1' href="#_ftn1" name="_ftnref1" title=""><span
class=MsoFootnoteReference><sup><span style='mso-special-character:footnote'><![if !supportFootnotes]><span
class=MsoFootnoteReference><sup><font size=3 face="Times New Roman"><span
lang=EN-GB style='font-size:12.0pt;font-family:"Times New Roman";mso-fareast-font-family:
SimSun;mso-ansi-language:EN-GB;mso-fareast-language:ZH-CN;mso-bidi-language:
AR-SA'>[1]</span></font></sup></span><![endif]></span></sup></span></a> since
your election, confident that your vision - if you can realize even part of it
unimpeded, will reinforce and accelerate that progress. <span
style='mso-spacerun:yes'> </span><o:p></o:p></span></font></p>
<p class=MsoNormal><b><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB;font-weight:bold'><o:p> </o:p></span></font></b></p>
<p class=MsoNormal><b><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB;font-weight:bold'>1. Inequality
should be the focus rather than poverty and insecurity<o:p></o:p></span></font></b></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'>You identify poverty and
insecurity as two of the greatest threats to harmony which as you rightly state
is "a word at the core of the WHO constitution".<span
style='mso-spacerun:yes'> </span>You state that "health is intrinsically
related to both development and security, and hence to harmony".<span
style='mso-spacerun:yes'> </span>The social justice perspective would go
further by stating that peace and security cannot be achieved without justice,
and health cannot be achieved without equitable and <span class=SpellE>emancipatory</span>
development. <o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'>Our focus today should be on
inequality rather than poverty, not because of a preference for the relative
over the absolute, but because unequal power relations are themselves the root
cause of both poverty and insecurity, and because inequality, over and above
any level of material wealth or deprivation, is bad for health and for<span
style='mso-spacerun:yes'> </span>cohesive, safe, healthy societies. Current
inequalities - in which the richest 1% of adults alone owned 40% of global
assets in the year 2000 and the richest 10% of adults accounted for 85% of the
world total - are not only grotesque in their divisiveness, they are
lethal.<span style='mso-spacerun:yes'> </span><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'><o:p> </o:p></span></font></p>
<p class=MsoNormal><b><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB;font-weight:bold'>2. Time to focus
attention on the rich but to meet with the poor<span style='mso-spacerun:yes'>
</span><o:p></o:p></span></font></b></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'>It has become fashionable to
focus attention on the poor but to meet <span class=GramE>-<span
style='mso-spacerun:yes'> </span>and</span> establish partnerships with - the
rich.<span style='mso-spacerun:yes'> </span>In order to address the
fundamental problem of inequality, this pattern must be reversed. It is time to
focus attention on the rich and powerful because they are the experts in the
mechanisms of unequal power relations and the architects of policies and
strategies which produce, reinforce and accelerate inequalities.<span
style='mso-spacerun:yes'> </span>Those systems must be closely examined and
opened up to public scrutiny and democratic control. <span
style='mso-spacerun:yes'> </span>To clarify, this is not a discourse on good
and evil; the issue is one of profoundly antisocial and violent <i><span
style='font-style:italic'>systems</span></i> not of the use made of those
systems by a handful of rapacious<i><span style='font-style:italic'>
individuals. <o:p></o:p></span></i></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'>Poor people do not attend G8
summits, board meetings of the latest "Global Fund" or
"philanthropic" foundation, let alone the World Economic Forum -
where Chief Executive Officers of transnational corporations are offered even more
privileged access to political leaders than they already enjoy. Poor people
also hold meetings and they are represented - if imperfectly - at the World
Social Forum (and in national and regional social <span class=SpellE>fora</span>)
and in trade union, social and political movements and elsewhere of course. <span
style='mso-spacerun:yes'> </span><span style='mso-spacerun:yes'> </span><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'>As Director-General of <span
class=GramE>WHO</span>, you are committed to "the people of <st1:place
w:st="on">Africa</st1:place> who bear an enormous and disproportionate burden
of ill health and premature death" and you have made this "the key
indicator of the performance of WHO".<span style='mso-spacerun:yes'>
</span>Your presence at the next World Social Forum on Health (Nairobi 21-23
January 2007 unfortunately coincides with your first Executive Board) and many other
such events in the future, would represent real hope and inspiration for the
world's people and an essential counterbalance to high level meetings with
government leaders and their corporate backers/advisers - who are increasingly
one and the same. <span style='mso-spacerun:yes'> </span><span
style='mso-spacerun:yes'> </span><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'><o:p> </o:p></span></font></p>
<p class=MsoNormal><b><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB;font-weight:bold'>3. Public-private
partnerships or a solid, equitable tax base?<o:p></o:p></span></font></b></p>
<p class=MsoNormal style='mso-layout-grid-align:none;text-autospace:none'><font
size=3 face="Times New Roman"><span lang=EN-GB style='font-size:12.0pt;
mso-ansi-language:EN-GB'>You note that "the landscape of public health has
become a complex and crowded arena for action, with a growing number of health
initiatives" and you remind us that WHO is "constitutionally mandated
to act as the directing and coordinating authority on health". <span
style='mso-spacerun:yes'> </span>As you know, public-private partnerships have
become the policy paradigm for global health work despite the evident conflict
of interest which would have outlawed such arrangements thirty years ago. Agencies
and organizations with public responsibilities are "partnering" with
the private sector for one reason. It (appears to have) become the only source
of funds. This situation has arisen because under <span class=SpellE>neoliberal</span>
economic regimes, public sector budgets have been slashed and tax bases
destroyed. T</span>hose developments are themselves the result of the influence
of transnational corporations on governments and the international financial
institutions.</font></p>
<p class=MsoNormal style='mso-layout-grid-align:none;text-autospace:none'><font
size=3 face="Times New Roman"><span style='font-size:12.0pt'><o:p> </o:p></span></font></p>
<p class=MsoNormal style='mso-layout-grid-align:none;text-autospace:none'><font
size=3 face="Times New Roman"><span style='font-size:12.0pt;mso-bidi-font-weight:
bold'>The solution to this problem is not for public bodies to go begging to
the private sector,</span> nor to the foundations of celebrity "philanthropists"
with diverse agendas, from industry. The solution is economic justice, including
an <span style='mso-bidi-font-weight:bold'>adequate tax base, both nationally
and internationally, to cover all public services, </span>as well as <span
style='mso-bidi-font-weight:bold'>proper funding of public institutions such as
WHO</span> through regular budgets so that they may fulfill their international
responsibilities unimpeded by corporate interests. </font></p>
<p class=MsoNormal style='mso-layout-grid-align:none;text-autospace:none'><font
size=3 face="Times New Roman"><span style='font-size:12.0pt'><o:p> </o:p></span></font></p>
<p class=MsoNormal style='mso-layout-grid-align:none;text-autospace:none'><font
size=3 face="Times New Roman"><span style='font-size:12.0pt'>You report that
"the amount of money being made available by foundations, funding agencies
and donor governments is unprecedented".<span style='mso-spacerun:yes'>
</span>This will be entirely positive if you are able to use these funds to
pursue your vision and priorities, as is your right and your duty. <span
style='mso-spacerun:yes'> </span>It can be argued that if WHO had operated
exclusively on regular budget, even with a significantly smaller workforce but
one that was dedicated to WHO's constitutional mandate, far more progress
towards Health for All would have been achieved.</span></font></p>
<p class=MsoNormal style='mso-layout-grid-align:none;text-autospace:none'><font
size=3 face="Times New Roman"><span style='font-size:12.0pt'><span
style='mso-spacerun:yes'> </span><span style='mso-spacerun:yes'> </span></span></font></p>
<p class=MsoNormal style='mso-layout-grid-align:none;text-autospace:none'><font
size=3 face="Times New Roman"><span style='font-size:12.0pt'>As you say "Primary
Health Care (PHC) is the corner stone of building the capacity of health
systems. It is also central to health development and to community health
security."<span style='mso-spacerun:yes'> </span>PHC will remain health
rhetoric if it is not supported by a solid, equitable tax base and other forms
of redistributive justice (debt cancellation and reparation, fair trade,
abolition of tax havens, democratic control of TNC activities etc). WHO itself
needs to set targets for the level of core funding, starting perhaps at 70% of
total expenditure, and increasing annually until undue influence is removed.
The private sector has no place in public health policy making at global or
national level. This does not of course exclude responsibly designed
interactions as in the past but it does exclude partnerships because partners
must share the same goal. <span style='mso-spacerun:yes'> </span></span></font></p>
<p class=MsoNormal><b><font size=3 face="Times New Roman"><span
style='font-size:12.0pt;font-weight:bold'><o:p> </o:p></span></font></b></p>
<p class=MsoNormal><b><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB;font-weight:bold'>4. Knowledge
for the public good - the world cannot afford corporate "science"<o:p></o:p></span></font></b></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'>You cite technical authority
as one of <span class=GramE>WHO's</span> four unique assets and you state that "we
can be absolutely authoritative in our guidance" and that "WHO must
influence the research and development agenda". <span class=GramE>WHO's</span>
role as the technical health authority is indeed the jewel in its crown. <span
class=GramE>All the more important then to address the current crisis in
science and reclaim knowledge systems for the public good.</span> <span
style='mso-spacerun:yes'> </span><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'>The commercialization of
science and the close relationship between industry and academic institutions
should be at the centre of <span class=GramE>WHO’s</span> concerns<a
style='mso-footnote-id:ftn2' href="#_ftn2" name="_ftnref2" title=""><span
class=MsoFootnoteReference><sup><span style='mso-special-character:footnote'><![if !supportFootnotes]><span
class=MsoFootnoteReference><sup><font size=3 face="Times New Roman"><span
lang=EN-GB style='font-size:12.0pt;font-family:"Times New Roman";mso-fareast-font-family:
SimSun;mso-ansi-language:EN-GB;mso-fareast-language:ZH-CN;mso-bidi-language:
AR-SA'>[2]</span></font></sup></span><![endif]></span></sup></span></a>. In
this regard, the public has every right to insist that assurances be provided that
WHO's recent reports on the health effects of Chernobyl and on the safety of genetically
modified foods were researched, developed and produced in full consultation
with independent scientists, unimpeded by other interests. <o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'>In relation to the corruption
of traditional ideals of science, an editorial in the Lancet reported that "Academic
institutions . . . <span style='mso-spacerun:yes'> </span>have become
businesses in their own right, seeking to commercialize for themselves research
discoveries rather than preserve their independent scholarly status". <span
style='mso-spacerun:yes'> </span>Equally worrying is the new trade-related
intellectual property regime which represents an unprecedented privatization of
knowledge.<span style='mso-spacerun:yes'> </span>Knowledge should be in the
public domain, accessible to all. It must above all be<i><span
style='font-style:italic'> truthful and reliable - </span></i><span
style='mso-bidi-font-style:italic'>a reminder which is not superfluous today.<i><span
style='font-style:italic'> </span></i></span><span
style='mso-spacerun:yes'> </span><span style='mso-spacerun:yes'> </span><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'>Given continuing high levels
of avoidable disease and death, alarming resurgence and emergence of old and new
infectious disease respectively, and the devastating effects of environmental
degradation and resource depletion on population health, the world cannot afford
corporate "science". As the world's technical health authority, WHO
must take the lead in transforming the way scientific research is conducted and
funded and the way knowledge is acquired and applied.<span
style='mso-spacerun:yes'> </span><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'><o:p> </o:p></span></font></p>
<p class=MsoNormal><b><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB;font-weight:bold'>5. Ethical
values and independence of international civil servants <o:p></o:p></span></font></b></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'>You state that "We share
the ethical foundations of the health profession. This is a caring, healing and
science-based profession dedicated to the prevention and relief of human
suffering. This gives us our moral authority and a most noble system of ethical
values". <o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'>It has not always been easy
for staff to stay close to <span class=GramE>WHO's</span> mandate nor to
maintain respect for ethical values either as public servants or as colleagues
during the <span class=SpellE>neoliberal</span> decades. <span
style='mso-spacerun:yes'> </span>The pressure often proved overwhelming while the
independence of international civil servants was increasingly undermined. As
you know, staff management relations reached a low point and resulted in the
first industrial action in <span class=GramE>WHO's</span> history in November
2005, a massive work stoppage involving 700 staff. <span
style='mso-spacerun:yes'> </span>This was despite threats of disciplinary
action including dismissal from the Director-General’s Office which
reflected not only deep dissatisfaction on the part of staff but astonishing
disregard for international labour standards on the part of a UN agency. <span
style='mso-spacerun:yes'> </span><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'>The work stoppage was not an
event to be deplored, lamented, let alone sanctioned<a style='mso-footnote-id:
ftn3' href="#_ftn3" name="_ftnref3" title=""><span class=MsoFootnoteReference><sup><span
style='mso-special-character:footnote'><![if !supportFootnotes]><span
class=MsoFootnoteReference><sup><font size=3 face="Times New Roman"><span
lang=EN-GB style='font-size:12.0pt;font-family:"Times New Roman";mso-fareast-font-family:
SimSun;mso-ansi-language:EN-GB;mso-fareast-language:ZH-CN;mso-bidi-language:
AR-SA'>[3]</span></font></sup></span><![endif]></span></sup></span></a>. It was
a needed signal to Member States and WHO's wider constituency that radical
change was needed.<span style='mso-spacerun:yes'> </span><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'>Staff who struggled against
the tide during these past two decades <span class=GramE>were</span> often "guilty"
of their attachment to the Declaration of Alma Ata which clearly identified
social and economic root causes of avoidable disease and death, placed the
debate squarely within international power structures and insisted on a broad
public health perspective which addressed non-health sector determinants of
health. <span style='mso-spacerun:yes'> </span>They were part of the broad
movement led by civil society organizations promoting a return to the values
and principles of Health for <span class=GramE>All</span>, which was
instrumental in the creation of WHO's Commission on the Social Determinants of
Health. <o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'>Some, through the Staff
Association, were also guilty of revealing to member states, as is their duty,<a
style='mso-footnote-id:ftn4' href="#_ftn4" name="_ftnref4" title=""><span
class=MsoFootnoteReference><sup><span style='mso-special-character:footnote'><![if !supportFootnotes]><span
class=MsoFootnoteReference><sup><font size=3 face="Times New Roman"><span
lang=EN-GB style='font-size:12.0pt;font-family:"Times New Roman";mso-fareast-font-family:
SimSun;mso-ansi-language:EN-GB;mso-fareast-language:ZH-CN;mso-bidi-language:
AR-SA'>[4]</span></font></sup></span><![endif]></span></sup></span></a> corruption,
nepotism, abuse of rules and procedures and an ineffective internal justice
system. In an exemplary response, members states called for a progress report
on staff management relations at the next EB (January 2007) and an audit of all
direct appointments at and under the D1 level. <span
style='mso-spacerun:yes'> </span><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'>The response however of the
last administration was dismal. WHO staff are now represented by a "Staff
Committee" which, apparently in collusion <span class=GramE>with <span
style='mso-spacerun:yes'> </span>administration</span>, opposed discussion of
the application of international labour standards (human rights in the
workplace) in WHO, at the Annual General Meeting of the HQ Staff Association.
This is an absurd situation, unworthy of a UN agency. Today, there is an
opportunity for civilised and dignified staff management relations in which staff
concerns and perspectives are welcomed with interest and respect. The first
step will be to declare that WHO supports not only a rights-based approach to
health but a rights-based organization which fully respects the ILO Covenants.<span
style='mso-spacerun:yes'> </span>Staff morale and motivation will soar as will
confidence in their leadership. <span style='mso-spacerun:yes'> </span><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB'><o:p> </o:p></span></font></p>
<p class=MsoNormal><b style='mso-bidi-font-weight:normal'><font size=3
face="Times New Roman"><span lang=EN-GB style='font-size:12.0pt;mso-ansi-language:
EN-GB;font-weight:bold;mso-bidi-font-weight:normal'>6. Health for All is value
laden and explicitly political <o:p></o:p></span></font></b></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'>In discussion with colleagues about all the above concerns, I have often
heard that with my views, I should rather work for an NGO, that my perspective
is “political” and that WHO is not an implementing agency. My
response to the first comment is that WHO staff should surely be more committed
to the values and principles of Health for All than staff of any other
organization, just as all UN staff should be at the frontline of the defense of
the UN Charter.<span style='mso-spacerun:yes'> </span></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'>My response to the second comment is that health <i><span
style='font-style:italic'>is</span></i> political and that the PHC approach and
Health for All was and is an explicitly political project – <i
style='mso-bidi-font-style:normal'><span style='font-style:italic;mso-bidi-font-style:
normal'>as is the <span class=SpellE>neoliberal</span> project for health and
health care.</span></i> <span style='mso-spacerun:yes'> </span>Today's
international health establishment denies any political values, intentions or
interests and presents itself as neutral, objective and armed with scientific
facts. <span style='mso-spacerun:yes'> </span>But scientific objectivity requires
awareness and acknowledgement of underlying values and principles. The States
Parties to the Constitution, in line with the Charter of the United Nations
accepted a set of nine ethical principles when they established the World
Health Organization. This is the source of our "moral authority" and
it is a value laden and highly political document - if one accepts that
politics is about the organization of societal structures and functions, in
particular in relation to the distribution of power and resources, for the
benefit of its members.<span style='mso-spacerun:yes'> </span><span
style='mso-spacerun:yes'> </span></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB;mso-bidi-font-weight:bold'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span lang=EN-GB
style='font-size:12.0pt;mso-ansi-language:EN-GB;mso-bidi-font-weight:bold'>My
response to the third comment is that although WHO is not an implementing
agency, it has a clear advocacy role in terms of identifying and promoting policies
and strategies - on the basis of serious science and sound evidence - that will
ensure the meeting of basic needs for health, among other things. <span
style='mso-spacerun:yes'> </span><span style='mso-spacerun:yes'> </span><o:p></o:p></span></font></p>
<p class=MsoNormal><b style='mso-bidi-font-weight:normal'><font size=3
face="Times New Roman"><span lang=EN-GB style='font-size:12.0pt;mso-ansi-language:
EN-GB;font-weight:bold;mso-bidi-font-weight:normal'><o:p> </o:p></span></font></b></p>
<p class=MsoNormal><b style='mso-bidi-font-weight:normal'><font size=3
face="Times New Roman"><span lang=EN-GB style='font-size:12.0pt;mso-ansi-language:
EN-GB;font-weight:bold;mso-bidi-font-weight:normal'>7. Conflicting loyalties <o:p></o:p></span></font></b></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'>In the <span class=SpellE>neoliberal</span> decades, WHO staff, and other
international civil servants, have found themselves in an uneasy position with
conflicting duties of loyalty on the one hand to WHO's constitutional mandate
and the UN Charter, and on the other hand, as WHO is an intergovernmental
agency, to member states and current office holders and <i><span
style='font-style:italic'>their interpretation of these mandates. </span></i>The
most obvious examples are UN sanctions and the invasion of <st1:country-region
w:st="on"><st1:place w:st="on">Iraq</st1:place></st1:country-region> which have
caused public health catastrophes. These actions have been qualified as war
crimes and genocide respectively<a style='mso-footnote-id:ftn5' href="#_ftn5"
name="_ftnref5" title=""><span class=MsoFootnoteReference><sup><span
style='mso-special-character:footnote'><![if !supportFootnotes]><span
class=MsoFootnoteReference><sup><font size=3 face="Times New Roman"><span
style='font-size:12.0pt;font-family:"Times New Roman";mso-fareast-font-family:
SimSun;mso-ansi-language:EN-US;mso-fareast-language:ZH-CN;mso-bidi-language:
AR-SA'>[5]</span></font></sup></span><![endif]></span></sup></span></a>.<span
style='mso-spacerun:yes'> </span></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'>Less spectacular examples of conflicting loyalties relate to certain
policies and strategies which do not make the headlines but which cause illness
and death on a daily basis and an even larger scale. WHO has failed to</span></font><span
style='mso-fareast-language:EN-US;layout-grid-mode:line'> denounce, in the strongest
possible terms, unfair rules of trade and commerce, odious debt, ruthless
liberalization of economies and privatization of public services and continued
exploitation of people's national resources. This is despite ample evidence
that these create poverty and inequality, interfere with people's capacity to
provide themselves with adequate supplies of food and water, and maintain more
than half the world's people in unspeakably miserable living conditions. <o:p></o:p></span></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt;mso-fareast-language:EN-US;layout-grid-mode:line'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt;mso-fareast-language:EN-US;layout-grid-mode:line'>At least 10 million
children die every year and the vast majority of those deaths are avoidable.
Life threatening, structural violence requires principled, unambiguous
resistance not cautious admonitions, let alone timid acquiescence. <span
style='mso-spacerun:yes'> </span><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt;mso-fareast-language:EN-US;layout-grid-mode:line'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt;mso-fareast-language:EN-US;layout-grid-mode:line'>We live in exceptional
times when leaders of powerful nations, who scarcely represent their own people
let alone all member states, embark on illegal action leading to death and
destruction and when transnational corporations, in collusion with international
financial institutions - with no democratic legitimacy or accountability - are
allowed to impose policies which have been shown to have devastating effects on
population health. </span>Should staff choose loyalty to current office holders
and selected member states rather than loyalty to the mandate of their
organization and the world's people who are often, very poorly represented by
their governments? Should respect for human rights and confidence in our own
moral judgment tip the balance in these conflicting <span class=GramE>loyalties
?</span> <span style='mso-spacerun:yes'> </span><span
style='mso-spacerun:yes'> </span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt;mso-fareast-language:EN-US;layout-grid-mode:line'><o:p> </o:p></span></font></p>
<p class=MsoNormal><b><font size=3 face="Times New Roman"><span
style='font-size:12.0pt;mso-fareast-language:EN-US;layout-grid-mode:line;
font-weight:bold'>8. Perhaps exceptional responses are required in exceptional
times<span style='mso-spacerun:yes'> </span><o:p></o:p></span></font></b></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'>"The way in which citizens of the rich countries currently live
their lives is, on the whole, morally acceptable".</span></font><a
style='mso-footnote-id:ftn6' href="#_ftn6" name="_ftnref6" title=""><span
class=MsoFootnoteReference><sup><span lang=EN-GB style='mso-ansi-language:EN-GB'><span
style='mso-special-character:footnote'><![if !supportFootnotes]><span
class=MsoFootnoteReference><sup><font size=3 face="Times New Roman"><span
lang=EN-GB style='font-size:12.0pt;font-family:"Times New Roman";mso-fareast-font-family:
SimSun;mso-ansi-language:EN-GB;mso-fareast-language:ZH-CN;mso-bidi-language:
AR-SA'>[6]</span></font></sup></span><![endif]></span></span></sup></span></a><span
lang=EN-GB style='mso-ansi-language:EN-GB'> </span><span
style='mso-spacerun:yes'> </span>Recognition that "everyone's <span
class=SpellE>favourite</span> prejudice" is profoundly wrong is
fundamental to the struggle for social justice and Health for All. <span
style='mso-spacerun:yes'> </span></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt;mso-fareast-language:EN-US;layout-grid-mode:line'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt;mso-fareast-language:EN-US;layout-grid-mode:line'>WHO (and other UN) staff
may be misinformed (by failing to consult alternative sources of information)
and <span class=SpellE>disinformed</span> (by accepting <i><span
style='font-style:italic'>la <span class=SpellE>pensée</span> unique </span></i>of
mainstream and conventional sources of information). However none of us can
claim lack of access to full information. It is time to consider whether t</span>he
way in which UN and WHO staff serve the UN Charter and WHO's constitutional
mandate, respectively, is, on the whole, morally acceptable or whether this
belief is "our <span class=SpellE>favourite</span> prejudice". </font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'>Dr Chan, the vision you have articulated is exemplary and an
inspiration to staff. But you will need them to summon up the courage of their
convictions, stand strong in the face of powerful opposition, and keep close to
<span class=GramE>WHO's</span> constitutional mandate, if they are to assist
you in its realization. </span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'>Sincerely, Alison Katz </span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><span style='mso-spacerun:yes'> </span><span
style='mso-spacerun:yes'> </span><span style='mso-spacerun:yes'> </span></span></font><span
style='mso-fareast-language:EN-US;layout-grid-mode:line'><span
style='mso-spacerun:yes'> </span><span style='mso-spacerun:yes'> </span><span
style='mso-spacerun:yes'> </span><o:p></o:p></span></p>
</div>
<div style='mso-element:footnote-list'><![if !supportFootnotes]><br clear=all>
<hr align=left size=1 width="33%">
<![endif]>
<div style='mso-element:footnote' id=ftn1>
<p class=MsoFootnoteText><a style='mso-footnote-id:ftn1' href="#_ftnref1"
name="_ftn1" title=""><span class=MsoFootnoteReference><sup><font size=2
face="Times New Roman"><span style='font-size:10.0pt'><span style='mso-special-character:
footnote'><![if !supportFootnotes]><span class=MsoFootnoteReference><sup><font
size=2 face="Times New Roman"><span style='font-size:10.0pt;font-family:"Times New Roman";
mso-fareast-font-family:SimSun;mso-ansi-language:EN-US;mso-fareast-language:
ZH-CN;mso-bidi-language:AR-SA'>[1]</span></font></sup></span><![endif]></span></span></font></sup></span></a>
<span lang=EN-GB style='mso-ansi-language:EN-GB'>Speech to the World Health
Assembly, 9 November 2006 as DG elect and Address to WHO staff, 4 January 2007,
as DG.<span style='mso-spacerun:yes'> </span><o:p></o:p></span></p>
</div>
<div style='mso-element:footnote' id=ftn2>
<p class=MsoFootnoteText><a style='mso-footnote-id:ftn2' href="#_ftnref2"
name="_ftn2" title=""><span class=MsoFootnoteReference><sup><font size=2
face="Times New Roman"><span style='font-size:10.0pt'><span style='mso-special-character:
footnote'><![if !supportFootnotes]><span class=MsoFootnoteReference><sup><font
size=2 face="Times New Roman"><span style='font-size:10.0pt;font-family:"Times New Roman";
mso-fareast-font-family:SimSun;mso-ansi-language:EN-US;mso-fareast-language:
ZH-CN;mso-bidi-language:AR-SA'>[2]</span></font></sup></span><![endif]></span></span></font></sup></span></a>
This section is drawn from the <span lang=EN-GB style='mso-ansi-language:EN-GB'>Convention
on Knowledge, <st1:place w:st="on"><st1:PlaceType w:st="on">Institute</st1:PlaceType>
of <st1:PlaceName w:st="on">Science</st1:PlaceName></st1:place> in Society. <o:p></o:p></span></p>
<p class=MsoFootnoteText><span class=SpellE><font size=2 face="Times New Roman"><span
lang=EN-GB style='font-size:10.0pt;mso-ansi-language:EN-GB'>www.i-sis.org.uk/conventiononknowledge.php</span></font></span><span
lang=EN-GB style='mso-ansi-language:EN-GB'><o:p></o:p></span></p>
</div>
<div style='mso-element:footnote' id=ftn3>
<p class=MsoFootnoteText><a style='mso-footnote-id:ftn3' href="#_ftnref3"
name="_ftn3" title=""><span class=MsoFootnoteReference><sup><font size=2
face="Times New Roman"><span style='font-size:10.0pt'><span style='mso-special-character:
footnote'><![if !supportFootnotes]><span class=MsoFootnoteReference><sup><font
size=2 face="Times New Roman"><span style='font-size:10.0pt;font-family:"Times New Roman";
mso-fareast-font-family:SimSun;mso-ansi-language:EN-US;mso-fareast-language:
ZH-CN;mso-bidi-language:AR-SA'>[3]</span></font></sup></span><![endif]></span></span></font></sup></span></a>
My post was abolished three weeks after the work stoppage and three weeks
before the normal renewal of my two year contract, after 17 years service. This
has been qualified as retaliation for industrial action (a violation of human
rights) by Swiss unions and staff association lawyers. </p>
</div>
<div style='mso-element:footnote' id=ftn4>
<p class=MsoFootnoteText><a style='mso-footnote-id:ftn4' href="#_ftnref4"
name="_ftn4" title=""><span class=MsoFootnoteReference><sup><font size=2
face="Times New Roman"><span style='font-size:10.0pt'><span style='mso-special-character:
footnote'><![if !supportFootnotes]><span class=MsoFootnoteReference><sup><font
size=2 face="Times New Roman"><span style='font-size:10.0pt;font-family:"Times New Roman";
mso-fareast-font-family:SimSun;mso-ansi-language:EN-US;mso-fareast-language:
ZH-CN;mso-bidi-language:AR-SA'>[4]</span></font></sup></span><![endif]></span></span></font></sup></span></a>
According to an Executive Board Resolution E<span lang=EN-GB style='mso-ansi-language:
EN-GB'>B91/1993/REC/1<o:p></o:p></span></p>
</div>
<div style='mso-element:footnote' id=ftn5>
<p class=MsoFootnoteText><a style='mso-footnote-id:ftn5' href="#_ftnref5"
name="_ftn5" title=""><span class=MsoFootnoteReference><sup><font size=2
face="Times New Roman"><span style='font-size:10.0pt'><span style='mso-special-character:
footnote'><![if !supportFootnotes]><span class=MsoFootnoteReference><sup><font
size=2 face="Times New Roman"><span style='font-size:10.0pt;font-family:"Times New Roman";
mso-fareast-font-family:SimSun;mso-ansi-language:EN-US;mso-fareast-language:
ZH-CN;mso-bidi-language:AR-SA'>[5]</span></font></sup></span><![endif]></span></span></font></sup></span></a>
See for example Initial Complaint prepared for the First Hearing by staff of
the International War Crimes Tribunal <a href="http://deoxy.org/wc/warcrim2.htm">http://deoxy.org/wc/warcrim2.htm</a><span
style='mso-spacerun:yes'> </span>and report on effects of UN sanctions </p>
<p class=MsoFootnoteText><font size=2 face="Times New Roman"><span
style='font-size:10.0pt'>http://www.geocities.com/iraqinfo/sanctions/holocaust.html</span></font><span
lang=EN-GB style='mso-ansi-language:EN-GB'><o:p></o:p></span></p>
</div>
<div style='mso-element:footnote' id=ftn6>
<p class=MsoFootnoteText><a style='mso-footnote-id:ftn6' href="#_ftnref6"
name="_ftn6" title=""><span class=MsoFootnoteReference><sup><font size=2
face="Times New Roman"><span style='font-size:10.0pt'><span style='mso-special-character:
footnote'><![if !supportFootnotes]><span class=MsoFootnoteReference><sup><font
size=2 face="Times New Roman"><span style='font-size:10.0pt;font-family:"Times New Roman";
mso-fareast-font-family:SimSun;mso-ansi-language:EN-US;mso-fareast-language:
ZH-CN;mso-bidi-language:AR-SA'>[6]</span></font></sup></span><![endif]></span></span></font></sup></span></a>
<span lang=EN-GB style='mso-ansi-language:EN-GB'>Thomas W. <span class=SpellE>Pogge</span>,
World Poverty and Human Rights, Polity Press 2002<o:p></o:p></span></p>
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