From: <b class="gmail_sendername">David G Legge</b> <span dir="ltr"><<a href="mailto:dglegge01@gmail.com">dglegge01@gmail.com</a>></span><br><div class="gmail_quote"><br>PHM-EXCHANGE ASKS FOR AN EXCUSE FOR THE HIGH VOLUME OF WHA-WATCH POSTINGS. THESE HAVE TO BE TIMELY FOR READERS TO UNDERSTAND THE ISSUES BEFORE THE WORLD HEALTH ASSEMBLY.<br>
<br><br><div link="blue" vlink="purple" lang="EN-AU"><div><div><p class="MsoNormal">As Member States of the World Health Organisation prepare to commence the 65th World Health Assembly on 21st May 2012, PHM has again called on the member states of WHO to mandate an increase in untied assessed contributions to the Organisation. The donor states (and philanthropies) are tightening their grip on WHO’s agenda with disabling effects on the WHO. <u></u><u></u></p>
<p class="MsoNormal"><u></u> <u></u></p><p class="MsoNormal">Under pressure from the donors WHO is presently going through a program of reform. For a commentary on WHO Reform at this week’s World Health Assembly and further links see <a href="http://www.ghwatch.org/who-watch/wha65" target="_blank"><span style="color:windowtext">http://www.ghwatch.org/who-watch/wha65</span></a><u></u><u></u></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif""><u></u> <u></u></span></p><p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif"">PHM is at the WHA, reporting through WHO Watch. Follow @WHOWatch on Twitter<u></u><u></u></span></p>
</div><div><h1><span style="font-size:18.0pt;font-family:"Arial","sans-serif"">12. WHO Reform </span><span style><u></u><u></u></span></h1><h2><span style="font-size:14.5pt;font-family:"Arial","sans-serif"">The issues before the Assembly</span><span style><u></u><u></u></span></h2>
<p class="MsoNormal"><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">The DG presents a </span><span style="font-size:13.5pt"><a href="http://apps.who.int/gb/ebwha/pdf_files/WHA65/A65_5-en.pdf" target="_blank"><span style="font-size:11.5pt;font-family:"Arial","sans-serif";color:#1155cc">Consolidated Report</span></a></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif""> (<a href="http://apps.who.int/gb/ebwha/pdf_files/WHA65/A65_5-en.pdf" target="_blank">http://apps.who.int/gb/ebwha/pdf_files/WHA65/A65_5-en.pdf</a>) on decision making and progress with respect to WHO Reform (A65/5). The CR is structured around 16 ‘decision points’ for decision by the Assembly. </span><span style="font-size:13.5pt"><u></u><u></u></span></p>
<ol start="1" type="1"><li class="MsoNormal" style="vertical-align:baseline"><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">Endorse EB Chairman’s report from February meeting of MS on priority setting (<a href="http://apps.who.int/gb/ebwha/pdf_files/WHA65/A65_40-en.pdf" target="_blank"><span style="color:#1155cc">A65/40</span></a>, <a href="http://apps.who.int/gb/ebwha/pdf_files/WHA65/A65_40-en.pdf" target="_blank">http://apps.who.int/gb/ebwha/pdf_files/WHA65/A65_40-en.pdf</a>) and guide further development of the draft 12th GPW (<a href="http://apps.who.int/gb/ebwha/pdf_files/WHA65/A65_5Add1-en.pdf" target="_blank"><span style="color:#1155cc">A65/5 Add.1</span></a>, see below also);<u></u><u></u></span></li>
<li class="MsoNormal" style="vertical-align:baseline"><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">Endorse a set of principles regarding governance of WHO; <u></u><u></u></span></li>
<li class="MsoNormal" style="vertical-align:baseline"><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">Scheduling of the meetings of governing bodies; <u></u><u></u></span></li><li class="MsoNormal" style="vertical-align:baseline">
<span style="font-size:11.5pt;font-family:"Arial","sans-serif"">Alignment between the work of regional committees and the EB;<u></u><u></u></span></li><li class="MsoNormal" style="vertical-align:baseline">
<span style="font-size:11.5pt;font-family:"Arial","sans-serif"">Harmonisation of procedures and protocols across regions;<u></u><u></u></span></li><li class="MsoNormal" style="vertical-align:baseline">
<span style="font-size:11.5pt;font-family:"Arial","sans-serif"">Revised terms of reference for the PBAC; <u></u><u></u></span></li><li class="MsoNormal" style="vertical-align:baseline"><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">Streamlining decision making in governing bodies<u></u><u></u></span></li>
<li class="MsoNormal" style="vertical-align:baseline"><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">Engagement with stakeholders and partnerships;<u></u><u></u></span></li><li class="MsoNormal" style="vertical-align:baseline">
<span style="font-size:11.5pt;font-family:"Arial","sans-serif"">Strengthening technical support to MS;<u></u><u></u></span></li><li class="MsoNormal" style="vertical-align:baseline"><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">Staffing policy and practice<u></u><u></u></span></li>
<li class="MsoNormal" style="vertical-align:baseline"><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">The new ‘financing dialogue’;<u></u><u></u></span></li><li class="MsoNormal" style="vertical-align:baseline">
<span style="font-size:11.5pt;font-family:"Arial","sans-serif"">Internal controls;<u></u><u></u></span></li><li class="MsoNormal" style="vertical-align:baseline"><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">Accountability, risk management, conflict of interest and ethics;<u></u><u></u></span></li>
<li class="MsoNormal" style="vertical-align:baseline"><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">Evaluation policy;<u></u><u></u></span></li><li class="MsoNormal" style="vertical-align:baseline">
<span style="font-size:11.5pt;font-family:"Arial","sans-serif"">External auditor’s Independent Evaluation (Stage I)<u></u><u></u></span></li><li class="MsoNormal" style="vertical-align:baseline"><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">Strategic communications<u></u><u></u></span></li>
</ol><h2><span style="font-size:14.5pt;font-family:"Arial","sans-serif"">PHM Comments on selected decision points</span><span style><u></u><u></u></span></h2><h3><span style="font-size:12.0pt;font-family:"Arial","sans-serif";color:#666666">3. Scheduling: giving the donors control of the agenda?</span><span style><u></u><u></u></span></h3>
<p class="MsoNormal"><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">The 65th WHA is invited to consider a number of options for re-scheduling the meetings of governing bodies. It appears that the favoured option would involve the annual cycle starting with regional committees in the first quarter of the year followed by the PBAC and EB leading then to the ‘financing dialogue’ with donors and ending with the Health Assembly in the last quarter. </span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">This arrangement would have the EB prepare a draft program budget which then goes directly to the donors (the financing dialogue) and only after the donors have decided what to fund does it come to the Assembly, scheduled in the last quarter of the year. </span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">It is hard to avoid the image of the Secretariat auctioning its programs to the donors and then presenting the assembly with a fait accompli with respect to the program budget.</span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">Apart from this indignity, the proposed arrangement will give Secretariat inadequate time to prepare for the new programme to start in January. </span><span style="font-size:13.5pt"><u></u><u></u></span></p>
<h3><span style="font-size:12.0pt;font-family:"Arial","sans-serif";color:#666666">5. Harmonising across regions</span><span style><u></u><u></u></span></h3><p class="MsoNormal"><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">The DG brings forth a number of initiatives and proposals for harmonising (or standardising) the ways in which the regions work. </span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">We are concerned about the passage in para. 33 which would allow Regional Committees to invite the observers that “they wish to attend”. If accreditation follows a known official procedure, then there is no place for picking and choosing which organisations get accredited. There is a pressing need to reform the procedures, rules and protocols for the participation of civil society in global and regional governing bodies. </span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">WHO is a member state body and this is part of its strength. However, there is untapped value to be gained from building a more collaborative relationship with public interest civil society organisations at the country, regional and global levels. </span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">Closer involvement of civil society as observers in RCs would strengthen the accountability of regional committees and bring fresh perspectives for discussion. Civil society collaboration would add value to program implementation as well as policy making and accountability.</span><span style="font-size:13.5pt"><u></u><u></u></span></p>
<h3><span style="font-size:12.0pt;font-family:"Arial","sans-serif";color:#666666">7. Streamlining decision-making in governing body meetings</span><span style><u></u><u></u></span></h3><p class="MsoNormal">
<span style="font-size:11.5pt;font-family:"Arial","sans-serif"">Under this heading the DG refers to a number of proposals for tighter discipline on late resolutions; for new mechanisms to vet resolutions coming to the governing bodies and for arbitrary limits on repeat progress reports.</span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">We support more discipline in managing late resolutions submitted to the WHA.</span><span style="font-size:13.5pt"><br><br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">We firmly oppose the proposal that Officers of the Board might curtail the right of Member States (MS) to propose resolutions to the governing bodies. There may be merit in reflecting on earlier resolutions and seeking coherence between resolutions on related subjects but this should not restrict the sovereign right of MS to table resolutions on matters they deem important.</span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">We reiterate the intergovernmental nature of the WHO, and of the processes taking place within its governing body meetings. In this context, we wish to caution against the seemingly increasing trend of using summaries of discussions developed by Chairs of intergovernmental meetings. </span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">The Chairman’s summaries under recommendation in para. 43 have no legal status and are not binding documents. They are not decisions, and do not reflect the intergovernmental nature, or capture the diverse opinions, of the meetings they summarise. They also face the difficulty of implementation, hence accountability, because of lack of consensus (necessary for any intergovernmentally agreed text).</span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">We urge MS to delete points (a), (c) and (d) from para. 43. </span><span style="font-size:13.5pt"><u></u><u></u></span></p><h3>
<span style="font-size:12.0pt;font-family:"Arial","sans-serif";color:#666666">8. Effective engagement with other stakeholders</span><span style><u></u><u></u></span></h3><p class="MsoNormal"><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">The DG reviews the different kinds of partnerships and relationships that WHO engages in, including: with other intergovernmental bodies, private sector organisations and non-government organisations. </span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">We appreciate the commitment to review WHO’s relationship with NGOs at global, regional and country levels and the recognition of the importance of discerning clearly between different types of NGOs engaging with WHO. </span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">We note with concern the recent trend for the Secretariat to hold separate consultations with public interest organisations and private interest ones including the private sector. Ensuring transparency in such processes necessitates the presence of all stakeholders in the same room for discussion. </span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">We appreciate also the focus on clearer protocols for managing conflicts of interest of various kinds and look forward to finalisation and implementation. We urge an explicit commitment to excluding private sector entities from direct involvement in policy-formation and norm-setting activities. </span><span style="font-size:13.5pt"><u></u><u></u></span></p>
<h3><span style="font-size:12.0pt;font-family:"Arial","sans-serif";color:#666666">9. Strengthening technical support to Member States</span><span style><u></u><u></u></span></h3><p class="MsoNormal"><span style="font-size:13.5pt"><br>
</span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">The DG articulates a commitment to strengthening technical and policy support to member states and reports on a number of initiatives to this end. We commend this commitment and the progress which has been made. </span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">We appreciate that the value of policy dialogue at the country level including civil society is recognised and the new emphasis on the role of the WHO country office in promoting such dialogue. Community based NGOs can contribute to policy formation and to constituency development for policy implementation. </span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">We appreciate the commitment to refine the role of country cooperation strategies (CCS) in shaping the WHO work program and in particular the recognition that the objectives articulated in the CCS must be funded. PHM calls for greater accountability and transparency with respect to CCSs. </span><span style="font-size:13.5pt"><br>
<br></span><b><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">10. Staffing policy and practice </span></b><span style="font-size:13.5pt"><br><br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">The DG reports on a number of initiatives designed to promote improved staff performance, and a more flexible mobile workforce. </span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">WHO works in a complex and shifting environment and getting staffing policies and practices right is of critical importance for the organisation and for global health. There is a range of debates over regional representation, recruitment policies, types of employment and mobility. </span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">There are clear risks associated with the proposed move to short term contracts, greater mobility and contracting out. If these options have been subject to robust analysis and evaluation this work should be published. </span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">It will be difficult for member states to endorse a particular staffing strategy in the absence detailed description and evaluation of current practice and evaluation of options for policy reform. </span><span style="font-size:13.5pt"><u></u><u></u></span></p>
<h3><span style="font-size:12.0pt;font-family:"Arial","sans-serif";color:#666666">11. Financing dialogue</span><span style><u></u><u></u></span></h3><p class="MsoNormal"><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">The DG’s comments on results based financing and the so-called financing dialogue presume the continued freeze on increases in assessed contributions. This freeze is disabling WHO. We urge MS to re-open consideration of a substantial increase in assessed contributions. We urge donors to convert earmarked contributions to untied grants.</span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">The DG commits to ‘results-based budgeting and resource allocation’ based on the new (12th) general program of work (GPW). We have commented elsewhere that the outline GPW which has been published (</span><span style="font-size:13.5pt"><a href="http://apps.who.int/gb/ebwha/pdf_files/WHA65/A65_5Add1-en.pdf" target="_blank"><span style="font-size:11.5pt;font-family:"Arial","sans-serif";color:#1155cc">A65/5 Add1</span></a></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">) is completely silent with respect to planning for, budgeting for and accountability for cross-cutting issues such as the right to health, trade and health, gender equity and the social determinants of health. </span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">The discussion of the scheduling of governing body meetings and the timing of the financing dialogue highlights the power that donors will have over the Program Budget before it is adopted by the Assembly. This is not compatible with the claim that WHO is a MS driven organisation. </span><span style="font-size:13.5pt"><u></u><u></u></span></p>
<h3><span style="font-size:12.0pt;font-family:"Arial","sans-serif";color:#666666">13. Accountability, risk management, conflict of interest (COI) and ethics</span><span style><u></u><u></u></span></h3>
<p class="MsoNormal"><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">The DG provides a detailed discussion of conflict of interest and describes the role of the new Ethics Office in managing COI.</span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">The DG foreshadows a new transparency and disclosure policy to be unveiled at the EB in Jan 2013.</span><span style="font-size:13.5pt"><u></u><u></u></span></p>
<h3><span style="font-size:12.0pt;font-family:"Arial","sans-serif";color:#666666">15. Stage I of Independent Evaluation</span><span style><u></u><u></u></span></h3><p class="MsoNormal"><span style="font-size:13.5pt"><br>
</span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">The Assembly is invited to note the report of Stage I of the Independent Evaluation (mislabelled as A65/5 Add.2 and actually published on the </span><span style="font-size:13.5pt"><a href="http://www.who.int/dg/reform/evaluation_report_stage1_reform_proposals.pdf" target="_blank"><span style="font-size:11.5pt;font-family:"Arial","sans-serif";color:#1155cc">DG’s WHO Reform page</span></a> (<a href="http://www.who.int/dg/reform/evaluation_report_stage1_reform_proposals.pdf" target="_blank">http://www.who.int/dg/reform/evaluation_report_stage1_reform_proposals.pdf</a></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">). </span><span style="font-size:13.5pt"><u></u><u></u></span></p>
<h2><span style="font-size:14.5pt;font-family:"Arial","sans-serif"">Draft outline of General Program of Work (GPW), 2014-2019 </span><span style><a href="http://apps.who.int/gb/ebwha/pdf_files/WHA65/A65_5Add1-en.pdf" target="_blank"><span style="font-size:14.5pt;font-family:"Arial","sans-serif";color:#1155cc">Document A65/5 Add.1</span></a> (<a href="http://apps.who.int/gb/ebwha/pdf_files/WHA65/A65_5Add1-en.pdf" target="_blank">http://apps.who.int/gb/ebwha/pdf_files/WHA65/A65_5Add1-en.pdf</a></span><span style="font-size:14.5pt;font-family:"Arial","sans-serif"">)</span><span style><u></u><u></u></span></h2>
<p class="MsoNormal"><span style="font-size:13.5pt"><br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">This draft outline of the GPW 2014-19 is presented first to the PBAC and will then be considered by the Assembly. A more detailed version will be considered by the regional committees in late 2012; a revised version goes to by the PBAC in December 2012; and then to the EB in Jan 2013 and for final adoption by the Assembly in May 2013. </span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">The draft outline GPW is scheduled for discussion with the DG’s Consolidated Report on WHO Reform because it seeks to operationalise the principles developed in the WHO Reform discussions. </span><span style="font-size:13.5pt"><u></u><u></u></span></p>
<h3><span style="font-size:12.0pt;font-family:"Arial","sans-serif";color:#666666">PHM Comment: The ‘cross-cutting’ issues (in particular, social determinants, trade relations, the right to health, primary health care, gender equity) are completely neglected in this GPW and in the DG’s Consolidated Report.</span><span style><u></u><u></u></span></h3>
<p class="MsoNormal"><span style="font-size:13.5pt"><br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">PHM recognises the logic of adopting a particular set of categories for budgeting purposes. Such categories are always going to be arbitrary and carry the risk of privileging those categories as against alternative possible categorisations. </span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">A more coherent and integrated GPW requires effective planning, budgeting, evaluation and accountability mechanisms for the cross cutting issues as well as the ‘categories’ which are adopted as line items for budget purposes. </span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">These cross cutting issues include social determinants, trade, the right to health, primary health care and gender equity. In this GPW some of these issues are identified as over-arching principles (PHC and trade are completely absent) but there is nothing in the GPW or the DG’s Consolidated Report about strategic planning and accountability in relation to issues.</span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">The achievement of the right to health and gender equity for example can only be assessed in relation to what is happening on the ground in countries. There should be robust reporting from country and regional offices on the achievement of these objectives.</span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">WHO’s evaluation framework needs to make provision for meaningful evaluation in relation to all of the agreed cross cutting issues, at the global, regional and country levels including targets and milestones.. </span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">The planning function is also vulnerable in relation to the cross cutting issues. The draft GPW identifies Preparedness, Surveillance and Response as one of the five categories. The risk is that the cross cutting issues of human rights, the role of primary health care, gender issues and social determinants in epidemics and disasters will be neglected. Disasters, including ‘natural’ disasters always impact more devastatingly on the poor who suffer lack of basic housing and sanitation. </span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">The </span><span style="font-size:13.5pt"><a href="http://www.who.int/sdhconference/declaration/en/" target="_blank"><span style="font-size:11.5pt;font-family:"Arial","sans-serif";color:#1155cc">Rio Declaration on Social Determinants of Health</span></a></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif""> has called for monitoring and accountability mechanisms. (</span><span style>See a</span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">lso resolution </span><span style="font-size:13.5pt"><a href="http://apps.who.int/gb/ebwha/pdf_files/WHA62-REC1/WHA62_REC1-en-P2.pdf" target="_blank"><span style="font-size:11.5pt;font-family:"Arial","sans-serif";color:#1155cc">WHA62.14 on Reducing health inequities through action on the social determinants of health</span></a>, <a href="http://apps.who.int/gb/ebwha/pdf_files/WHA62-REC1/WHA62_REC1-en-P2.pdf" target="_blank">http://apps.who.int/gb/ebwha/pdf_files/WHA62-REC1/WHA62_REC1-en-P2.pdf</a></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">.) The WHO EB endorsed the Rio Declaration in its 130th session last January, and recommended to the 65th WHA a draft resolution text with that very content (</span><span style="font-size:13.5pt"><a href="http://apps.who.int/gb/ebwha/pdf_files/EB130/B130_R11-en.pdf" target="_blank"><span style="font-size:11.5pt;font-family:"Arial","sans-serif";color:#1155cc">EB130.R11</span></a></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">). </span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">There is no reference in the GPW to the issues of planning, evaluation and accountability in relation to SDH, at the time when MS are about to consider a draft resolution on the matter!</span><span style="font-size:13.5pt"><br>
<br><u></u><u></u></span></p><h2><span style="font-size:14.5pt;font-family:"Arial","sans-serif"">Stage I Evaluation Report on WHO Reform Program (ref. to </span><span style><a href="http://www.who.int/dg/reform/evaluation_report_stage1_reform_proposals.pdf" target="_blank"><span style="font-size:14.5pt;font-family:"Arial","sans-serif";color:#1155cc">A65/5Add. 2</span></a>, <a href="http://www.who.int/dg/reform/evaluation_report_stage1_reform_proposals.pdf" target="_blank">http://www.who.int/dg/reform/evaluation_report_stage1_reform_proposals.pdf</a></span><span style="font-size:14.5pt;font-family:"Arial","sans-serif"">)</span><span style><u></u><u></u></span></h2>
<p class="MsoNormal"><span style="font-size:13.5pt"><br></span><b><span style="font-family:"Arial","sans-serif";color:#666666">The issues before the Assembly </span></b><span style="font-size:13.5pt"><br>
</span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">At WHA64 a decision was taken to hold a special session of the EB in November 2011 and the DG was commissioned to prepare papers for this meeting. One of the papers circulated in July 2011 dealt with </span><span style="font-size:13.5pt"><a href="http://www.who.int/dg/reform/en_who_reform_evaluation.pdf" target="_blank"><span style="font-size:11.5pt;font-family:"Arial","sans-serif";color:#1155cc">evaluation</span></a></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">. These papers were reworked into a </span><span style="font-size:13.5pt"><a href="http://apps.who.int/gb/ebwha/pdf_files/EBSS/EBSS2_2-en.pdf" target="_blank"><span style="font-size:11.5pt;font-family:"Arial","sans-serif";color:#1155cc">single paper</span></a></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif""> for the EBSS. </span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">The EBSS (in </span><span style="font-size:13.5pt"><a href="http://apps.who.int/gb/ebwha/pdf_files/EBSS/EBSS2_DIV2-en.pdf" target="_blank"><span style="font-size:11.5pt;font-family:"Arial","sans-serif";color:#1155cc">EBSS2(3)</span></a></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">)</span><span style="font-size:13.5pt"><br>
<br><u></u><u></u></span></p><p style="margin-right:0cm;margin-bottom:0cm;margin-left:36.0pt;margin-bottom:.0001pt"><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">“4. Decided to proceed with an independent evaluation to provide input into the reform process through a two-stage approach, the first stage of which will consist of a review of existing information with a focus on financing challenges for the Organization, staffing issues, and internal governance of WHO by Member States, following up where possible to produce more information in response to questions arising from the Executive Board at its special session. Ideally, stage one should be completed in time for the Sixty-fifth World Health Assembly;”</span><span style="font-size:13.5pt"><u></u><u></u></span></p>
<p style="margin-right:0cm;margin-bottom:0cm;margin-left:36.0pt;margin-bottom:.0001pt"><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">“5. Decided further that the first stage review will also provide a roadmap for stage two of the evaluation, the goal of that second stage being to inform the Sixty-sixth World Health Assembly, through the Executive Board at its 132nd session, as an input into the general programme of work. Stage two of the evaluation will build on the results of stage one and further consultations with Member States, focusing in particular on the coherence between, and functioning of, the Organization’s three levels. As one input into reform, this evaluation will proceed in parallel to other aspects of the reform;’ </span><span style="font-size:13.5pt"><u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:13.5pt"><br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">An independent evaluation of the WHO reform process was conducted in February/March 2012 by the Comptroller and Auditor General of India. </span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">The Assembly is invited to note the findings of the (</span><span style="font-size:13.5pt"><a href="http://www.who.int/dg/reform/evaluation_report_stage1_reform_proposals.pdf" target="_blank"><span style="font-size:11.5pt;font-family:"Arial","sans-serif";color:#1155cc">Evaluation Report of Stage 1</span></a></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">) and recommendations, as well as the Roadmap for Stage II.</span><span style="font-size:13.5pt"><u></u><u></u></span></p>
<h3><span style="font-size:12.0pt;font-family:"Arial","sans-serif";color:#666666">PHM Comment</span><span style><u></u><u></u></span></h3><h4><span style="font-size:11.5pt;font-family:"Arial","sans-serif";font-weight:normal">The Evaluator has COMPLETELY failed to address the first term of reference. </span><span style><u></u><u></u></span></h4>
<p class="MsoNormal"><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">The team has undertaken an evaluation of the WHO Reform Program as implemented so far (see </span><span style="font-size:13.5pt"><a href="http://www.who.int/dg/reform/evaluation_report_stage1_reform_proposals.pdf" target="_blank"><span style="font-size:11.5pt;font-family:"Arial","sans-serif";color:#1155cc">Stage I Evaluation Report</span></a></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">, from page 57). This they were not asked to do; at least, not by the Executive Board. The (unmandated) evaluation of the Reform Program is very positive. </span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">The evaluator has created a new set of terms of reference for the evaluation which bear no relationship to those adopted by the EB (see page 9). </span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">He has not reviewed the existing information with respect to finance, staffing and internal governance. This he was asked to do.</span><span style="font-size:13.5pt"><br>
<br></span><span style="font-size:11.5pt;font-family:"Arial","sans-serif"">He has provided a ‘road map’ for Stage II of the Evaluation (which was part of the brief) but in view of his very positive assessment of the reform process to date - an assessment which was not commissioned by the EB - it would seem unwise to proceed on the basis of his advice (unless with extreme caution) and unwise to rely on him to undertake the next stage of the evaluation.</span> <u></u><u></u></p>
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