WHO reform is among the hot topics for consideration at the 130th session of the WHO Executive Board which meets from 16 January 2012 to 23 January 2012. One paper in particular, EB130/5 Add.4, entitled, “Governance: Promoting engagement with other stakeholders and involvement with and oversight of partnerships” describes how WHO may re-assess its relationship with non-governmental organizations including,
(i) widening and improving the modalities for the participation of nongovernmental organizations at regional and global governing body meetings;
(ii) seeking the views of nongovernmental organizations in the development of new health policies and strategies; and (iii) updating practices and criteria for accreditation. In relation to the last point, the review will consider ways of differentiating between the different types of
nongovernmental organizations that interact with WHO.
In framing its relationship with intergovernmental organizations and non-governmental organizations, the paper cites Article 2 of the WHO Constitution which delineates WHO’s functions:
to act as the directing and coordinating authority on international health work; and (b) to establish and maintain effective collaboration with the United Nations, specialized agencies, governmental health administrations, professional groups and such other organizations as may be deemed appropriate.
The paper further notes that,
4. In order for WHO to play its directing, coordinating and collaborating role, the Organization needs strong links, cooperation and engagement with the increasing range and number of stakeholders. These relationships, however, must respect the primary role of the Member States, clearly contribute to WHO’s mandate and avoid conflicts of interest.5. In 1948 stakeholders in global health were few, and only three types were categorized in WHO’s Constitution: governments, intergovernmental organizations and nongovernmental organizations. Today’s global health landscape is different and more complex than when WHO was founded. Yet given WHO’s leadership role in global health governance, the Organization’s need to engage with other stakeholders is more critical and relevant than ever. Current rules and practices now apply only to a small fraction of the multiple stakeholders. In some cases, clear principles, policies or frameworks approved by the governing bodies already exist; in others, further work is needed to define such frameworks and present them for consideration by the governing bodies. Frameworks for engagement and cooperation should reflect the nature and particular contribution that different categories of stakeholders can make to the pursuit by WHO of its constitutional mandate, while safeguarding the integrity of WHO’s technical and normative work and minimizing the risk of conflicts of interest.
At the November 2011 special session of the WHO Executive Board, EB members agreed in decision EBSS2(2) that engagement with non-state actors be guided by the following principles,
- the intergovernmental nature of WHO’s decision-making remains paramount; 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;
- any new initiative must have clear benefits and add value in terms of enriching policy or increasing national capacity from a public health perspective;
- building on existing mechanisms should take precedence over creating new forums, meetings or structures, with a clear analysis provided of how any additional costs can lead to better outcomes.
WHO’s paper on engagement with non-state actors notes that the procedures governing relations with NGOs are set by WHA resolution 40.25 adopted by the 40th World Health Assembly in 1987. The paper recognizes that the “principles need to be updated in order to reflect better the increasingly important role now played by nongovernmental organizations”.
For partnerships, the paper notes that no specific provisions exist in the Constitution that govern WHO’s relations with private for-profit organizations; not-for-profit philanthropies and public–private partnerships. The paper states that WHO member states indicated their desire to have greater involvement with the oversight of partnerships and have expressed the view that the WHO Standing Committee on Nongovernmental Organizations is not a suitable instrument for considering WHO’s involvement with formal partnerships or for providing oversight”. The Secretariat paper suggests that the Executive Board take a more pro-active role in the oversight of partnerships by stating,
the Board may wish to include regularly in its agenda an item on partnerships, under which it would establish a dialogue with formal partnerships. This would create the possibility of greater oversight by Member States of the involvement of WHO in formal partnerships, while achieving a higher level of engagement with important international health initiatives and aiming at coordination between their activities and those of WHO.
One wonders what form the envisioned “dialogue with formal partnerships” will take in achieving the goal of increased levels coordination and engagement between the WHO and international health initiatives.
In terms of pathways for increased engagement with NGOs, private, for-profit sector as well as not-for-profit philanthropic organizations, the WHO secretariat provides the following two proposals for the WHO Executive Board to consider and provide guidance on.
(a) To review and update the principles governing WHO’s relations with nongovernmental organizations. The review will consider (i) widening and improving the modalities for the participation of nongovernmental organizations at regional and global governing body meetings;(ii) seeking the views of nongovernmental organizations in the development of new health policies and strategies; and (iii) updating practices and criteria for accreditation. In relation to the last point, the review will consider ways of differentiating between the different types of nongovernmental organizations that interact with WHO.
(b) To develop comprehensive policy frameworks to guide interaction with the private, for-profit sector as well as not-for-profit philanthropic organizations. The proposed frameworks should, inter alia, tackle the issue of institutional conflicts of interest.