Currently, the participation of non-State actors in official relations with the World Health Organization (WHO) is regulated by the WHO’s Framework of Engagement with non-State actors (FENSA) which is “a privilege that the Executive Board may grant to nongovernmental organizations, international business associations and philanthropic foundations that have had and continue to have a sustained and systematic engagement in the interest of the Organization” (Source: WHO reform, Involvement of non-State actors in WHO’s governing bodies, EB146/3).
Document EB146/33 on WHO reform notes the following:
Although the practice of non-State actors in official relations addressing WHO governing bodies after Member State representatives have taken the floor on a given topic has served the Organization well for several decades,the increasing number of non-State actors participating and subsequent rise in requests to speak has not resulted in a more meaningful involvement. When a large number of non-State actors speak one-by-one at the end of a discussion, their interventions have little impact on the content or direction of the debate.
In terms of reform, the WHO secretariat proposes that the new modalities governing the engagement of non-State actors engagement at WHO governing bodies including the World Health Assembly and the Executive Board be piloted at the Seventy-third Assembly (2020) or the Seventy-fourth Assembly (2021).
The proposed changes include the following:
An informal meeting between Member States and non-State actors in official relations, including multiple side events and a forum with WHO technical programmes and regions,could be organized in parallel to sessions of the Programme Budget and Administration Committee of the Executive Board,continuing into the weekend preceding the Health Assembly. This would allow for more in-depth exchanges between non-State actors, WHO technical units, WHO regional and country offices and Member States, and would provide an opportunity for non-State actors to consult with each other, form groups and prepare joint statement.
Non-State actors could choose the agenda items on which a maximum of five joint statements would be delivered early in the debate. The statements would be subject to the same time limit as that allocated to representatives of Member States and the opportunity to speak would be given at the discretion of the Chair of the meeting. Such joint statements must represent the views of broad constituencies of non-State actors in official relations with WHO. For agenda items on which joint statements are given, there will be no possibility for individual statements from non-State actors, although those could still be posted on the WHO website prior to the debate. For agenda items where non-State actors choose not to deliver joint statements, previous practice would apply, with a maximum of seven individual statements on a first-come-first-served basis at the end of the debate. The Secretariat would make an initial proposal regarding the agenda items likely to attract the most interest for joint statements. This proposal could be subject to change, with the non-State actors’ agreement
The joint constituencies model envisioned by the Secretariat is more akin to the practice at global health agencies including the Global Fund to Fight AIDS, Tuberculosis and Malaria, GAVI, and Unitaid.
The WHO Secretariat proposed the following types of constituencies: “constituencies by topic of interest, where non-State actors could participate in three to five groups; areas of mutual interest or expertise; WHO operational areas; or technical topics aligned to the work of WHO divisions. Geographical representation should not be overlooked”.
In terms of individual statements delivered by a non-State Actor (NSA) at WHO governing bodies meetings, WHO proposed limiting the number of interventions to a “maximum of three per non-State actor.” In terms of delegation size, the WHO secretariat proposed capping the size of NSA delegations to a “maximum of 25 delegates”.