Editorial: The World Health Organization, its reform and its relevance

Dear reader,

Last week the Executive Board (EB) of the World Health Organisation conducted its 130th session. This board, consisting of 34 member states, governs the organisation on behalf of the World Health Assembly, the overall governing body of the WHO that consists of 194 member states. Last week the EB had to provide guidance for and decide on several elements of reform that the organisation requires. Over the last 20 years WHO has become “outpaced” by other actors in the growing global health arena, including global health initiatives like the Global Fund on AIDS, Tuberculosis and Malaria, the World Bank, philanthropists like the Bill and Melinda Gates foundation, but also other UN Agencies as UNAIDS, UNFPA and UNICEF.

The reform, that has become somewhat a process in its own, was during the EB discussed in the sub-themes “priority setting for the Organisation”, “internal governance and the relation with external stakeholders like companies and NGOs”, and “financing, management and evaluation”. I will not go into detail on the reason and background of the reform, the precise content of the last EB discussions and its outcomes, as these have already been extensively covered by others such as WHO Watch, Medicus Mundi International, the Centre for Global Health Policy and Innovation and the Global Health Diplomacy Network.

I take a step backward and look to the process. The WHO functioning, necessary reforms and more precisely its lack of available and predictable financing for core tasks have been already discussed since two years. What can be observed is that after a formal reform process, a special session of the EB in November 2011, discussions at the regional committees of the WHO and numerous consultations and background papers further …so little progress is made: The 130th EB only decided that an intergovernmental working group will develop further criteria for priority setting in February 2012; that a new consolidated document for the World Health Assembly 2012 will be prepared with a more detailed proposal for stakeholder engagement; and thirdly that a new financing mechanism (a financing dialogue and pledging conference) will be further elaborated. One could assess this process from two sides; either you see it that the member states taken it very serious and cautious; hence moving on a step-by-step approach to strengthen the constitutional mandated leader in global health; or that WHO currently lacks real relevance in global geo-politics.

Will WHO remain relevant? That’s hard to say. Last week Margaret Chan was re-elected for her second five-year term as Director General of the WHO. She was the only candidate for the post. This indicates that member states choose for a technocratic option for the WHO in this time of reform, rather than to play a political power play over leadership.

The question is whether the UN system in itself is still considered as relevant. In a multi-polar world order much pressing global issues are discussed under the G20 umbrella and directly between regional blocks (like EU, UNASUR and ASEAN). Ban-Ki-Moon, the UN Secretary General also recently elected for a second five year term, highlights the challenges coming ahead for the UN system, with its 15-member security council remaining deadlocked. The current financial austerity will affect considerably the voluntary contributions from member states and donors to several UN agencies. While the health focus on WHO has broadened to areas like health systems strengthening, the social determinants of health and NCDs, its traditional focus on infectious disease control, elimination and eradication (e.g. smallpox, malaria, polio) in “developing” countries has proportionally reduced. WHOs current focus is less on health security and more on health development, where equity and human rights are important values. States tend to act in terms of (their own) security and it takes true courage for statesmen to bridge this paradigm and propagate a global good.

Remco van de Pas, Wemos
remco.van.de.pas@wemos.nl 

Extended version with references:
http://bit.ly/xOa6vg

Network Events

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Network events: Medicus Mundi International Network
Board meeting in Basel, 16 March 2012
Annual Assembly in Geneva, 25 May 2012

The Board meeting in March will focus on reviewing and steering the implementation of the MMI strategy 2011-15 and the three Network programs defined so far. We will also hold a re-launching event of a wider MMI research working group as a side event to the Board meeting in March. An invitation for this half-day side event to the Board meeting will be sent to all Network members and those partners having shown their interest in developing a NGO-Research interface. The group, supported by the Board members, will develop a proper work plan, and we will have talks and a visit at Swiss Tropical and Public Health Institute in order to see how they do operational research and what they could offer to the MMI Network and its members.

As usually, the Annual Assembly of the Medicus Mundi International Network will take place in the week of the World Health Assembly. We will meet at the Ecumenical Institute Château de Bossey, a beautiful venue a few kilometres outside Geneva.

Mark the dates!

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Network event: Medicus Mundi Switzerland
A critical shift to chronic conditions: Learning from the frontliners
Geneva Health Forum, 18-20 April 2012

”This year’s theme of the Geneva Health Forum is the result of a consultative process involving hundreds of previous participants and partners. While there have been several calls to action, aiming at raising the profile of non communicable diseases, very little has been heard from those at the frontlines. Those, who are already active all over the world in this field, dealing with both chronic communicable and non-communicable diseases. We intend to give them a voice and keep the health debates pragmatic and grounded in action.” The Geneva Health Forum is organized by the Division of International and Humanitarian Medicine at the Hospitals of the University of Geneva, a member of Medicus Mundi Switzerland

www.ghf12.org

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Network event: Medicus Mundi International Network
Third People’s Health Assembly
Cape Town, 6-11 July 2012

The People’s Health Assembly (PHA) is a global event bringing together health activists from across the world to share experiences, analyse the global health situation, and develop civil society positions which promote health for all. It is an opportunity to reassess, redirect and re-inspire, organized by the People’s Health Movement. “PHA3 is not just about developing our movement. It is also about impacting directly in the struggle for social justice: health for all, decent living conditions for all, work in dignity for all, equity and environmental justice.” (People’s Health Movement) The Medicus Mundi International Network plans to participate in the People’s Health Assembly. Details will be communicated after the Board meeting in March.

www.phmovement.org/en/pha3

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Network News and Resources

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MMI Network campaign: Medicus Mundi Switzerland
Do not resolve the Swiss health personal crisis at the expense of the poorest

“Together with a broad coalition the Network Medicus Mundi Switzerland launched a manifesto that addresses the worldwide need for properly trained healthcare professionals and urges Swiss stakeholders to implement the WHO Code of practice on the international recruitment of health personnel. Within the coalition organisations focusing on international health cooperation worked together with professional associations (such as the Swiss Medical Association or the Swiss Nurses) and trade unions. The media coverage exceeds the coalition’s expectations. Newspapers, the national TV and Radio covered the issue

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MMI Network campaign
WHO Watch: great work at EB meeting facilitated by Medicus Mundi International

The 130th session of the WHO Executive Board that closed on Monday was again followed by a group of young “WHO Watchers” trained and coordinated by the People’s Health Movement and supported by various civil society organizations and networks such as the Medicus Mundi International Network. This year, together with the World Council of Churches’ “Churches Action for Health” program, MMI facilitated the work of the watchers by hosting a group of watchers in the MMI delegation and forwarding jointly developed statements on various technical items and on the WHO reform.

 

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MMI Network report: Medicus Mundi Spain
Health in development cooperation and human action. Report 2011

The 10th annual report “La salud en la cooperación al desarrollo y la acción humanitaria” on health and development cooperation published by Medicus Mundi Spain together with MdM Spain and Prosalus. The report 2011 is focusing on Spanish development cooperation but drawing a broad picture of international health development and health development policy. Among the topics highlighted the report: human resources for health; social determinants of health and health in all policies; WHO reform – towards privatization of global health? The original report (Spanish language) can be found on the website of Medicus Mundi Spain.

www.medicusmundi.es

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MMI Network report: ACHAP and EPN
Faith-inspired health care providers in Africa: targeting the poor?

“Faith-inspired institutions (FIIs) state as their mission the aim to provide quality health services to all, and in particular to serve the poor or the rural poor. Are FIIs then more willing to (cross)subsidize services for those who can least afford such services? And do FIIs serve the (rural) poor more or better than other providers?
The article by Jill Olivier and Quentin Wodonion is one of many interesting contributions to: FBOs on a mission. 30 years of supporting pharmaceutical services. WCC Contact magazine No. 193, September 2011 (download: 4.5 MB).

www.oikoumene.org

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MMI Network report: Medicus Mundi Italy
40 years dedicated to international health care cooperation

That fine “thick black book” with all its information, testimonies and photographic documentation about 40 years of activity of Medicus Mundi Italy is now available online.

www.medicusmundi.it

Global Health: MMI updates

Bits and pieces of news on international health policy. Each “MMI update” is 140 characters or less – these are the rules of the game on twitter. Just enough for a headline, eventually an author, a date, the source – and a link to the website where you find the full information. Have a look at some of our “tweets” published during the last month. As usual, it’s a bit much, so take it or leave it.

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Human resources for health
Migration of health personnel

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Social determinants of health
Equity and universal coverage

 

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Non-communicable diseases
Mental health

 

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WHO reform

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International cooperation
Global health governance

 

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Debate on international NGOs
in: The Broker (and others)

 

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UN Rio+20 Conference
Sustainable development – and health?

 

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Health in emergencies and fragile states

 

Neglected tropical diseases

 

Global health in 2011
End of the year reviews

 

Other topics

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https://twitter.com/mmi_updates