WHO adopted a “Framework of engagement with non-State actors”

Dear reader,

As they were about to conclude the work of the 69th World Health Assembly (WHA), Member States of the World Health Organization adopted a “Framework of collaboration with non-State actors”, under applause by national delegates. A standing ovation followed for Julio Mercado, the Argentine president of the drafting group, which had met every day during the week to reach a consensus among Member States. Known as FENSA, the framework is meant to enable WHO to develop its relations with NGOs, corporations, philanthropic foundations and academic institutions, while preserving its intergovernmental character, independence and integrity.

The excitement surrounding the adoption expressed relief at the end of a five-year process, but also pride at seeing WHO tackle the thorny issue of private sector participation, which many UN agencies face in a context of scarce resources.

However, some NGOs did not fail to highlight the shortcomings of the text (cf. WHA statements by IBFAN, HAI, MMI, TWN and PHM as well as a joint public statement published during the WHA). Some important progress was done in the last rounds of negotiations, for example a prohibition on private-sector staff secondment to WHO. But other issues were not satisfactorily resolved, such as an inadequate definition of conflicts of interest, a risk of undue private-sector influence on normative work, or a lack of debate around the expending role of philanthropic foundations. The Bill and Melinda Gates Foundation is now the second largest financial contributor to WHO, behind the US. Since it allocates its funds to specific programs, in accordance with its own priorities, the foundation has already gained influence on the operations of an intergovernmental organization.

What becomes of these risks to the credibility and independence of WHO and global public health now depends largely on the implementation of the framework. An onerous task awaits the WHO Secretariat, including his future Director General who will be elected next year. WHO should allocate enough resources and staff to evaluate its collaborations with the private sector. Employees should be trained in the management of conflicts of interest. Transparency requirements should be forcefully implemented, especially in the absence of competent judicial scrutiny. National governments and delegations should be held to the same standards as well. But the framework should also help increase wide-range democratic consultation. For example, adequate provisions should foster the participation of less well-endowed civil-society organizations. In all areas, the willingness of Member States to contribute to the policies they have negotiated will be crucial.

Health policies are grounded on trust. When suspicions of collusion fall on global health messages, they lose their force, as we saw in the aftermath of the H1N1 scare. The implementation of the framework should be seen as an opportunity to increase trust and improve governance, and not just resources. Otherwise risks for WHO’s legitimacy and policies could be great. By negotiating and adopting FENSA, Member States of the World Health Organization endorsed its openness to civil society and the private sector, while reaffirming their grip on the governance bodies. It is now up to them to give WHO the means to implement FENSA, but also to promote more health democracy globally. The role of civil society organizations to remind them of their responsibilities and to critically watch FENSA implementation will be crucial.

Guest editorial by Auriane Guilbaud

Associate Professor of Political Science
Université Paris 8, Institut d’Etudes Européennes
Member of the MMI delegation at the World Health Assembly

 

MMI Network: News, events, papers and reports

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Network event: Medicus Mundi Switzerland
Health in fragile contexts
Bern, 24 August 2016

“In an increasing number of countries the implementation of health programmes is challenged by fragile contexts. At the same time, fragility of a state is considered as one of the main causes for malfunctioning health services. Emergency situations aggravate such situation and reveal the weaknesses of the system. These settings evoke not only questions on how to adapt to shaking working environment or on sustainability, but also whether health programmes could make a contribution to reduce fragility.” Organizers: Swiss Red Cross, Swiss Agency for Development and Cooperation and Network Medicus Mundi Switzerland.

> www.medicusmundi.ch/en/conference/conference-on-health-in-fragile-contexts

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Network news: Medicus Mundi Spain
Medicus Mundi Spain was awarded the WHO Sasakawa Health Prize for its work in the transformation of public health systems

Geneva, 27 May 2016. In a ceremony at the 69th World Health Assembly, the World Health Organisation (WHO) has awarded the Sasakawa Health Prize 2016 to Medicus Mundi Spain (FAMME) for its project entitled “The Transformation of Public Health Systems Based on the principles of Primary Health Care (PHC)”, thanks to the initiative of the Spain’s Ministry for Health.

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Network news: DWA Cuamm
Pope Francis received CUAMM: “Health is not a consumer good, but rather a universal right”

Rome, 7 May 2016. “Doctors with Africa CUAMM met with Pope Francis in a special papal audience with were more than 9,000 supporters and friends of CUAMM from all over Italy and elsewhere. In his remarks to CUAMM Pope Francis said: ‘In the wake of these great witnesses of missionary and evangelically fruitful closeness, you carry on your work with courage, giving expression to a Church that is not a clinic exclusively for super A-list VIPs, but rather a ‘field hospital’: a Church with a great heart, close to the many wounded and humiliated of history, to the poorest of the poor'”

> www.medicusmundi.org/en/contributions/conference-report/2016/pope-francis-received-cuamm

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Conference report: MMI, Medicus Mundi Switzerland, Cordaid
Promoting access to health in fragile contexts: What role for international cooperation?

Geneva, 28 May 2016. As a side event to the General Assembly of the MMI Network – which itself took place on the last day of the 69th World Health Assembly -, the Network Medicus Mundi Switzerland in cooperation with the Swiss Red Cross (a member of MMS) and Cordaid co-hosted a public workshop on challenges and policies for international health cooperation in fragile contexts.

Workshop documentation: www.medicusmundi.org/en/contributions/events/2016/WS2016
> Assembly documentation: www.medicusmundi.org/en/contributions/events/2016/GA2016

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Network paper: medico international
Resilience: Fit for Disaster

“Sustainable development”, at least, was driven by the idea to actively and politically shape the world. Conversely, the concept of resilience is only about making people fit for survival. The introductory lecture given by Thomas Gebauer, director of medico international, at the “Fit for Disaster” symposium organised by medico in June 2015 is now available in English.

> https://www.medico.de/en/fit-for-disaster-16434/

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Network paper: Ecumenical Pharmaceutical Network
EPN strategy for 2016-2020

“The strategy of the Ecumenical Pharmaceutical Network for 2016-2020 builds on the achievements of the previous strategy period while also addressing the factors that compromised success in the previous period. For example, EPN will review its approach to advocacy, investing more in campaigning in addition to lobbying. The organization will also tackle the issue of lack of skilled human resources in pharmaceutical services in Africa. The areas of EPN’s expertise can be used as entry points for addressing broader issues in pharmaceutical service delivery in churches. The ultimate goal is to support the achievement of higher levels of efficiency and effectiveness that benefit the patient.”

> http://www.epnetwork.org/en/about-epn/strategy

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Network reporting: Network members
Annual Reports 2015

First Annual Reports 2015 of Network members are published on the organizations’ website. Have a look at them – and let us know when further reports (or further language version of the current reports) are available.

Contributions (“short stories”) of MMI Network members to the Annual Report of the MMI Network have been published in the May issue of the Network news.