Info Service on Health Issues (Jan15/05)
WHO: Secretariat ignores requirement of review report on GSPOA
Geneva, 29 January (K. M. Gopakumar) – The World Health Organization’s Secretariat has failed to submit a review report on the implementation of the Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property.
A decision of the World Health Assembly (WHA62.16) requested the WHO Director-General (DG) “to conduct an overall programme review of the global strategy and plan of action in 2014 on its achievements, remaining challenges and recommendations on the way forward to the Health Assembly in 2015”.
However, the document prepared by the Secretariat (EB 136/31) for the on-going 136th session of the EB acknowledges the fact of the decision but does not provide any such review report. (http://apps.who.int/gb/ebwha/pdf_files/EB136/B136_31-en.pdf). The Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property (GSPOA) was adopted in 2008.
The WHO Executive Board (EB) is meeting from 26 January to 3 February at the WHO Headquarters in Geneva. This issue is expected to be discussed late evening of 29 January or on 30 January.
The Secretariat document (EB 136/31) states: “In resolution WHA62.16, the Director-General was requested, inter alia, to conduct an overall programme review of the global strategy and plan of action in 2014 on its achievements, remaining challenges and recommendations on the way forward to the Health Assembly in 2015 through the Executive Board. At its 133rd session, the Executive Board endorsed the approach proposed by the Secretariat for the evaluation exercise, including to combine the evaluation with the overall programme review”.
Thus the report implicitly conveys the message that even though there is a WHA resolution request, since the EB approved the submission of the evaluation report in 2017 there is no need for a review report for the 2015 WHA.
The same document (EB 136/31) now before the EB provides a footnote referencing the records of the 133rd EB session and the preparatory document for the 133rd session (EB 133/7: http://apps.who.int/gb/ebwha/pdf_files/EB133/B133_7-en.pdf).
Interestingly, the document EB 133/7 proposed: “The Executive Board is requested to note the report and endorse the suggested approach for the evaluation exercise”. However, the timeline of the evaluation was shifted to 2017.
The summary record of the EB at its 133rd session shows that there was an agreement to provide a progress report (see section 1 of document EB133/2013/REC/1:http://apps.who.int/gb/ebwha/pdf_files/EB133-REC1/B133_REC1-en.pdf). The EB chair had orally proposed the decision. The summary of records on page 84 states:
“The CHAIRMAN said that it was her understanding that the Board wished to request the Secretariat to prepare a progress report for consideration by the governing bodies in 2015, on the understanding that a report on a comprehensive independent evaluation would be submitted for consideration in 2017. If there was no objection, she would assume that, the Board, taking into account the discussion at its 133rd session, was prepared to note the report and endorse the suggested approach for the evaluation exercise, including in respect of reporting arrangements.
It was so agreed.”
Thus the summary record clearly shows that there was no formal decision regarding the evaluation of the GSPOA. During the discussion of the EB at that time both South Africa and Argentina raised the issue of review under resolution WHA66.16.
South Africa requested “clarification of the implications of an extension in the reporting deadline on existing resolutions, including resolution WHA62.16, which further requested the Director-General, in addition to continued monitoring, to conduct an overall programme review of the global strategy and plan of action in 2014 on its achievements, remaining challenges and recommendations on the way forward to the Health Assembly in 2015”.
Argentina said that, “notwithstanding the practical difficulties of reporting on 2015 in that year, Argentina would appreciate a progress report in 2015. He asked whether Board members would volunteer or be invited to participate in the Evaluation Monitoring Group”.
The summary record also shows that prior to the summing up by the Chair, the DG had indeed agreed to a report in 2015. It reads:
“The DIRECTOR-GENERAL said that it was important to be mindful of reporting requirements given to the Secretariat in resolutions adopted at previous governing body meetings. However, coherence was crucial. Paragraph 6 of resolution WHA62.16 requested the Director-General, in addition to continued monitoring, to conduct an overall programme review of the global strategy and plan of action in 2014 on its achievements, remaining challenges and recommendations on the way forward to the Health Assembly in 2015. The Secretariat was now being requested to perform an independent evaluation and produce the report in 2015. The Secretariat could do what was asked of it only if the financial resources were available. She suggested that a progress report might be produced in 2015, paving the way for a later report of the comprehensive, independent evaluation”. (Emphasis added.)
The above quoted summary record shows that the 133rd EB had decided to have a progress report to be submitted at the 135rd EB session. Instead of a comprehensive review report, the EB agreed to receive a progress report even though resolution WHA62.16 has explicitly requested the DG to conduct a programme a review of the GSPOA containing “achievements, remaining challenges and recommendations on the way forward to the Health Assembly in 2015”.
The non-compliance with the requirement under resolution WHA 62.16 raises serious questions of governance and legal questions with regard to the binding nature of a WHA resolution on the Secretariat. It also questions whether a mandate for a review under a WHA resolution can be overruled by a decision of the EB. The ministerial level WHA is considered as the highest decision making body under the WHO Constitution and representing 192 Member States while the EB comprises only 34 Member States.
Another important issue related to the evaluation is the terms of reference (ToR) for the evaluation and the agency or actors to conduct the evaluation.
The EB document 136/31 provides only the time line of the evaluation and simply states the establishment of an evaluation management group in January 2015 and finalisation and approval of the ToR in March 2015. Further, the document makes a vague statement that “The Secretariat will ensure the involvement of relevant stakeholders throughout the evaluation process”.
However the summary of records of the 133rd EB session is revealing. In response to a pointed question from the delegate of Brazil on “whether the terms of reference developed would be submitted at the next session of the Board for approval” the DG said as follows:
“ … draft terms of reference would be prepared by the Secretariat on the basis of comments made, and submitted to the Evaluation Monitoring Group. Those terms of reference could be submitted to the Board at its next session for approval, but in view of time constraints, it would then not be possible to submit the final evaluation report in 2015”.
However, there is no ToR before the consideration of the current 136th Session of EB and the document 136/31 does not give any indication that the Secretariat will submit the ToR to the constitutionally-created governing WHO bodies such as the EB and WHA.
Another concern is the nature of the agency which is going to conduct the evaluation. A WHO official familiar with the issue told Third World Network that the evaluation will be given to a successful bidder of a tender. The time line document also states that in March 2015 the Secretariat would “request proposals for potential members of the evaluation team”.
From past experience, this means that mostly management consultancy firms would conduct the evaluation. Many developing country Member States do not want an evaluation to be conducted by a management consultancy firm. They prefer a panel of Member States or a panel of experts to conduct the evaluation.
A draft decision at the on-going EB session jointly proposed by Argentina, Brazil, India and South Africa proposes that “the Evaluation Management Group will be composed of 4 Member States from each region, in a transparent manner”. (http://apps.who.int/gb/ebwha/pdf_files/EB136/B136_CONF7-en.pdf)
To counter this proposal, developed countries are proposing an amendment to the above draft decision. According to the proposed amendments, the evaluation should be conducted as per the WHO Evaluation Policy and WHO Evaluation Practice Handbook. It further proposes the creation of an Evaluation Management Group (EMG), which includes the members of the EB Bureau and the four evaluation experts appointed by the Secretariat. These experts could be from the United Nations Evaluation Group or the Joint Inspection Unit.
Another important issue is the extension of the implementation of the plan of action of the GSPOA. The draft decision proposed by Argentina, Brazil, India and South Africa proposes an extension of the plan action from 2015 to 2022. According to the original WHA resolution the implementation of the plan of action ends in 2015.
Third World Network learned that there is an emerging consensus for the extension of the plan of action.+
(Edited by Chee Yoke Ling)