TWN Info Service on Health Issues (Jan17/02)
19 Jan, Geneva (TWN): World Health Organization (WHO) Member States raised the issue of information deficit to make decisions on official relations with Non-State Actors on the first day of the on-going meeting of the Programme, Budget and Administration Committee (PBAC).
Member States are expected to make several decisions this week but the information available to them is insufficient. The PBAC is scheduled to make recommendations to the WHO Executive Board regarding the Organization’s official relations with a number of non-State actors (NSAs).
The 22nd Meeting of the PBAC is taking place on 18-20 January. The 140th Executive Board meeting is scheduled for 23 January to 1 February. Both meetings are at the WHO headquarters in Geneva and will address the issue of entities in official relations with the Organization.
The Secretariat’s initial response was that there is no need to share with Member States the joint action plan submitted by NSAs as evidence of their collaboration with WHO. However they acknowledged the mistake after a developing country Member State read out the relevant provisions of the Overarching Framework on Engagement with Non-State Actors (FENSA) that was adopted in 2016 following intense multi-year negotiations.
FENSA allows nongovernmental organizations (NGOs), international business associations and philanthropic foundations to enter into official relations with WHO. One of the essential conditions for entering into official relations is a joint work plan for the collaboration between WHO and the entity applying for official relations.
Third World Network learned that the Secretariat has now agreed to share the work plans and other relevant information by Friday, 20 January. Germany also raised concerns over the delay in releasing the relevant document EB 140/42 (http://apps.who.int/gb/ebwha/pdf_files/EB140/B140_42-en.pdf), which gives a very small window for analysing the document.
The PBAC is to consider the following proposed decisions contained in document EB 140/42 based on the WHO Secretariat’s triennial review (2014-2016) of the collaboration with NSAs in official relations with WHO:
The review of collaboration with NSAs during 2014-2016 covered 74 entities. This exercise is in accordance with the FENSA, whereby the EB, through its PBAC, shall review collaboration with each NSA in official relations every three years and shall decide on the desirability of maintaining official relations or defer the decision on the review to the following year. The EB’s review shall be spread over a three-year period, one third of the entities in official relations being reviewed each year.
The joint work plan for the collaboration between WHO and the entity applying for official relations is a crucial condition and accordingly needs to be assessed by Member States. This is because a joint work plan bears the risk of drawing up a work programme that involves conflicts of interest or is against the provisions of FENSA. In the past, joint work plans have shown conflicts of interest, and activities involving norms and standard setting. Paragraph 5 of FENSA lists the overarching principles of engagement. One of these is to “protect WHO from any undue influence, in particular on the processes in setting and applying policies, norms and standards”.
For instance, the joint work plan between the Global Medical
Technology Alliance and WHO as part of the documentation for the consideration
of the Standing Committee on NGOs states: “Promote the safe use of medical
devices through compiling and distributing materials and training on the safe
use and proper disposal of medical devices for health care professionals,
through the Alliance member associations” (http://apps.who.int/gb/NGO/pdf/B136_NGO_11-en.pdf).
This implies that a trade association would work with the WHO to promote use of
medical devices through compiling and distributing materials. This would
clearly result in economic benefits to the members of the association. It
would also result in unnecessary promotion of the use of medical devices
without adequate evidence and putting commercial interests above public health
(see Concerns that “official relations” are used for promoting business
In 2016, the EB allowed official relations with Micro Nutrient Initiative, a private sector partnership. The Initiative’s Board of Directors include Robert Black, who is a member of the Nestle Creating Shared value council (http://www.nestle.com/csv/what-is-csv/governance). Micro Nutrient Initiative’s earlier President Vankatesh Mannar is also a member of the Nestle Creating Shared value council. The joint work programme includes activities which clearly fall within the area of norms and standard setting, such as a publication for decision-makers on the prevention and control of anaemia, and a framework for assessing and establishing surveillance systems to monitor the achievement of nutrition targets at the country level.
Until 2016 the scrutiny of applications for official relations and renewal of official relations every three years was by the Standing Committee on NGOs. After the adoption of FENSA this function is handed over to PBAC.
The Secretariat has not provided sufficient information to Member States to make a judgment on whether a particular joint work programme complies with the provisions of FENSA. In order to ensure transparency with regard to joint work plans paragraph 52 of FENSA states that, “Official relations shall be based on a plan for collaboration between WHO and the entity with agreed objectives and outlining activities for the coming three-year period structured in accordance with the General Programme of Work and Programme budget and consistent with this framework. This plan shall also be published in the WHO register of non-State actors”.
However, the Secretariat has not published the joint work programmes of five new entities seeking official relations as well as 58 organisations seeking for renewal of official relations in WHO’s register for NSAs. Instead of making available the joint work programmes the Secretariat provides only a summary with regard to the five new entities seeking official relation. As for the 58 entities seeking renewal of official relations even the summary is not available in the public domain.
[The Secretariat started publishing the joint work programmes since 2015. Agreed programmes prior to 2015 are not publicly available: http://apps.who.int/gb/NGO/]
Further, paragraph 52 of FENSA also states that, “These plans shall be free from concerns which are primarily of a commercial or profit-making nature”. It would be almost impossible for Member States to verify whether a joint work plan satisfies the abovementioned conditions in the absence of access to the full version of the joint work plan.
This year’s joint work plans could raise such concerns. For instance, Bill & Melinda Gates Foundation, the second largest donor to WHO, is seeking official relations. Interestingly, the financial statement contains only two entries viz. total assets and revenue without any further details. This is in contrast with many other entities found in the WHO’s Register of NSAs. Bill & Melinda Gates Foundation states in the NGO registry that it has engagements with the food and beverages industry, health care industry and pharmaceutical industry.
With regard to food and beverages industry it states: “The foundation has engagements with select members of the food and beverage industry, in pursuit of our public health goals”. However, this relationship does not preclude the Foundation from having joint work programmes with WHO in the area of nutrition. For example, it is a well-known fact that Bill & Melinda Gates Foundation receives revenue from equity in Coca Cola, a product that has direct conflict with the notion of nutrition.
Paragraph 45 of FENSA states: “WHO will exercise particular caution, especially while conducting due diligence, risk assessment and risk management, when engaging with private sector entities and other non-State actors whose policies or activities are negatively affecting human health and are not in line with WHO’s policies, norms and standards, in particular those related to non-communicable diseases and their determinants.”
However, there is no information available in the public domain on what kinds of measures are taken by the Secretariat to address conflicts of interest and risk of involvement of the Bill & Melinda Gates Foundation in WHO’s activities in the area of nutrition.
According to paragraph 42 of FENSA, “Member States have electronic access to a summary report on due diligence of each non-State actor and their respective risk assessment and risk management on engagement”. However, it is not very clear whether Member States received such summary reports for this week’s decision-making.
An observer familiar with the FENSA development termed the Secretariat’s approach as “trust us, no need to verify”. Another observer pointed out that the Secretariat cannot by-pass FENSA provisions for its convenience. +