CSOs voice concerns over corporate takeover of WHO
At the World Health Assembly in May, civil society organisations criticised the rich countries for refusing an increase in their assessed contributions to WHO and opposing any action by the agency which would be contrary to the interests of their corporations. Kanaga Raja reports.
THE Framework for Engagement with Non-State Actors (FENSA), initiated to safeguard the independence, integrity and credibility of the World Health Organisation (WHO), now seems to bear the threat of facilitating and legitimising corporate capture of the organisation, civil society groups have charged.
Ahead of the first meeting of the drafting group that was to consider the latest draft of the framework at the 68th World Health Assembly, some 33 civil society organisations (CSOs) and social movements called on delegates to defend the integrity, independence and democratic accountability of WHO.
In a joint statement, the CSOs called on WHO member states to take such time as is necessary to achieve a robust framework for engagement with non-state actors in order to protect the organisation from improper influence.
The CSOs also called on member states to support WHO Director-General Margaret Chan's proposals to increase the assessed contributions to the organisation. (Assessed contributions are funds provided by governments which can be spent according to WHO's priorities without being tied to specific uses.)
According to the groups, there is strong apprehension that the FENSA negotiations may fundamentally alter the engagement with the private sector and philanthropic foundations and non-governmental organisations (NGOs) sponsored by the private sector in a manner that would compromise the credibility of WHO.
'Many proposals by rich countries in draft FENSA text [are] promoting corporate capture of WHO in the name of promotion of engagements without discussion on any comprehensive mechanism to avoid conflict of interest. These proposals, if accepted, would institutionalise the undue corporate influence on WHO,' said Lida Lhotska of the International Baby Food Action Network (IBFAN) in a press release.
The signatories to the joint CSO statement included Alianca de Combate de Tabagismo/Brasil (ACT/Br), All India Drug Action Network, Corporate Accountability International, Diverse Women for Diversity, Health Action International (HAI), IBFAN, Medico International, NGO Forum for Health, People's Health Movement (PHM), Public Services International, Society for International Development (SID), Third World Network (TWN), Wemos, and World Social Forum on Health and Social Security.
The signatories also expressed concern that rich member-state donors have been deliberately undermining WHO and weakening its capacity to promote global health by under-funding, tight earmarking of donor funding and opening spaces for corporate influence.
'We learnt that many member states are opposing any curb in the existing practices, which facilitate the corporate intrusion in WHO. The opposition of certain member states to ban the secondment from private sectors and other non-state actors as well as using the financial resources from private sector to pay the salary of WHO staff reinforce the status quo and threaten the credibility of WHO,' said KM Gopakumar of the Third World Network.
'The refusal of [an] increase in the assessed contribution is the technique deployed to force WHO to [be] open for corporate influence,' said David Legge of the People's Health Movement. 'The compromised flexibility in financial resources forces the vulnerability of WHO to look for resources from donors with profit motives and endangers the constitutional mandate of WHO.'
At a media briefing in Geneva on 19 May, Gopakumar of the Third World Network explained that on the following day at the World Health Assembly, the WHO member states would be restarting the negotiations on the Framework for Engagement with Non-State Actors. Non-state actors include NGOs, the private sector, philanthropic foundations and academic institutions.
The idea to have a set of policies to regulate the engagement with non-state actors came about as part of WHO's governance reform programme that was launched in 2011.
Gopakumar noted that many states have raised concerns about the way in which WHO is engaging with non-state actors. There were serious concerns about conflict of interest, as well as on the credibility, integrity and independence of WHO, based on the existing practices.
During the reform process, there was a push to have more engagement with non-state actors, and many member states raised concerns that this may compromise WHO's credibility. The process, he said, is now at the stage where it may legitimise or reinforce the status quo.
According to Gopakumar, it could also bring about a further deterioration of the credibility, integrity and independence of WHO by facilitating greater intrusion by non-state actors, in particular the private sector and philanthropic foundations controlled by the private sector.
Lhotska of IBFAN, referring to the WHO reform process, said that 'we are suddenly faced with the challenge that threatens to undermine all those years of our work, and we are also very concerned that WHO, if things go wrong, may come out of the reform captured by the corporate actors ...'
According to Lhotska, the current draft framework further reasserts old channels of undue influence and contains new policies that open up official relations not only to NGOs but to all the other so-called non-state actors. This means that it would open up official relations to philanthropic foundations, the private sector, in particular business associations, academia and NGOs, without distinguishing the NGOs which may lean far more to the business side than to the public side.
'If the framework is accepted as proposed, we fear that it will lead to the loss of credibility of WHO,' she said.
Legge of the People's Health Movement underlined that the failures in WHO's response to the 2014 Ebola outbreak were in large part a consequence of a funding freeze which has been operating with increasing stranglement over the last 20-30 years.
Over the last 20 years, the proportion of WHO's budget which is met through mandatory assessed contributions has fallen from 75% to 20%. This is a consequence of continuing new functions being added to the organisation and a continuing freeze on assessed contributions, he said.
He pointed out that the remaining 80% is met by voluntary donations, including from the rich countries, the World Bank and the Bill & Melinda Gates Foundation.
Noting that the WHO Director-General has been asking for a 5% increase in assessed contributions, Legge said that at WHO's Programme, Budget and Administration Committee in mid-May, Belgium and the United Kingdom both spoke firmly against the 5% increase. (The Director-General's proposal was eventually withdrawn before the World Health Assembly commenced.)
He said that the UK contributes $24 million in assessed contributions per year to WHO, while its voluntary contributions amount to $65 million a year. And it is refusing to pay an extra $1.25 million, which is the 5% increase that the Director-General is asking for. Belgium contributes $4.65 million in assessed contributions per year, and a 5% increase would amount to $230,000, he added.
In their joint statement, the CSOs and social movements noted that donor funds account for 80% of WHO's budget and 93% of donor funds are tightly earmarked to programmes that the donors support.
'This prevents WHO from implementing programmes that rich countries do not support, even when they are decided by the World Health Assembly. Threats of further funding cuts are held out if attempts are made to implement such programmes.'
According to the joint statement, WHO's compromised ability to intervene effectively during the 2014 Ebola crisis is a tragic illustration of the impact of the budgetary crisis on WHO's capacity to fulfil its mandate.
Over the last four years, WHO has been through a far-reaching reform programme driven in part by arguments that the freeze on assessed (mandatory) contributions should remain in place until the organisation addresses its inefficiencies. 'Such arguments fly in the face of clear evidence that these inefficiencies are largely a function of WHO's financial crisis brought on by the freeze on assessed contributions,' said the groups.
Referring to the Director-General's proposal for a 5% increase in assessed contributions, the statement said that while 5% is a relatively small increase, much less than what the big donors contribute as voluntary contributions, it is of huge symbolic value and a crucial step towards breaking the logjam of a freeze on assessed contributions.
'Predictably, certain large donor countries are gearing up to oppose the increase and refuse to adopt the budget.'
According to the groups, threats to health and barriers to affordable healthcare arise due to the commercial interests of big corporations. The increasing incidence of obesity, diabetes, heart disease and stroke due to intensively marketed cheap, ultra-processed foods is a stark example.
'Pharmaceutical corporations clearly value shareholders' demand for profits over affordable access to essential medicines and vaccines. For WHO to fulfil its mandate, it must be able to name such threats and barriers and develop and implement policies and programmes to manage them.'
However, said the joint statement, rich member states, the US and the UK in particular, have repeatedly opposed WHO taking any action which might run counter to the interests of transnational corporations.
Furthermore, certain rich member states are seeking to force WHO to open up its policy-making and decision-making spaces to the transnational corporations.
The civil society groups argued that proposals for 'multi-stakeholder partnerships' would designate junk food manufacturers as partners in the task of addressing obesity, heart disease and stroke.
They noted that over the last two years, WHO and its member states have been locked in a contentious debate around the rules governing corporate influence over decision-making in WHO. 'Rich countries are seeking to use these rules to clear the way for transnational corporations to buy influence and insert corporate staff into strategic positions within the WHO Secretariat.'
According to the joint statement, the present draft of the Framework for Engagement with Non-State Actors is contested and problematic. 'It is more important to get a good outcome than rush to adopt a document that might further legitimise corporate influence on decision-making in WHO,' said the groups.
Kanaga Raja is Editor of the South-North Development Monitor (SUNS) published by the Third World Network. This article is reproduced from SUNS (No. 8025, 21 May 2015).
*Third World Resurgence No. 298/299, June/July 2015, pp 35-37