[Ip-health] TWN Info: Overhaul needed on rules on WHO-NGO' relationship

Sangeeta ssangeeta at myjaring.net
Thu Jan 19 01:22:43 PST 2012

Dear all, 

Please find below a news report on the need to overhaul rules on WHO-NGO

Apart from the antiquated rules that govern this relationship....and thus in
need of reform...another issue that is most problematic is WHO's scrutiny
and censorship of NGO statements. To make statements, the text must be
submitted at least 24 hours before delivery. This text will then be
scrutinized for its length (max 300 words) and content. The Secretariat may
also ask you to change the content or to delete some sections. They may also
deny you the right to make the intervention.

None of these practises are seen in other UN bodies, where accredited NGOs
are free to speak up without any form of censorship.  I understand that the
above requirements are not part of the rules that govern WHO-NGO
relationship and yet they are practised by the Secretariat.

We hope that this will change as part of the WHO reform and that NGOs will
not be subjected to such practices and will have the freedom to speak up.


TWN Info Service on Intellectual Property Issues
19 January 2012
Third World Network

WHO: Overhaul needed on rules on NGOs' relationship
Published in SUNS #7290 dated 19 January 2012

London, 18 Jan (Sangeeta Shashikant) -- The World Health
Organisation's executive body meeting in Geneva this week is expected
to take important decisions on the organisation's relationship with
non-governmental organizations (NGOs) that may include overhauling the
current antiquated principles.

WHO's relationship with NGOs has been a controversial issue for more
than a decade. Criticisms include antiquated rules governing WHO-NGO
relationship with complicated and onerous procedures to enter into
official relations with WHO, which fail to distinguish between public
interest NGOs (PINGOs) and business interest NGOs (BINGOs); scrutiny
and censorship of NGO statements prior to delivery; inadequate
conflicts of interest safeguards; lack of space and opportunity to
organize events (e. g. during the annual World Health Assembly); or to
interact with the Secretariat and WHO member states.

[In recent years, the WHO Secretariat has suspended NGOs' privilege or
made it difficult for NGOs to hold technical briefings during the
World Health Assembly.]

There were some attempts to overhaul this relationship following the
launch of the "Civil Society Initiative" (CSI) in 2001 by Dr. Gro
Harlem Brundtland, then WHO Director-General. However, the Initiative
had little success as key recommendations emerging from a thorough
review of WHO-NGO relationship (2002 Review report) never made it past
WHO member states, and thus remains in a coma, ignored and

The topic has however resurfaced and is now on the agenda of the WHO
Executive Board (EB) as part of the WHO reform following a decision of
a Special Session of the Executive Board (EBSS) held in November 2010
which requested the Director-General to conduct further analysis of
the proposals to promote engagement with other stakeholders.

[This decision of the EBSS was arrived at following numerous
objections against the Director General's proposal to convene
multi-stakeholder forums such as the World Health Forum as a method of
promoting WHO's engagement with stakeholders.]

The lack of suitable guidelines on WHO-NGO relationship is only one
part of the problem. Over the years significant concerns have also
been raised over the lack of appropriate policies guiding WHO's
interaction with the private, for-profit sector as well as
not-for-profit philanthropic organizations, particularly the
inadequacy of WHO conflicts of interest policy and the need for more
oversight of the numerous partnerships with WHO engagement.

Clearly, these are issues that need to be addressed comprehensively if
any meaningful outcome is to emerge from the WHO Reform.

The WHO Secretariat in its report (EB130/5 Add. 4) does raise several
of these issues and has put forward two proposals for the
consideration of member states:

(a) "To review and update the principles governing WHO's relations
with non-governmental organizations. The review will consider (i)
widening and improving the modalities for the participation of
non-governmental organizations at regional and global governing body
meetings; (ii) seeking the views of non-governmental organizations in
the development of new health policies and strategies; (iii) updating
practices and criteria for accreditation. In relation to the last
point, the review will consider ways of differentiating between the
different types of non-governmental organizations that interact with

(b) "To develop comprehensive policy frameworks to guide interaction
with the private, for-profit as well as not-for-profit philanthropic
organizations. The proposed frameworks should, inter-alia, tackle the
issue of institutional conflicts of interests."

The Secretariat is also proposing that the EB have greater oversight
of partnerships, further adding that the EB could include regularly in
its agenda an item on partnerships under which it would establish a
dialogue with formal partnerships.

As the WHO appears to be embarking on a major reform, it is indeed an
opportune moment to take steps to address the various concerns on
WHO's engagement with stakeholders that have been raised for many
years by public interest civil society groups, and yet has eluded
scrutiny on the part of WHO member states.

However, to fully tackle these valid concerns, the various
deficiencies and gaps in the Secretariat proposals need to be


The first set of working principles governing admission of NGOs in
Official Relations was adopted by the World Health Assembly (WHA) in
1948. These were amended and expanded with the current "Principles
governing relations between the World Health Organization and
Non-governmental Organizations", in place since 1987.

These 1987 principles constitute the current legal basis for all
aspects of relations between WHO and NGOs including criteria and
procedure for admission of NGOs in official relations with WHO and
privileges conferred on NGOs. They also define WHO interactions with
NGOs to be formal (official relations) or informal.

To be in official relations, NGOs need to establish a joint programme
of work and a 3-year plan with a technical department of WHO, with
technical WHO officers appointed as the focal points for such
collaboration. A review process of these relations is based on 3-year
reports and the drawing up of new work plans.

Admittance into official relations is authorized by a formal decision
at the EB. Regional offices use the list of NGOs in official relations
to invite participation at regional meetings. NGOs in official
relations are accorded the privilege of participating in WHO meetings
and the right to make a statement.

As of July 2002, there were 189 NGOs in official relations with WHO
while all other relations with NGOs are considered informal, thus not
entitled to privileges accorded to the former. The data available as
of February 2002 suggests that out of the 482 established relations
with WHO, 45% were with NGOs in official relations while 55% of the
NGOs were not in official relations.

Thus, while interaction, consultation and cooperation with NGOs is
clearly encouraged by the WHO Constitution in Articles 2(h), Art. 33,
Art. 71, and Art. 18(h), antiquated principles have created obstacles
to effective WHO-NGO relationship and NGO participation in WHO
governing bodies.

Attempts to improve WHO-NGO relationship were made in 2001 following
the launch of Dr Brundtland's Civil Society Initiative. This led to
the establishment of a thorough review of WHO's current policy and
practice regarding civil society, ending with a Review Report
containing recommendations in 2002.


The Review process was carried out through a desk review of documents
and a process of consultations during the period July 2001-July 2002.

The Review highlighted a number of deficiencies in the 1987 principles
as well as WHO practice with regard to NGO relationship. In
particular, this includes:

(a) The Principles do not provide guidance to distinguish between
public interest NGOs and those linked to commercial interests.

(b) Insufficient safeguards on conflicts of interests. The Review
report noted that the closer the involvement of NGOs in the work of
WHO and in the setting of policies, norms and standards, the more
important it is for WHO to be aware of, make transparent and eliminate
all risks of real or perceived conflicts of interests.

(c) The Principles contain lengthy, complicated, onerous, rigid and
overly bureaucratic procedures for NGOs to gain the status of
"official relations".

(d) Imbalance between participation of organizations from North/West
and South/East.

(e) Lack of access to and transparency about WHO processes at the
Geneva headquarters, regional and country level. The Review report
noted that information needs range from understanding how WHO
governance works to gaining updated knowledge on specific technical

(f) The link between NGO in relation and WHO is between 2 individuals
i. e. between the WHO and NGO focal points, which can be broken during
a turnover of WHO.

(g) The Principles have no formal requirement to analyse and make
public the information received on NGOs e. g. knowledge about the
sponsors and the interest groups behind individual NGOs.

(h) Lack of participation of NGOs not in official relations.

(i) Existing Principles do not offer the needed managerial and policy
guidance for WHO staff interacting with NGOs at headquarters, regional
and country level.

The Review concluded that the 1987 Principles were inadequate and less
relevant to the realities of WHO and to the needs and aspirations of
civil society and called for a new policy that would establish
principles to distinguish between different kinds of NGOs and their
related interests.

The new policy was also proposed to consist of the following:

(a) An Accreditation Policy: to guide the participation of NGOs in
WHO's governing meetings. The Report proposed that unlike the present
system, accreditation would not be conditional on working relations
with the Secretariat.

(b) A Collaboration Policy: to enhance general interactions between
the WHO Secretariat and NGOs including clarity on differentiating
between organizations and the role of WHO in supporting Member states'
work with civil society.

Following the review a new policy was discussed and presented to the
2003/4 WHA but never made it past WHO member states.

According to sources, the policy had a few good features and quite a
few problematic sections. In particular, the policy did not adequately
address the key concerns and findings of the CSI review report
especially distinguishing between public interest, non-profit entities
and those representing commercial interests, as well as sufficient
safeguards against conflicts of interests.


The Secretariat proposal on WHO-NGO relationship does not go far
enough. A decision taken on this matter needs to build on the key
outcomes that emerged from the 2002 Review report, in particular
overhauling the 1987 Principles to develop a policy for accreditation
(which is not conditional on NGOs having working relations with WHO)
and another for collaboration as well as distinguishing between
different kinds of NGOs and their related interests.

There should also be a decision point that eliminates the practice of
scrutiny and censorship of NGO statements by the Secretariat prior to
delivery. The Director-General should also be requested to make all
efforts to ensure that NGOs are afforded sufficient space and
opportunity to hold side events, for example, during the WHA.

With regard to private for-profit organizations and not-for-profit
philanthropies, the proposal for comprehensive frameworks of
interaction with these actors, is indeed timely. However, it is
important from the outset to be clear with regard to ongoing
interactions as well as envisaged interactions as well as the basic
principles that will underpin such frameworks.

It is critical that such frameworks are firmly underpinned by
principles of transparency, and avoiding of conflicts of interests.
Such frameworks should also not influence or undermine members' role
in decision-making in WHO.

On the matter of transparency, any framework on WHO's interactions
with private for-profit organizations and not-for-profit
philanthropies should ensure that details of all formal and informal
interactions including the inputs provided by such actors are publicly
available on WHO's website. This is an important step to safeguarding
the independence and constitutional mandate of WHO.

The inadequacy of WHO's conflicts of interests has been noted on a
number of occasions.

Most recently, an Expert Review of the International Health
Regulations concluded that WHO lacks "a sufficiently robust,
systematic and open set of procedures for disclosing, recognising and
managing conflicts of interests among expert advisors".

Thus, the ongoing discussions afford a timely opportunity to undertake
a thorough review of WHO's current conflicts of interest safeguards
with the aim of developing a comprehensive conflicts of interests
policy which tackles both individual and institutional conflicts of
interest, with adequate measures and mechanisms for its
implementation. A comprehensive approach to conflicts of interest is
absent from the Secretariat's proposal, which only vaguely touches
upon the issue.

On partnerships, while the oversight function is proposed to be handed
to the EB, key concerns remain unaddressed.

The Secretariat's proposals should be amended to establish a process
to map and analyse all formal and informal partnerships WHO is engaged
in, with the aim to conduct a thorough impact assessment of WHO's
involvement in such partnerships including the financial implications
for WHO, the purpose, strategy, and cost effectiveness of
partnerships, as well as their compliance with the WHO Constitution
and work plan. +

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