[Ip-health] TWN Info (Health, UN Sust Dev.and Trade): WHO – Intergovernmental meeting on engagement with non-State actors begins

Mirza Alas mirzalas at gmail.com
Thu Jul 9 02:30:24 PDT 2015

*Title :* TWN Info (Health, UN Sust Dev.and Trade): WHO – Intergovernmental
meeting on engagement with non-State actors begins
*Date :* 09 July 2015


*WHO: Intergovernmental meeting on engagement with non-State actors begins*

Geneva, 9 July (K M Gopakumar) – The intergovernmental meeting of the World
Health Organization on the draft Framework of Engagement with Non-State
Actors (FENSA) is taking place on 8-10 July.

This three-day meeting at the WHO headquarters in Geneva is expected to
conclude the FENSA negotiations.

The term ‘non-state actors’ refers to academic institutions,
non-governmental organisations (NGO), the private sector and philanthropic
foundations. FENSA consists of five parts: (i) the overarching framework of
engagement with non-state actors (NSAs); (ii) the WHO Policy and
Operational Procedures on Engagement with Non-governmental Organisations
(Draft NGO Policy); (iii) the Draft WHO Policy and Operational Procedure on
Engagement with Private Sector Entities (Draft Private Sector Policy); (iv)
the Draft WHO Policy and Operational Procedure on Engagement with
philanthropic Foundations (Draft Philanthropic Foundation Policy); and (v)
the Operational Procedure on Engagement with academic institutions.

The FENSA negotiations were initiated according to the decision of the
136th Session of the WHO Executive Board (EB). Following the first round of
negotiation on 29 March - 1st April, there were at least two rounds of
informal consultations and 7 days of negotiations during the 68th World
Health Assembly (19-26 May).  In the absence of consensus, the Assembly
adopted a resolution requesting the Director-General “to convene as soon as
possible, and no later than October 15, an open-ended intergovernmental
meeting to finalize the draft framework of engagements with non-State
actors on the basis of progress made during the Sixty-eighth World Health
Assembly as reflected in the Annex (

These negotiations clearly brought out differences between developing and
developed country Member States. The developing countries are pushing for
more regulation and transparency on WHO’s engagement with NSAs especially
with the private sector. On the other hand developed countries are pushing
for more engagement with NSAs especially with the private sector and want
minimal regulation.

According to many pubic health experts and civil society organisations a
liberal approach on engagement with NSAs especially with the private sector
bears the danger of furthering of corporate capture of WHO and compromises
the credibility, independence and integrity of WHO.  Many developing
country delegates have shared the same concerns with the author.

The original idea of the WHO Secretariat was to create a multi-stakeholder
platform called World Health Forum. This was dropped due to resistance from
a large section of Member States and the process moved towards regulating
the engagement.

The past negotiations resulted in consensus in major parts of the text
dealing with the conceptual framework of FENSA. However, operational
details of the concepts are going to be negotiated at this on-going round.
These include:  conflict of interest, transparency, engagement with certain
industries, transparency requirements, and oversight of FENSA, staff
secondment from NSAs and scope of FENSA.

Conflict of Interest (Paragraphs 23-26): Even though one could find
reference to conflict of interest in various World Health Assembly
resolutions or WHO documents there is no document existing at least in the
public domain providing details of the procedures to avoid or to
effectively manage conflict of interests.  As a result there are no uniform
practices within WHO to address conflict of interests. This has pushed the
Organisation into many controversies.

For instance, even though there is a Guideline for the Declaration of
Interests for experts, in 2010 it was revealed that one of the experts Dr.
Juhani Eskola who is the Director-General of the Finnish National Institute
for Health and Welfare (THL) and a member of the WHO ‘Strategic Advisory
Group of Experts on Immunization’ (SAGE), received almost 6.3 million Euros
from GlaxoSmithKline for research on vaccines during 2009. GlaxoSmithKline,
a pharmaceutical giant, produces the H1N1-vaccine ‘Pandemrix,’ which the
Finnish government – following recommendations from THL and WHO – purchased
for a national pandemic reserve stockpile.

Transparency (Paragraphs 37-38): Transparency is another contentious issue.
Developing countries propose a high degree of transparency, especially the
availability of due diligence reports in the public domain as well as
details of financial contributions in the pubic domain of developed
countries. However, the Secretariat does not support this view.

Engagement with certain industries (Paragraph 44): Developed countries
would like to retain the Secretariat’s original proposal of explicitly
excluding the engagement with the tobacco and arms industry but without
naming any other industry. Developing countries propose that apart from the
tobacco and arms industry, WHO needs to exercise particular caution when
dealing with other industries that negatively affect public health such as
those related to food and beverages, alcohol etc.  Developed countries
oppose any mention of the food and beverages and alcohol industry.

Oversight mechanism (Paragraphs 65-66): Similarly difference of opinion
persists with regard to an oversight mechanism. Developed countries prefer
to leave the oversight mechanism largely in the hands of the Secretariat.
However, developing countries propose a role for the Independent Expert
Oversight Advisory Committee (IEOAC) in overseeing the implementation of
FENSA by the Secretariat.

Secondment (Paragraphs 18 and 46): Another contentious issue is on staff
secondment i.e. NSAs deploy their employees to work as WHO staff and pay
their salaries as well. According to several experts, this raises serious
concerns on the independence of the WHO and compromises the independence of
international civil servants.

Many developing country Member States have proposed to exclude human
resources from the scope of the definition of resources because it would
result in such secondment. Further, some developing country Member States
also added a blanket ban on secondments.  The Secretariat favours the use
of human resources in emergency work. However, there is no clarity on what
kind of emergency work for which NSA personnel can be used.  Developed
countries are opposing a blanket ban on secondments from NSAs.

Scope of FENSA (Paragraph 48): The alignment of other existing policies
such as WHO’s partnership policy with FENSA is the other important
unresolved issue for the on-going meeting. Whether FENSA would prevail over
these existing policies, including the Partnership Policy, was the main
issue that was another point of conflict between developing and developed
countries in the last round of negotiations in May.

The first day of the current negotiations meeting focussed on Paragraph 48
of the draft FENSA, which spells out the relation of FENSA with other
existing policies such as WHO’s Partnership Policy adopted at the 63rd
session of the World Health Assembly (WHA 63.10). It is learnt that there
is a consensus that existing policies would be implemented in alignment
with FENSA and in case of conflict between existing policies and FENSA, the
governing bodies would be informed for further action.  According to a
developing country delegate, this would ensure that the existing policies
like the Partnership Policy could not operate independently after the
adoption of FENSA.+

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