[Ip-health] WHO: Member States raise information deficit for decisions on official relations

K.M. Gopakumar kumargopakm at gmail.com
Fri Jan 20 01:53:30 PST 2017

*TWN Info Service on Health Issues (Jan17/02) 19 January 2017 Third World


* WHO: Member States raise information deficit for decisions on official

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:

   - Approval of five organizations to enter into official relations with
   the WHO. These are Bill & Melinda Gates Foundation, Grand Challenges
   Canada, International Rescue Committee, Knowledge Ecology International,
   and The Fred Hollows Foundation;

   - Discontinue relations with the following organizations: Inclusion
   International, Inter-African Committee on Traditional Practices affecting
   the Health of Women and Children, International Centre for Trade and
   Sustainable Development, World Association for Psychosocial Rehabilitation
   and World Association for Sexual Health;

   - Maintain the official relations of 58 NSAs with WHO, taking into
   account their past collaboration and proposed plans for collaboration for

   - Defer decisions with regard to the following organizations till the
   142nd session of the EB in January 2018: European Generic Medicines
   Association; Handicap International Federation; International Alliance of
   Women; International Federation of Business and Professional Women;
   International Insulin Foundation; International Spinal Cord Society;
   International Union for Health Promotion and Education; Italian Association
   of Friends of Raoul Follereau; Medical Women’s International Association;
   Rehabilitation International; and World Federation of the Deaf.

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

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 interests:*

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:

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. +

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