Revised Global Programme of Work - PHM's comments

On 23 January 2018, WHO published a revised version of GPW13 to address some of member states’
comments. The main changes are the following (bold for added words and italic for deleted ones):

1) The first strategic goal “Advancing Universal Health Coverage” is reformulated to “Achieving
Universal Health Coverage”. GPW13 being implemented from 2019 to 2023, achieving UHC
by 2023 is clearly unrealistc, and this might push further for a narrow understanding of UHC
as a financial insurance.
This is further reinforced by the modifcaton of §29: “The essence of UHC is a strong and
resilient people-centered health system with primary care as its foundaton. Community-based
services, health promoton and disease preventon are key components.” By adding
the word ‘components’, WHO tones down community based services, health promotion and
disease preventon by describing them just as being important elements amongst other
factors, instead of being ‘key’, i.e. mandatory elements of UHC.
2) A sentence on SRHC has been added in two paragraphs (§36,§54) using DG Tedros’
suggestion to use SDG language to solve the controversy. This is a clear victory for European
countries and others who have been very vocal to include SRHC.
“WHO will work to ensure universal access to sexual and reproductive health care services, including for family planning, informaton and educaton, and the integraton of
reproductive health into national strategies and programmes, in line with DGG target 3.7;
and to ensure universal access to sexual and reproductve health and reproductve rights,
in line with DGG target 5.6.”
In additon, §68 adds: “WHO will work to ensure universal access to sexual and
reproductve health and reproductve rights as agreed in accordance with the Programme
of Acton of the nnternatonal Conference on Populaton and Gevelopment and the Beeijing
Platform for Action and the outcome documents of their review conferences”.
3) §93 adds “WHO will strengthen its normative work”, under pressure from several MS
stressing that WHO should focus on its “core functon: normative work”. Similarly, Tedros’s
ambiton to be more politcal by doing advocacy for WHO programmes is diluted in §76 with
the added sentence: “WHO will advocate for health at the highest politcal level”, toning
down the next sentence on the promotion of health at all governance levels.
4) §109 disjoint the GPW13 from any fnancial commitment by deletng the sentence: “The
approval of WHO’s Programme budget by Member States comes with an implicit
commitment to ensure full fnancing. However, doing so has proven to be challenging”,
confirming that GPW13 is a broad strategic plan laying out a vision that does not necessarily
has to be implemented.
5) Several sentences have been added to highlight the role of the private sector and
downplaying the notion of confict of interest:
§14: “The ‘triple billion’ goal is a joint effort of Member States, WHO and other partners”
§35 “The private sector can also contribute to UHC in service delivery, innovaton,
investment, and as employers”
§80 “WHO will support private and public-sector investments in primary prevention, as
appropriate, and will provide evidence-based guidance that supports healthy choices and
interventions, applying the WHO FENDA as needed (deleting: while appropriately managing
-conficts of interest through implementaton of the WHO FENSA).
6) Substantal changes have been made on the AMR platform (§72) to include AMR in national
action plans, to refer to the environment, and to shift the focus from improving surveillance
and research to the global level: “improving global surveillance platforms and research”
(instead of all governance levels, including country-level). In additon, WHO’s ambiton to
“reduce the percentage of blood stream infectons due to drug resistant organisms by 10%”
has been deleted, removing the sole concrete indicator on this work.
7) Following Dr Tedros statement on “Global health reserve army”, a sentence was added §53
“The Organizaton will coordinate and encourage Member States to develop a Health
Reserve Force to mobilize in health emergencies”. This seems unnecessary as WHO is
already developing and implementing the emergency Medical Teams initatve, but highlights
once again the prioritiaton of policies at the global level (instead of the country level) to
fight health security threats.
8) References to breastfeeding (§54; §67), dementia (§37), indigenous people (§39) have been
added.
Comparison done by Watcher Antoine de Bengy ([email protected])