EBSS 3.3 Governance

Document

WHO Reforms for a healthy future, Chapter 2. Governance (EBSS/2/2, from para 48)

Debate

Official record of debate, from page 59

Decision

See Decision EBSS2(2) 

WHO Watch comment and report on discussion of Item 3.3 – Governance

After hours of deliberation (see Official Records from pp 59-78), EB Members reached a decision which reaffirms a number of principles that have been agreed to guide the reform process.  

These principles include the intergovernmental nature of the WHO decision-making process, and its multilateralism; strengthening and using the existing WHO structures, mechanisms and fora; and developing norms and policies based on evidence while ensuring protection against vested interests.

The decision also provides guidance on the role of the WHO governing bodies, and on its engagement and partnerships with other stakeholders in terms of the management of conflict interest. Sessions of the Executive Board and the Programme, Budget and Administration Committee (PBAC) will be optimised or extended rather than holding additional sessions of the EB, an option with significant cost implications, as several Member States have pointed out.

Also the role of the PBAC will be extended in terms of monitoring and evaluation functions.

The decision has acknowledged the importance of strengthening the linkages and alignment between Regional Committees, the EB and the WHA. This need was repeatedly expressed by Member countries during the EB deliberations.

According to this decision, the WHO will perform a coordination function on health matters within the UN system, and globally with other international stakeholders. 

Also, the EB thoroughly discussed the management of partnerships has been, and it was finally agreed to examine partnerships separately from nongovernmental organisations (NGOs) in official relations with the WHO.

This Special Session of the EB (SSEB) took place from 1 till 3 November 2011 at the WHO HQ in Geneva.

Introducing the Agenda Item on Governance, Dr. Margaret Chan, Director General of the WHO, noted that one of the aims of discussing this issue is to have the WHO play a greater role in Global Health Governance (GHG).

She then explained the kind of harmonisation proposed at the WHO, saying that it is not to disrupt or influence the independence of Regional Committees, but rather to align practices in terms of rules of procedure. She noted that some regions are willing to share best practices in this regard, particularly on the appointment of Regional Directors, and nominating EB Members. “There is value in preserving diversity”, she added.

Statements and positions expressed by the EB-Members and non-Members on the on the WHO governance reform covered a plethora of important issues, clearly reflecting  the current status quo of the organisation, yet with guidance on addressing those issues.

At the outset of its statement, Mozambique speaking on behalf of AFRO highlighted the need to address the WHO engagement in partnerships. Mozambique also called for strengthening the role of country offices, in order to assist governments, and their links with regional offices and HQ. Mozambique noted the existence of a vast array of high quality documents produced by the WHO; however, there is absence of a mechanism for follow up, particularly on the implementation of WHA resolutions. Along those lines, it requested more information on the criteria of selection to be applied by the EB to filter resolutions for consideration by the WHA. On multistakeholder fora, Mozambique said they have to be mandated by the WHO, with focused discussions, giving the examples of conferences such as the International AIDS Conference, Vienna; Global Ministerial Conference on Healthy Lifestyles and Noncommunicable Disease Control, Moscow; and the World Conference on Social Determinants of Health, Rio de Janeiro

Syria speaking on behalf of EMRO called for strengthening of the WHO governing bodies and for reviewing their way of working. Syria noted that additional EB session of the EB would incur additional costs, and suggested extending the existing sessions instead. 

Ecuador speaking on behalf of the Union of South American Nations (UNASUR) saw that there is a “golden opportunity” for the WHO to carry out its role in coordinating global health. That said, Ecuador said that the WHO should not lose the leadership of its Member States. Ecuador called for strengthening of regional offices so that regional priorities reflect the needs of the region.

On the engagement of the WHO with other stakeholders, India supported the “PIP Model”, referring to the WHO’s experience in the Pandemic Influenza Preparedness (PIP) negotiations where consultations were held with both the civil society and industry, suggesting to replicate this exercise in other areas within the WHO.

Brazil, a non-EB Member, supported the same model.

Whether the WHO should continue to hold Intergovernmental Working Groups (IGWGs) or not, was also deliberated.

Ecuador speaking on behalf of UNASUR said that IGWGs should not be abolished, because they are the “most representative” of Member States. Ecuador added that IGWGs are “very strategic” and should be retained.

On the other hand, the USA favoured the rationalisation of IGWGs, and increasing the number of sessions of the EB.

The management of partnerships at the WHO was a rather divisive issue. The draft decision had included a paragraph on expanding the mandate of the Standing Committee on Nongovernmental Organisations to include providing guidance on WHO’s work with partnerships. This proposal has been vehemently objected to by several EB Members who preferred not to mix partnerships with matters concerning nongovernmental organisations.

Papua New Guinea was “very concerned” that expanding the role of the Standing Committee on NGOs to provide guidance on partnerships can be “counterproductive”.

It also referred to the WHO policy on NGOs which allows for accepting NGOs with commercial interests along with those of public interst.

India saw that it was “premature” to hand partnerships to the Standing Committee on NGOs, preferring to deal with them individually.

Also, Brazil, a non-EB Member, was not in favour of expanding the role of the Committee to include partnerships, saying that the two issues should not be mixed.

It was agreed to remove this paragraph from the final decision text.

See WCC, PHM, DGH Statement on WHO Governance and WHO's Role in GHG

Return to SSEB, 1-3 Nov, 2011