WHO Debates Changes To Safeguards Against Undue Influence By Outside Actors

This week a group of delegates at the UN World Health Organization is seeking to finalise agreement on a draft framework defining the organisation’s relationships with external actors, such as philanthropy, the private sector, academia, and civil society. Today, Norway put forward a potential compromise. Meanwhile, dozens of civil society organisations called on member states to stand up to pressure to compromise the intergovernmental body’s independence from private sector influence.

The WHO Executive Board (EB) in January extended work of the Open Ended Inter-Governmental Meeting working on the draft Framework of Engagement with Non-State Actors (FENSA) for one last session before the World Health Assembly next month (IPW, WHO, 2 February 2016). Member states are holding a closed-door meeting on FENSA from 25-27 April. WHO declined to speak to the press about the meeting, citing the sensitivity of the talks at this stage.

And the subject is indeed sensitive, as WHO must seek financial stability while retaining its member state-driven nature. The January WHO Executive Board meeting decided to extend the mandate of the Open Ended Inter-Governmental Meeting, and also requested the WHO secretariat to present “an objective and balanced report on the implications for WHO of the implementation of the framework.” This decision was suggested [pdf] by the Programme, Budget and Administration Committee of the Executive Board.

External Audit Report Undecided On Financial Implications

In March, the WHO secretariat published an “External audit report [pdf] on the implications for the World Health Organization of the implementation of the framework of engagement with Non-State actors (FENSA).”

According to the document, “The purpose of the paper was to provide an overview of the possible implications of the implementation of FENSA, describing its impact and effects from a policy, financial and human resource perspective at all levels of WHO.”

The report stated that, “As presented in the non-paper [unofficial document] of the Secretariat, the adoption and implementation of FENSA will involve considerable costs, from a policy, financial and human resource perspective, at all levels of the Organization.”

However, the report said, “As a major part of the additional workload could be undertaken in the technical units and at country level, the financial and human resource implications cannot be estimated with a sufficient degree of accuracy to provide a solid figure, but will need to be monitored as FENSA is progressively implemented.”

An October report [pdf] from the WHO secretariat on the implications of the implementation of FENSA gave projected financial and human resource costs. For instance, the cost for building up and maintaining a system for the register of non-state actors: Global engagement management (in 2015) would amount to US$ 734,000 in start-up costs, and thereafter US$ 76,000 per year.

[Update:] Norway Suggests Another Approach

This morning, as discussions are focused on the implementation of FENSA, Norway made a proposal, which they say could allow WHO to carry out its assessment of non-state actors in a transparent and accountable manner, and in a realistic way.

According to a Norwegian delegate, the WHO, by its own admission, could not carry out due diligence and risk assessment of all non-state actors it is working with. Under the current guidelines, he told Intellectual Property Watch, WHO only carry out due diligence and risk assessment on 5 percent of the non-state actors it is working with. The other 95 percent are subject to the judgment of the organisation, which does not create transparency or accountability, he said.

The proposal made today is seeking to find an alternate mechanism recognising that a large proportion of non-state actors do not pose a serious potential risk and can be dealt with in another manner, he said, insisting that this has to be done in a transparent and accountable manner.

European Countries Set to Block FENSA, Civil Society Says

Civil society groups are watching the process closely. On 21 April, the Third World Network (TWN) pointed fingers at some European countries for allegedly putting conditions on the adoption of FENSA. In particular, according to TWN, “these countries also warn that the Secretariat should be given flexibility to suspend FENSA norms while engaging with non-State actors to respond to emergencies.”

According to TWN, some European countries jointly wrote to the WHO secretariat expressing concerns about the external auditor’s report, as it does not refer to the exact cost implications of the implementation of FENSA. TWN said the letter was backed by the Czech Republic, Finland, Germany, the Netherlands, Norway, Sweden, Switzerland and the United Kingdom. This list was not confirmed by press time.

The alleged letter requests that additional information be provided:

“a)       an estimated figure or figure range for the current volume of engagements annually.

1. b) an estimated figure or figure range for the cost of implementing FENSA as it currently stands.
2. c) an estimated figure or figure range for the number of additional staff expressed as work years that implementation would require, as well as for the additional overall workload on existing staff in technical and other units not primarily tasked with operating the mechanisms FENSA would establish.”

Citing a developing country delegate, TWN said, “the request for additional information is an indirect way of putting conditions to block the adoption of FENSA even after the conclusion of negotiations.”

In addition, on 25 April, TWN published a report indicating that a new proposal from Norway on an emergency exception to the application of FENSA “would neutralise the safeguards” of the framework.

Global Health Groups Request Strong Framework

Meanwhile, some 34 civil society groups issued a letter [pdf] this week, titled, “Save the World Health Organization from the undue influence of corporations and corporate linked entities.”

According to the letter, the current process [pdf] of engagement with non-state actors restricts the acceptance of financial resources from the private sector to support salaries of WHO staff, while the current FENSA draft “ignores such restrictions and allows the Secretariat to accept financial support from the private sector to pay staff salaries.”

The groups are worried that reliance on financial support from the private sector “risks leading to the corporate capture of WHO.” They are calling for WHO member states to address the concern of sustainable financing of the organisation.

They are asking that safeguards against undue influence from the private-sector-linked entities and public-private partnerships be strengthened, and “at the very least, FENSA should not dilute the existing WHO safeguards.”

They also request WHO’s core function be “fully” protected, in particular its norm- and standard-setting activities, from the undue influence by putting in place clear rules against acceptance of cash or in-kind contributions from non-state actors for norm- and standard-setting activities. Finally, they request that the independence and integrity of WHO be protected from undue influence even during humanitarian emergencies.

William New contributed to this story.