WHO Draft 5-Year Plan Would Focus On Impact & Innovation, Be Discreet On Medicines Access

After the new head of the World Health Organization provided his vision for his tenure of the global health institution this summer, the organisation is working on its next programme of work for the period 2019-2023. A preliminary concept note has been issued for public consideration. The note lays out priorities and new orientations and describes a financially sober, more efficient organisation, focused on measurable impact, set on aligning with the United Nations Sustainable Development Goals, and affirming its role as a multi-stakeholder platform of global governance on health, but stays clear of controversial issues, such as the affordability of medicines.

The WHO consulted stakeholders after the publication of a Draft concept note towards WHO’s 13th General Programme of Work 2019–2023 [pdf], which was open for comments from 28 August to 13 October.

On 1 November, a draft 13th WHO General Programme of Work is expected to be released, and according to a source is expected to be published on the WHO governing bodies website, taking into account the comments received, according to the WHO.

A special session of the WHO Executive Board may be held on 22-23 November to discuss the draft. The decision has not been made yet, according to the WHO. A regular meeting of the Executive Board is held every year in January.

The comments – or even how many there were – have not been made available by the WHO, although the dedicated webpage says the comments received “will be posted on the WHO website and publicly available.” A WHO spokesperson told Intellectual Property Watch that the idea is to have comments published at a later stage but no precision on which date this would happen has been discussed.

According to the WHO, the draft concept note was to be discussed by the six WHO regional committees before 13 October.

Separately, new WHO Director General Tedros Adhanom Ghebreyesus informed staff this week in an internal communication that a “town hall” meeting scheduled for tomorrow would be delayed to allow him to first meet “for the first time with WHO’s entire senior management group, including all WRs and the incoming senior management team, to be followed by meetings with the Deputy Directors-General and Regional Directors who make up the Global Policy Group.”

“We will discuss a number of important strategic initiatives, including the new General Programme of Work and the transformation agenda, that will be vital for the future direction of WHO,” he said.

The WHO might possibly also be considering a leaked memo from within the Trump Administration that went public this week showing WHO recommended for a major funding cut by the US.

WHO Fight for Poor, Help Countries, with Help

An estimated 400 million people have no access to essential health services, the note says, and “the world needs an organization to fight for these people, who are often the poorest, so they can receive access to health services without financial hardship.”

The WHO is “the only international organisation in health accountable to all the world’s governments,” according to the note. It underlines the role of collective action and positions the WHO as a trusted coordinator for such action, a governance platform “where countries come together to share lessons, engage with non-state actors, and make collective decisions.”

WHO’s role is to help countries accelerate the attainment of the 2030 UN Sustainable Development Goals (SDGs) targets, the note says, adding that “some of the most significant health gains originate in policies from sectors outside of health and in this sense all the SDGs are health related.”

According to the note, WHO “will help ensure all people at all ages can access the health services they need without risk of impoverishment, including by encouraging domestic investment in health and strengthening primary health care.” Universal health coverage includes health promotion, preventive services, diagnostics and medicines for communicable and noncommunicable diseases (which are a key driver of out of pocket costs), and curative and rehabilitation services,” it explains.

Universal health coverage “is first and foremost a political choice,” the note says, remarking that countries at various levels of economic development have achieved it.

Fostering Innovation

According to the note, “WHO will embrace innovation to a much greater degree in several ways.” WHO. The organisation “will be a better partner with innovation funders, including foundations and innovation programmes of governments.” WHO will continue its work on pre-qualification of medicines, vaccines and diagnostics as well as in health information, the note adds.

“WHO has a role in fostering innovation, identifying priorities and coordinating R&D [research and development] in specific circumstances such as epidemics and areas where innovation has been lagging,” says the note. It also highlights the role of WHO in building capacity for research and innovation in low and middle-income countries.

The note, however, does not touch upon the prickly and growing global issue of the affordability and accessibility of medicines, in particular new innovations.

Governance Platform for Health, Multiple Stakeholders

According to the note, global governance has moved away from intergovernmental governance alone, and the WHO “is also an emerging platform for multistakeholder governance,” including governments and nongovernmental organisations, private sector entities, philanthropic foundations and academic institutions. The WHO will more clearly define the roles and responsibilities and inter-relationships among the Executive Board Bureau; the Programme, Budget and Administration Committee; the Executive Board; and the World Health Assembly, the note says.

On partnerships, the note points out that WHO exists in an ecosystem of partners. The WHO will use its Framework of Engagement with Non-State Actors [pdf] (FENSA) “as an enabler of responsible and productive partnerships.”

Focus on Outcomes and Impact, Budget Priorities

According to the note, the WHO will use a measurable results framework and “describe with rigor its contribution to outcomes and impact.” For example, the notes says, “it is more meaningful to contribute 10% to a drop in maternal mortality than 100% to a maternal mortality action plan (these are not mutually exclusive but the focus of measurement should be on impact first).”

The note also highlights the need to align budgets to priorities. The WHO will set priorities based on the clear endorsement by member states of five leadership priorities: health emergencies, universal health coverage; women, children and adolescent health; climate and environmental change, it says.

Other priorities are included in the overall WHO plan such as antimicrobial resistance, polio eradication and other elements of the UN Sustainable Development Goals (Goal 3: Good health and wellbeing).

Value for Money

Seeing the country contributions as an investment, the note says, they are entitled to “the best return on their investment.” The most important aspect of value for money is cost effectiveness, it says, adding that WHO will address travel and meeting management, procurement, and “other related tools to optimise cost efficiency and economy.”

“WHO will develop a culture of results focusing on impact,” it said in the note.

Some members states during past meetings of the annual World Health Assembly have underlined the need for WHO to provide tangible results for the funds it is given, in a “value for money” fashion.

William New contributed to this report.

 

Image Credits: World Health Organization