GHF2010 – PS10 – WHO and Global Health Governance

Session Outline

Parallel session PS10, Tuesday, April 20 2010, 16:00-17:30, Room 3
Chair(s):  Sisule F. Musungu, President, IQsensato, Switzerland
Summary: According to the Constitution of WHO, the first function of the Organization is to act as the directing and coordinating authority on international health work. Owing to the gradual influx of various partners in the health arena, WHO, although remaining important, has seemingly lost its preeminent leading role. Several former WHO staff, not excluding others, have pondered about the current situation and would try to indicate some broad policy changes for WHO. These opinions are offered constructively and are based on the deep loyalty they feel towards the Organization.
Towards a Slimmer WHO: Redefining Functions by Concentrating on its Normative Role, Leaving Service Delivery to Others? 
Dev Ray, President, Association of former WHO Staff & previously Chief, WHO Governing Bodies, Switzerland
Tuning WHO Interventions to Needs of Countries: Can Support Be Fine-Tuned Based on Intrinsic Country Differences? 
Fernando Antezana, previously Chairman of WHO Executive Board (2006) & Deputy Director-General of WHO, Switzerland, former Minister of Health of Bolivia
WHO and Public-Private Partnerships: Have Partnerships Proved Beneficial in the Long Run?
Yves Beigbeder, previously WHO Legal Expert in the Human Resources Department, Switzerland

Session Document

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Session Report

Submitted by: Anne Descours (ICVolunteers); Contributors: Christoph Wirth (ICVolunteers)

Public-Private Partnerships are of increasing importance for entities such as the World Health Organization. Exhibition booth at the Geneva Health Forum 2010. Photo by V. Krebs, ICVolunteers.org

The primary mission of the World Health Organisation (WHO) is to provide global health governance. But with an increasing number of powerful stakeholders in the health arena, the WHO has lost its leading role. A panel of former staff members try to analyse why and to propose changes and solutions.

President of the former WHO staff, Dev Ray, thinks that the World Health Organization (WHO) should slim down and revert to its normative role. The size of the WHO’s management staff as well as the volume of paper it publishes has dramatically increased in the last decades, while the influence of a few rich countries has been increased. Yet the WHO’s mission is to serve countries, not itself. Moreover the number of actors in funding health programmes has increased and private donors have poured huge amounts of money into the WHO. Whereas a few decades ago, 20% of funds were coming from voluntary donors and 80% from governments, the reverse is now true. This has led to a lack of transparency and a will to please donors instead of an orientation towards results. To re-establish its leading role in health, the WHO should now concentrate on its primary mission of concentrating on people’s needs and setting international standards and rules. Voluntary contributions should be rejected when they are not flexible. A monitoring and evaluation system should be developed within the organisation to understand where it has failed.

Fernando Antezana has been Chairman of the WHO’s executive Board and Minister of Health of Bolivia. With the benefit of both viewpoints, he raised the question of the adaptability of WHO interventions to the needs of individual countries. Several issues come to his mind. Each country and even each community has its own agenda and has problems adjusting to external agendas imposed by private donors. WHO’s executive board, which meets only twice a year, is busy with an increasing amount of paperwork instead of focusing on taking decisions. Finally, there are huge discrepancies in the specialisation and number of delegates in individual countries. The WHO needs more collaboration centres to come back to its normative function and these should always be based in developed countries. Teams should be limited and represent many sectors.

A former legal expert from the WHO’s human resources department, Yves Beigbeder reported on the recent tendency for the WHO to use Public-Private Partnerships (PPPs). After Kofi Annan opened the UN to the private sector, the WHO saw the number and variety of its partners growing: pharmaceutical companies, the World Bank and business-related foundations have joined the traditional partners of governments and NGOs. Private-public partnerships help to tackle successfully a number of diseases thanks to more funding, a wider expertise, increased R&D and increased production capacity. On the other hand, the primary mission of the WHO has been taken over by others and it is more and more difficult for the WHO to impose public health standardisation onto companies on which it depends. This has cast doubt on the neutrality of the WHO. Public-private partnerships will stay, but to better manage them there is a need for independent assessment and better regulation. The ratio of public/private funds has to come back to a more reasonable one. These efforts are compulsory for the WHO to keep its identity and integrity.

Many questions remain because of the complexity of the problem. Is it even possible for the WHO to regain its leading role? This topic has to be discussed within the WHO itself and solutions have to be found.

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