Democratising Global Health Coalition

Letter on the World Health Organisation reform sent to Geneva Missions of Member States of the WHO by Democratising Global Health Coalition.

13th September 2011

Dear Member States of the World Health Organisation,

Aware of the upcoming discussions on the progress of the WHO reform process and related documents, we would like to share with you the perspective of a large group of public-interest NGOs and other concerned citizens, the Democratising Global Health Coalition (DGH,

The coalition is following the reform process as closely as feasible and is facilitating, to the extent possible, a dialogue among the public interest groups aimed at developing constructive and realistic proposals. It is in this spirit that DGH sent you a letter on 30th June 2011 and is sending letters to all WHO Regional Committee meetings (see both letters attached to this email). These present the DGH coalition’s comments on the concept papers prepared by the WHO Secretariat and expressed concerns related to some of the proposals contained in these documents, as well as suggestions for moving forward.

We have now had the opportunity of looking at the latest Preview Paper on the WHO Managerial Reforms, which further reinforces our serious concerns about the direction this process is taking. None of our earlier proposals have made their way into the Secretariat’s papers on reform. Thus, we feel compelled to call upon you as Members States, the legitimate political voice in the World Health Organization, to reiterate our major remarks:

1. The rationale of the WHO reform has yet to be established, based on a solid, in-depth situation analysis to justify it

The reform was introduced through considerations on financial difficulties and prospects for future financing of the agency. Alarmingly enough, as of today, not one single document has yet been made available by the Secretariat on WHO’s financing, i.e. the root causes of the current situation, present constraints, limitations of the system, opportunities for potential savings and ideas for future sustainable funding. Can this ever be considered a serious approach on which to found and justify a reform?

2. Far beyond a managerial reform, what you are dealing with today is a major political and strategic move. This reform must be placed in the context of a globalised economy, the current financial crisis and the need for reasserting WHO as the leading intergovernmental agency for health.

3. The risk of the proposals currently put forward is that they undermine, rather than reinforce, WHO’s constitutional mandate, further diluting the right to health perspective by opening the door to private and corporate for-profit entities to take part into policy setting on global health. Giving more influence to private for-profit actors in international public health decision-making processes runs counter basic democratic principles.

4. The unprecedented speed of the reform process, coupled with its opacity and the lack of participation by the public health community, makes it practically impossible even for Member States to follow the route with any real ownership and capacity to contribute. Yet, it is precisely the Member States – the legitimate constituency of WHO – who should drive the entire process.

5. In addition to impairing proper governmental guidance and contributions, the current WHO reform further suffers from the exclusion of public-interest members of the civil society, the ones who seem to have taken this initiative with the serious attention it deserves.

At this stage of the process we urge you, as representatives of the people of your countries, to measure the quality and relevance of the Secretariat’s proposals against the WHO constitutional mandate:

Do any of the proposed changes enhance WHO’s objective to work for the “attainment by all peoples of the highest possible level of health”? (Article 1)

Do they enhance or undermine WHO’s function to “act as the directing and co-ordinating authority on international health work”? (Art. 2.a)

Do they enhance or undermine WHO’s role as regulatory and standard setting body in international health matters? (Art. 2. k and u)

We appeal to you to kindly ensure that any changes proposed to the ways in which WHO functions and is financed are truly a contribution towards making global governance for health democratic and accountable. They must not lead to more plutocratic global health decision making and to the erosion of peoples’ universal human right to health.

We thank you for your attention and look forward to future dialogue with you on these issues and beyond.

Democratising Global Health Coalition (DGH)

CHESTRAD International, Global

Community Working Group on Health (CWGH), Zimbabwe

Declaration de Berne, Switzerland

Health Action Information Network (HAIN), Philippines

Health Action International, Global

Health Innovation in Practice (HIP), Switzerland

International Baby Food Action Network (IBFAN), Global

Justicia, Salud & Desarrollo, PHM-IBFAN, Bolivia

Knowledge Ecology International (KEI), Global

Medico International, Germany

Medicus Mundi International Network (MMI), Global

Partners in Health, USA

People’s Health Movement (PHM), Global

People’s Health Movement, India

Prayas, India

South Centre, Geneva

Third World Network (TWN), Global

Wemos, Holland

World Council of Churches, Global

World Social Forum on Health and Social Security, Brasil