Professional Documents
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Watch
Report on WHO Workshop and EB Watch
January 2011
23-Jan-11
A five day workshop on WHO Watching was held in Geneva from 12‐16 Jan 2011. Five
volunteer watchers from five continents sat with resource people from Geneva and
beyond plus PHM mentors to explore the structure of global health governance; the
history, operations and troubles of the WHO; and the items on the Executive Board
agenda.
During the succeeding 8 days (17‐24 Jan) the ‘watchers’ monitored and analysed the
discussion in the EB and through the documents produced. Opportunities, formal and
informal, for advocating a PHM position were taken including a letter to all EB members,
a statement from the floor regarding the financing of WHO and informal discussions
with delegates. The workshop discussions and EB watching were supported by the GHW
website and a shared Skype channel.
The watchers, in consultation with the wider PHM group (and NGO friends), identified a
number of priority topics for continued advocacy and commenced the task of preparing
draft advocacy plans for the short and medium term for these topics.
WHO faces multiple crises; financial, managerial and legitimacy crises. The vultures are
circling; seeking to reduce it to a purely ‘technical’ agency, undertaking ‘normative’
‘standard setting’ work with no effective role in global health governance, let alone a
leadership role. If WHO is reduced in this degree the voice of L&MICs in health
governance will have been silenced in that WHO is the only intergovernmental
organization in the health field.
PHM and GHG partners should prioritise our efforts to defend WHO as well as making it
more accountable and more effective. The WHO Watch Project is designed to contribute
to the accountability, effectiveness and survival of WHO through monitoring, analysis
and advocacy, in particular strengthened advocacy at the country level. This EB watch
(primarily directed to monitoring and strategizing) has achieved its objectives but EB
Watch is only the first stage of the project. The next stage is country level advocacy and
behavior change of member states. Whether such behavior change is to be seen in one
cycle or whether it will need a build up of advocacy over several cycles is yet to be
discovered.
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The WHO Agenda, the Constitution, the work of the Secretariat at all levels and the
corpus of previous resolutions provide an entry point into a very broad range of policy
issues, many of which affect the health of people around the world. Organising some of
our work around the WHO Agenda provides PHM and GHG partners with policy and
advocacy capacity in a broad range of important issues. While WHO is only one of the
many fora where global health issues are discussed familiarity with the issues coming
through the WHO agenda also points towards the involvements of other big players. As
the Democratising GHG Initiative develops we will be in a better position to extend our
watching to these other big players.
Special appreciation is owed to the WCC for financial and logistics support for this first
EB Watch.
Further information:
For more logistic and procedural detail regarding EB Watch, Jan 2011, see Annex
1;
For the program for the Orientation Workshop at Annex 2;
For our evaluation of the EB Watching see notes from the evaluation discussion
at Annex 3;
For advocacy recommendations from the watchers see Annex 4;
For a summary of the Democratising GHG Initiative see Annex 5.
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Annex 1
Logistics Report on WHO Workshop and EB Watch
January 2011
Personnel
Watchers: John Mahama (Ghana), Naveen Thomas (India), Denise Nascimento (Brazil),
Jef Rentein (Australia), Ilker Kayi (Turkey).
Mentors: David Legge, Hani Serag, Amit Sen Gupta, KM Gopakumar,
Resource people: German Velasquez, Alison Katz, Garance Upham, Thomas Schwartz,
Jose Utrera, Sangeeta Shashikant, Heba Wanis, Manoj Kurian, Andreas Wulf, Thomas
Gebauer, Ellen ‘t Hoen
Recruitment of watchers
PHM regional coordinators were approached to nominate a small group of younger
activists who might be able to commit to perhaps 20 days a year and would be able to
participate in the monitoring, analyzing, advocacy and organizational activities required
for this project.
These nominees were approached and a group of watchers confirmed.
Logistics
Air travel was arranged through the Cairo office of the Global Secretariat
Accommodation and meetings were arranged and supported by World Council of
Churches
The watching website was managed by Indranil and Amit in Delhi and Azza in Cairo.
Orientation workshop
A five day orientation workshop was presented; at WCC and the John Knox Centre.
The program of discussion is presented at Annex 2.
As planned the workshop canvassed the history, evolution and current troubles of the
WHO. We worked through the detail of the EB agenda and discussed priorities,
strategies and directions for PHM advocacy in relation to the priority issues on the
agenda (and a few which were not on the agenda.
The Global Health Watch website provided an invaluable anchor to the discussions of
agenda items by aggregating in one place a range of references and URLs of relevance.
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Practical details were explored including how to approach delegates.
Watching
Watchers and mentors were accredited as observers through the WCC delegation.
A common Skype channel was established for instant group messaging throughout the
EB discussions.
Denise took responsibility for voice recording the whole debate. This role includes
editing the sound files into folders which correspond to the Agenda Items and recording
the elapsed time when different speakers commence so particular contributions can be
located.
A daily roster was created to share the work of note taking and the watchers assigned
particular topics among themselves for purposes of summarizing and commenting on
the agenda items and suggesting advocacy strategies.
A nightly debrief was held to review each of the topics discussed and reflect on the
contributions of the different country representatives and to report other interesting
engagements.
Watchers were tasked with drafting a summary commentary on each of the priority
agenda items for posting on the website.
Advocacy
The last two days of the Orientation Workshop focused on the preparation of a letter to
members of the EB providing PHM advice on a range of topics. This letter was well
received by a number of delegations and clearly influenced member state contributions
in a number of debates.
Numerous contacts were made with delegates and with observers from other
organizations. In particular, each of the watchers were able to make contact with their
own country delegations.
PHM also read a statement to the EB during the debate on the future of financing of
WHO.
Resources consumed
Item PHM WCC In Kind Total
Air fares (8 return flights to Gva) $9,532
Accommodation refreshments etc $11,460
(100 person days at JKC) $4,152
$1,576
Person time (100 person days @ $50 pd) $1,000 $5,000
Total $10,532 $17,188 $5,000 $32,720
4
Next steps
The watchers have arranged to continue to work together through: monthly Skype
meetings and a shared folder on the internet.
Further follow up of EB Watch
1. Consult with CoCo and GHG partners regarding advocacy recommendations and then
disseminate to regional coordinators and country circles;
2. Implement advocacy activities focusing on priority issues in consultation with PHM
streams and partner networks including position papers / statements on selected
priority issues;
3. Organise WHO advocacy circles at the regional and country levels (involves
communicating with regional coordinators and country coordinators and driven as
necessary by watchers); follow up the contacts made with the representatives of
member states who showed interest in collaboration with the PHM especially Brazil,
Thailand, India and Bangladesh;
Preparing for WHA
4. Seek further funding for the next 1‐2 years
5. Recruit a further 5‐6 watchers from the regions (depending on funding availability) for
WHA
6. Implement GHG stream in IPHUs
7. Plan for another training workshop in advance of WHA (including old and new
watchers)
8. Plan for CS Event in advance of WHA focusing on key agenda items
9. Implement new and improved Watch and Advocacy protocols at WHA
10. Identify a short list of member states (may be 10 countries) to negotiate PHM
positions regarding selected items on the WHA agenda and proceed with such
negotiations
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Annex 2
Program for WHO Watchers Workshop (Jan 2011)
Day Time Topics and themes Key Resource
People
Wed 09:00 – Welcome Manoj Kurian
12 Jan 12:30 About the project and about global health David Legge
governance (including case studies) Hani Serag
About PHM’s previous WHO liaison and the need for German
more systematic watching, analysis and advocacy at Velasquez
global, regional and country levels
About the workshop , the program and the agenda
for the EB
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Day Time Topics and themes Key Resource
People
Fri 13:30 – 8.1 Election of DG (EB128/27) – German ‐ Hani Battina
14 Jan 17:00 MDGs (Item 4.4, EB128/7, GHW) Schwethelm
Infant & child nutrition (Item 4.15, EB128/18, GHW) German
MCH (Item 10.2I, WHA58.31, GHW) Velasquez
Waste management (Item 10.2H WHA63.25, GHW) Denise
Pesticides (Item 10.2G, WHA63.26, GHW) Nascimento
Child injury (4.16, (EB128/19 and EB128/19 Add.1,
GHW)
Leishmaniasis ‐ Naveen
International Health Regulations _ DL
Prioritise topics on agenda for comments (additions,
deletions) and to whom are we sending what
comments ‐ Gopa
Steering committee
Review letter
How do we work over the next week
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Annex 3
WHO Watching – Improving Our Process
Meeting of Watchers (23 January 2011)
Attendance
Jef, Heba, Ilker, Gopa, Naveen, John, Denise, David, Hani
How to make it better?
Workshop
There was a general appreciation of the Workshop in setting the scene. Without it we
would have been quite lost. A lot of what we needed comes from experience only; don’t
get everything which is presented; much of what we did emerged spontaneously. This
needs to be captured and passed on.
However, there is a recognition that this was the first round of watching and we are
learning as we go.
Suggestions for improvement include:
more discussions about the WHO position and role within the global health
governance structures;
more information about how WHO works, including constitution,
procedural relationships between governance and secretariat and how
resolutions and budget work;
more discussion of the very practical aspects of ‘watching’: where to sit,
distribution of the watchers, collection of images and sounds, need for
clearer ‘protocols’ for lobbying; how to use our time;
clearer guidance about pre‐reading, in particular, guidance in browsing the
WHO site;
pre‐reading should be provided on the priority issues; the focus on agenda
items in the Workshop was good but need to know more about PHM’s
position; how to tackle it; whom do we need to push; what else can we do;
allocation of issues among watchers could have been done earlier;
current round of watchers to put together a resource package on issues,
aspects of watching; organisational memory; how did we do certain things;
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need to rethink the pedagogy of the workshop; there was strong dialogue
between senior PHM folk and the resource people; need to get the
watchers more involved in this discussion;
longer lead time would have been appreciated to allow time for pre‐
reading and writing;
explore scope for more organised teamwork teamwork; eg small groups on
priority issues;
closer links between the watchers and PHM experts, including those not
attending in person; before, during and after the workshop;
recognition that the preparation of briefs prior to the workshop by PHM
experts was a bit disappointing this time around; in future trained
watchers drive the process of generating the briefs working with the senior
people;
as the pool of watchers widens we can have more people working on briefs
and analysis;
ask people from missions (India, Brazil, Thailand) and key people from
delegations to give us some insiders’ perspectives;
need to include stronger focus on global governance and macro
economics;
need to provide a clearer sense of how the outcomes of the watching are
to be used which will help to shape how the watchers work;
can we meet by teleconference before we come to Geneva with a view to
dividing the work among ourselves; and finding the additional expertise
that we need;
can we convey more effectively subtle understandings of coalitions and
trends in decisions and EB practices; recognising that there are boundaries
between what can be ‘taught’ and the common understandings that a
community of watchers builds up;
need to focus more on PBAC and the budget; following the budget is very
important; we don’t get to PBAC because it is closed but we could analyse
those papers in advance; maybe two years down the line; we need
competence in terms of accounting and public health; maybe in two years
time
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need to have speakers from WHO Secretariat; contacted the NGO Liaison
but got no response; next time invite senior officials with responsibilities in
our priority topics to provide a briefing but not our advocacy discussion
leave a day off between the workshop and the commencement of the EB.
EB Watching: How to make it better?
Suggestions:
fine tune the division of labour; note taking, listening, recording;
note taker should not be the responsible person; how to divide effort in
time; rewarding debriefs; report writing;
recording and accessing the sound files; renaming, saving on internet;
creating lapsed time notes;
recordist and note taker not the person with resp for topic; responsible
person needs to be able to listen and absorb;
should not take notes on everything they are saying; a lot of words that are
not needed to be recorded; need to be listening at a sufficient level to
identify the key turning points in the speeches; catch the discourse;
could have had more practical introduction to watching in the Workshop,
including to discourse listening;
don’t have all the watchers watching all the time; some of the watchers to
leave the EB for working on their notes and analysis; watching all the
sessions and then coming to the debriefs is too tiring and does not leave
enough time to do the notes and reports;
can use the overflow room more; can track what is happening but also
work; need to find a way to divide the labour; different configuration at
the Palais de Nations and more sessions running in parallel; no formal
overflow room;
need to explore the utility of a separate Skype channel so people not in
Geneva or in the room can listen; might need a dedicated watcher;
About regional committee watch
depends on having enough people which we will have soon
attending the RCs will help us to set the agenda; if you want issues taken
up in EB and WHA we need to work through the regional committees; we
can work through PAHO, SEARO and AFRO and EMRO particularly.
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WHA Watch
more complicated than EB; technical briefs; regional gatherings;
will need another orientation workshop If we can bring new watchers;
include selected country reps.
Reworking the GHW Website
DL reported discussion with Amit. The EB watching pages will be archived. A new index
page for the WHA will be prepared. A new set of pages will be prepared, issues pages,
which carry all of the stuff generated during the EB Watching and which will be directly
linked from the new index page for the WHA. Thus the issues pages will be able to
remain more stable and not needing to be changed at every new watched meeting.
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Annex 4
Advocacy Recommendations
Meeting of Watchers (23 January 2011)
Attendance
Jef, Heba, Ilker, Gopa, Naveen, John, Denise, David, Hani
Advocacy strategies
We have two broad advocacy strategies: centrally driven and locally driven.
Leadership with respect to locally driven advocacy lies with PHM’s regional
coordinators, country and regional circles and the WHO Watchers. We are presently
finalising report on all of the items on the EB Agenda; all of these reports will include
broad brush advocacy recommendations. These reports will all be posted on the WHO
Watch website. When they are so posted we propose to communicate with PHM SC
members, regional coordinators, country circles and GHG partners drawing these
reports to their attention.
Centrally driven advocacy involves global level initiatives directed as described below.
Priority topics
We decided to discuss priority items under two broad headings; first, the priorities for
preparing for the WHA in May and participating in other ways with the WHO processes;
and second, the longer term priorities for PHM and GHG partners.
Priorities for action in the lead up to the WHA:
The future of financing for WHO
Health System Strengthening (incl HRH)
NCDs
Immunization
AIDS HIV strategy
Counterfeit, Intellectual Property Rights
Pandemic Influenza and benefit sharing
Social determinants
Innovation and treaty
Rational use of medicines
IHRs
Priority Issues for PHM and GHG partners:
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Health System Strengthening (incl HRH incl immunisation)
The role of WHO in GHG
Trade and health including counterfeit, innovation, and benefit sharing
Social determinants (incl NCDs and drinking water)
AIDS HIV strategy
Malaria
NCDs
Maternal and Child Health
Structure of item reports
We discussed the report with Jef and David had prepared on Benefit Sharing by way of
thinking about the structure of such reports. Agreed that we need something like:
context of EB consideration of this item
background to the issues
descriptive report of EB consideration
what level of priority?
contentious issues?
active organisations (including potential lead organisations)
advocacy opportunities and strategies
We agreed that we would not post detailed advocacy strategies on the GHW website.
Rather we post general directions for advocacy but when we post these general
directions we also write an email to the group outlining our detailed suggestions for
advocacy.
Future of financing of WHO
For WHA advocacy
TWN to take the lead on this issue; undertake research; develop resource material;
provide advice to PHM and GHG partners;
We definitely want change; don’t want a forum which features the private sector and
big foundations; concerned about the dangers of the new global forum of giving donor
club opportunity to set the priorities which are then imposed on countries; need to
emphasise country level prioritisation;
We want more effective NGO participation; link of accreditation; don’t want our
statements censored before being read to the EB or WHA; this is the practice in all other
UN agencies; NGOs should be able to comment on each item, even on MS comments
Key messages: (i) Increase assessed contributions; (ii) reform the management of WHO;
(iii) caution about the Forum; (iv) make it easier for NGO participation.
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Steps: Prepare discussion paper on future of WHO including reference to current glob al
health architecture and how it is shaping or preventing HSS; summarise the debates
about GHG and within WHO; provide analysis (deliberate intention to reduce the role of
WHO in global governance); then lead to PHM/NGO Statement; Advocacy directed to
supporting PHM country circles to push MOHs and MOFs to increase funding to WHO as
assessed contributions or untied donations;
We also need a detailed analysis of revenues and expenditures over the last say 10
years; allocation of funds to different programs; what resolutions are funded and those
which aren’t; link between extra budgetary funding; need to look at what has been
published; perhaps ask Ravi Duggal to provide an overview; South Centre may be able to
help with getting non published data; India has been on PBAC for two years; ask them to
share the data;
Longer term PHM priorities: the role of WHO in GHG
Need detailed background paper; identifying health governance as a subdomain; link to
GHG reform discussions; resource for different activities for PHM eg IPHU and WHO
Watching ; link to governance architecture; a vision statement on the role of WHO in
global health governance; one nation one vote; restructure of WHO to play this role;
Health System Strengthening (incl HRH)
For WHA
Go through the HSS resolutions; suggest possibilities for new resolutions or
amendments if needed; and advise advocacy action on country level; identify countries
whom we should engage with who would be supportive; planning for a pre‐WHA
workshop or inputs into pre‐WHA workshop; recruit as necessary; look at other
initiatives; Look at global health architecture and how it is shaping or preventing HSS;
need to go through other resolutions also looking for opportunities to make the HSS
linkages; eg malaria, immunisation
NCDs
Key issue under NCDs is whether treatment should be included; Bangladesh has put up
amendment asking MS to recognise and ensure access to diagnostic tools and medical
products; asking states to invoke legal and policy tools to ensure treatment; asking Sect
to prepare a database of evidence based treatments and survey of availability and cost
of treatment; to provide tech ass to MS whenever to ensure access to affordable
treatment;
We may need to include in our report the development and pushing of a resolution for
treatment as well as prevention and control
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Open for consideration at Moscow Meeting April and WHA in May
We need to think about how where our focus should lie:
‐ Criticise big pharma for cynical support to NCDs in the hope of market building
‐ Push the SDH, HSS and political economy agendas; away from victim blaming but
looking at the social and economic context, eg fast food control; also can be an
opportunity for pushing the universal health insurance; these diseases are not
included in the min pack model in many countries; growing BOD but not health
coverage;
‐ Opportunity to build links with specialist networks;
‐ Specific social determinants (caution with general language)
If we don’t go to the NCDs discussion then in the dry run global forum CS will be rep’d
by the vertical dis spec programs; so PHM should be there;
We need a position paper on NCDs to support our presence in Moscow
Immunisation
Planning for May WHA
Need for country assistance for country specific needs assessment
Problems with the financial model: GAVI gives the country money; drive down the price;
then pull out in five years; need to look at viability of this logic; campaign to change the
perception of vaccines; should not weaken public understanding of the science and the
importance of evidence; tech transfer and public sector production; new partnerships
with private sector; IPRs; what do to; concerns about WHO pushing Hib and
pneumococcal vaccines in India
Also Health Systems implications regarding delivery without disrupting health services
Consider all of the issues; evaluate the Vision and Strategy paper; evaluate the
resolution; and devise amendments if appropriate, produce a draft position paper and
identifies possible amendments for WHA
Involve MSF and Oxfam
AIDS/HIV
The main issue is WHO’s role in UNAIDS strategy including the Division of Labour and
the Lead responsibilities.
The WHO Strategy appears to be heavy on treatment and less so on prevention but this
may reflect the UN division of labour; there are also issues about access to ARVs;
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integrating treatment and prevention would be appropriate a health systems
strengthening perspective;
There is concern about the lack of money for the next GF replenishment; MSF says
political interest in HIV has gone down and this is leading to decreasing funding; we
have heard a lot of talk during the EB about financial crisis and economic crisis; what it
points to is that charity is unsustainable as a funding source if it dries up at times of
economic crisis; lots of money for the banks tho; AIDS is a collective responsibility;
charity is unstable; GF is an NGO;
Note the US comment on the failures of diff pricing; and the need for more generic
mfrs; and MSF comment on the use of TRIPS flexibilities;
HIV AIDS technology network; not functioning; look at this also
forms of access to technology;
Need a CS Position Paper with recommendations for amendments but we would like
AIDS groups to take the leadership
Counterfeit & intellectual property rights
Next event is the meeting of the IG WG (Feb 28‐2 Mar):
TWN will be working on EUs involvement, Interpol involvement, and the way forward
within WHO framework.
TWN will prepare a letter to country delegates on Counterfeit and Vaccines in advance
of the Feb working group
Social determinants
For WHA
There will not be much action at WHA; main action will be at the conf in Brazil in
October.
We need to engage with the idea of SD as a cross cutting issue in WHO without dept
(after the conference); we expect that this dept will remain until the conf and will then
be closed; need to have a PHM statement and position about implementation of SDH to
be ready before the conf in Brazil and to plan for PHM good participation in the Brazil
conf; note that the DG will be particularly touchy at this stage regarding her second
term election
Prepare report on our discussions of SDH and relevant passages at the EB and our
concerns about mainstreaming and cross cutting; perhaps M Marmot might undertake a
framework for the monitoring the mainstreaming of gender, HR, SDH, PHC, etc into the
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various work programs of WHO; and to conduct a baseline assessment and to present
an interim report in November; suggest that he involve streams and knowledge
networks and CS
Longer term PHM position
We need to keep linking SDH to macro economics; not to have SDH reduced to
sanitation and water and intersectoral collaboration. The CSDH report, plus the
Globalisation KN, plus the recent Labonte Schrecker book provide us with good
conceptual and evidence base; the theory is already there; we need to move to action.
A lot of the SDH does not relate to the daily realities of primary health care; need to
articulate SDH at the PHC level.
Perhaps our focus should be on the role of the PHC sector in mobilising communities to
drive health in all policies; good policy is not enough; also need the political drive which
comes from local level mobilisation
We need to create a framework and then ask countries to do brainstorming to find case
studies which fit this framework; stories which throw light onto how health systems can
mobilise around such issues with a strong macro economic flavour; clearly making links
with NGOs and CS advocacy in other sectors; ask to present these case studies at the
Brazil conference in October
Innovation and treaty
TWN will take the lead
Rational use of medicines
Invite member state to prepare a resolution asking Secretariat to provide a report to
WHA on implementation of various resolutions on RUM over the last 10 years, including
in
‐ Resolutions report format
‐ How much money
‐ Human resources and how and where
‐ Outcomes
‐ Lessons from RDU for management, implementation and accountability
‐ Future plans for funding of implementation of RUM
IHRs
Prepare a report on IHRs to circulate on this list, including recommendations for action
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Longer term PHM policy work
Trade and Health
Watch and wait while the above groups work on the IP aspects
Malaria
We need to make the links between malaria and HSS and SDH.
Need to ensure that in implementing the HSS project (above) in Africa we include a
strong focus on malaria both in the IPHUs and the regional assemblies and in the
country level platforms
In collecting the case studies (as above under SDH) from Africa we include a focus on
malaria showing how PHC practitioners can approach the SDH and HSS issues associated
with malaria
Womens and Childrens’ Health
Suggest a chapter for GHW on UN Global Strategy and High level Commission
http://www.everywomaneverychild.org/
http://www.who.int/topics/millennium_development_goals/accountability_commissio
n/en/
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Annex 5
The Democratising GHG Initiative
The Democratising GHG Initiative is directed to changing the patterns of global decision
making and implementation in matters which affect the global health crisis through
strengthening alliances and advocacy around such decision making.
The original project proposal emerged out of the Workshop on Democratising Global
Health Governance held in Geneva on 14‐15 May, 2010
(http://www.phmovement.org/en/node/2897).
The project is advised by a steering committee including TWN, South Centre, MMI, MI,
WCC, HAI and Cordaid.
Goal
The goal of the Democratising GHG Initiative is to improve the global environment for
health development by changing the information flows and power relations which
frame global health decision‐making and implementation.
Objectives
The more specific objectives of the Project are:
build an alliance of civil society networks, social movements and academic institutions
and with links with participating governments to jointly plan for actions directed to
democratizing global health governance;
build a stronger, better informed, more strategically organized ‘health for all’
constituency to participate more actively in global decision making which affects health;
identify specific initiatives which might contribute to:
o constructive collaboration at the national and international levels between
ministries of health and health advocacy bodies within civil society to promote
health equity objectives across policy making in different sectors;
o better informed and organized collaboration among governments at the
international level (especially developing country governments) in relation to
global decision making affecting health;
o building lobbying capacities of governments, civil society organizations, and
academic institutions to influence global decision making which affects health,
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including support for social mobilization, creating evidence, analyzing policies,
developing informed alternatives, and building alliances and pressure groups.
Theory
The structures and dynamics of Global Health Governance (GHG) are dominated by the
big powers (in particular, USA and Europe) and by large transnational pharmaceutical
corporations. The big players operate through the UN system, the Bretton Woods
system and a plethora of global public private partnerships. They also operate directly
through bilateral and regional trade agreements; through the operations of bilateral
international assistance; and through direct advice and pressure. The operating
paradigm of this regime is strongly influenced by the ideology of neoliberalism which is
promoted through a much wider range of channels including the commercial media and
various corporate peak bodies (such as at the World Economic Forum).
In many respects the regulatory, financing and policy outcomes of this system reflect
the interests of the rich world. This bias is reflected in:
continuing unimpeded brain drain, in part because the rich countries do not train
enough of their own professionals (it is much cheaper to import professionals trained in
the developing countries);
an intellectual property rights regime which is largely focused on maintaining the profits
of transnational pharmaceutical companies and discounts the urgent needs of millions
of people in developing countries;
trade policies which sanction the dumping of agricultural produce on developing
country markets (which jeopardises the livelihoods of small farmers);
trade policies which pressure developing countries to cut tariff protection and export
duties without regard to the consequent unemployment and loss of government
revenues (and public services);
health system policy models which are oriented to stratified health care delivery with
private care for the rich, social insurance for the middle and safety nets for the poor;
resistance to the kinds of sectoral policies suggested by the WHO Commission on the
Social Determinants of Health which could greatly improve population health.
Low and middle income countries are largely excluded from the corridors and forums in
which the decisions and policies of the prevailing regime of GHG are formed. Even
outside the corridors and forums the voices of most low and middle income countries
are muted and dispersed. There are important exceptions; a small number of LMICs
have invested significantly in their intersectoral work (eg between health and trade) and
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in global health policy making and advocacy. There are also resources within civil
society globally which are well informed and supported by high level analysis and which
are sympathetic to the perspectives of L&MICs. Civil society networks which link North
and South constituencies also provide an avenue through which the health needs of
LMICs can be brought to Northern consciousness.
There is a strong case for new alliances; for policy research and capacity building with a
view to changing in some degree the perspectives which inform GHG and the balance of
forces which shape such decision‐making.
Phase 1. WHO Watch
Goal
Support and strengthen WHO in achieving the mandate of its constitution and in
engaging in the broader field of global health governance
Objectives
Monitor and evaluate the work of WHO including WHA, EB, Regional Committees and
various special purpose processes.
Advocate progressive policies within WHO governing bodies
Work with the secretariat at all levels to support the implementation of progressive
policies and initiatives
Support and encourage member states in taking more proactive positions in favour of
the Health For All agenda and a more progressive WHO
Strengthen CS networks at the country and regional level who are aware of the work of
WHO and who are able to work together and with ministries of health and member
state governments to promote a more progressive WHO
Develop a cadre of health activists who will support the systematic monitoring and
analysis of WHA’s decisions and work and the development and implementation of
advocacy and support strategy at the country, regional and global levels.
1.1. Regional WHO Watch
Build regional networks of activists who attend or otherwise follow the agenda and
decision making at the regional committee level and who can assist and encourage
member states to adopt more progressive policies in regional decision making and can
encourage the regional and country officials to implement effectively the more
progressive policies.
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And who will use the regional committees to develop a stronger constituency for
progressive policy making at the WHO.
1.2. EB Watch
Recruit WHO Watchers from IPHU alumni.
Provide short course training for volunteer watchers:
‐ Understanding GHG
‐ History, structure and functions of WHO
‐ Current issues concerning WHO
‐ Current issues on WHO’s agenda
Participants in this course will stay on to monitor the EB and where possible intervene
and will lead the documentation of future WHAs and Regional Committees.
Future program of such short courses as necessary.
1.3. Advocacy in the lead up to the WHA
Based on analyses developed at January EB and arising from regional WHO watching
Focus on country level advocacy around selected issues and selected countries with a
view to encouraging more progressive decision making at the WHA.
1.4. Website
We have established a WHO Watch webpage on the GHW site. See
http://www.ghwatch.org/who‐watch.
This will serve as the public reporting face of WHO Watch.
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