G2H2 Working Group on WHO and global health governance and financing
A new G2H2 Working Group on “WHO and global health governance and financing” was launched by the G2H2 Steering Committee at its meeting on 5 December 2018, based on a proposal received from two G2H2 members and built on earlier conversations and plans. The Working Group is currently in the making; a call to G2H2 members to join it and contribute to it will be launched in mid-December. For the time being, please refer to the outline below.
WHO and global health financing
Since the beginning of the WHO reform process in 2010 a number of civil society organizations have called for Member States to increase their financial contributions to WHO and enhance their impact in the organization. Besides the call of these organizations, also the WHO DGs Chan and Tedros, a number of Member States and a range of organizations have called for a proportional increase of Assessed Contributions to finance core activities of the WHO. However, the financial situation of the organization has in essence not improved over the years. This is again expressed and addressed in a distorted way in an “investment case” launched by the WHO secretariat in September 2018.
The continued financial crisis of the WHO shows that financing of global public goods such as knowledge generation, harmonizing norms and standards, sharing intellectual property as well as financing the leadership and stewardship function in complex global health systems, and the existence and financing of global public institutions responsible for delivering these global public goods are not evident any more. Instead, WHO deepened its engagement with the philanthropic, private and financial sector all with the underlying notion that the innovation and engagement of all actors is needed to address global challenges, public health threats and attain sustainable development. The majority of funding coming from these actors is tied to single issues based on donors’ interests instead of the overall performance of WHO as global health authority.
What is now needed is both deconstructing and critiquing the proposed financial and investment models, providing alternatives in WHO and global health financing and creating a transnational movement calling for just economic reforms that would be redistributive, regulatory and regenerative in nature.
WHO and global health governance
The WHO financing and governance crisis are closely interrelated, as expressed in the “WHO reform” project launched by the former DG Margaret Chan in 2011 and since then critically watched and commented by civil society. But WHO (and global health) governance issue go also beyond the financing aspect.
The engagement of many civil society organizations and the need for sharing assessments, joint strategizing and coordinated interventions regarding the WHO financing and governance crisis was one of the roots of the Geneva Global Health Hub in 2015-2016.
At the same time when G2H2 was launched, the 69th World Health Assembly adopted, in May 2016, the WHO Framework of Engagement with Non-State Actors (FENSA). The Framework “endeavours to strengthen WHO engagement with non-State actors (NGOs, private sector entities, philanthropic foundations, and academic institutions) while protecting its work from potential risks such as conflict of interest, reputational risks, and undue influence.”
After the adoption of the Framework of Engagement by the WHA, civil society groups agreed at strategy meetings in January and May 2017 on the need to critically watch FENSA implementation and requested G2H2 to support this process by hosting a “FENSA Watch” working group open to members and other engaged civil society organizations.
There is a clear assessment within G2H2 that WHO financing and governance issues cannot be separated from the overall global health governance crisis and, e.g. our critical analysis of actors such as the World Bank and OECD, philanthrocapitalist foundations, Global Health Initiatives and Public Private Partnerships – and related civil society actors and engagement.
Rationale, references and initial fields of work
Global health governance is a mess altogether – why focus a working group on the WHO?
As already outlined, we consider WHO governance and financing as a key case for global health governance and the financing of global public goods beyond the WHO.
To initially limit the focus of a new working group on global health financing and governance on WHO related matters and processes is based on a realistic assessment of our limited capacity, with our concerns on WHO financing and governance as the most solid common ground.
However, we are aware that a critical analysis of global governance and financing is requested to understand, watch and provide critical civil society input into the particular WHO processes. This analysis can be provided by G2H2 members and partners beyond Geneva, as already done in the past.
As outlined above, critically watching and commenting WHO governance and financing is part of the DNA and history of the Geneva Global Health Hub. WHO is the key Geneva global health institution and the one that has been at the core of our attention and work over the last years.
Key WHO processes needing immediate civil society attention and action
– to become initial fields of work for the new working group
To launch a new G2H2 working group on WHO and global health governance and financing at this moment is based on our assessment that there are some current processes at the WHO that need our immediate attention, such as:
- Review of WHO Framework on Engagement with non-state actors (2019, in preparation)
- “Transformation of WHO” (Tedros) with unclear scope and consequences
- Reform of WHO Governing Bodies and perspectives of a further shrinking space for civil society (after WHA 2018, with Brazil in the lead)
- Interaction of the new WHO leadership with various “civil society” teams and related governance issues (in particular: “WHO-CSO Task Team” coordinated by the UN Foundation and RESULTS delivering its recommendations on 7 December 2018)
- WHO financing: “Investment case” launched in autumn 2018 and the related creation of “CSO Advisory Group” by the WHO secretariat
- Preparation of a “Global Action Plan for healthy lives and well-being for all” (preliminary launch at World Health Summit, autumn 2018) and related governance issues, including civil society representation
We expect these fields to become the initial fields of work for the new group.
Initial references: Civil society demands related to WHO governance and financing
As starting point, and reference to the history of recent civil society engagement in this field, and as a concrete expression of the “common solid ground”, the working group will refer to three broadly endorsed civil society statements:
- Delhi Statement, 2011: Time to untie the knots: the WHO reform and the need of democratizing global health
- Civil society organisations’ call for delegates to World Health Assembly, 2015: Defend the World Health Organization from corporate takeover
- A message from civil society, 2017: The WHO we want and the leadership WHO needs
The working group
Mandate and initial tasks of the working group
- Gather and share intelligence about critical processes and actors related to WHO governance and financing.
- For this purpose, engage through its members and, if possible and adequate, through designated working group representatives in a conversation with the WHO Secretariat and other key actors.
- Provide a space for sharing and deepening the analysis of key issues and processes related to WHO governance and financing and for the development of related civil society positions and demands.
- Convene regular civil society gatherings (sharing, brainstorming and/or strategizing) on these WHO related issues and processes, as part of the G2H2 meetings ahead of the meetings of the WHO Governing Bodies in January and May.
- Support and facilitate specific civil society advocacy interventions at the WHO secretariat, the WHO Governing Bodies, the WHO member states and their Geneva missions.
- If feasible/in a mid-term: Provide a hub for linking analysis and advocacy related to WHO governance and financing with civil society institutions and advocates engaged in global health governance and the financing of global public goods beyond the WHO case; by, in particular:
- convening or reaching out to a broader team for conducting an International Political Economy analysis of the WHO “investment case” and the actors involved.
- convening or reaching out to a broader team to assess global health finance models and their governance in thematic areas, most notably Universal Health Coverage, pandemic preparedness and NCDs.
- linking and learning from economic alternative models and transnational movements, providing models for just and ecological model financing global health priorities based on the notion of shared responsibility.
Membership in the working group is open for all representatives of G2H2 member organizations. Representatives of other civil society organizations and scholars working in the fields covered by the working group can be invited by or admitted by the bureau, based on proposals by working group members. A mailing list of group members is administered by the secretary. There is no public list of institutions represented in the working group.
The bureau of the working group is initially composed as follows:
- Mareike Haase, Brot für die Welt, working group coordinator
- Thomas Schwarz, MMI Network, working group deputy coordinator and secretariat
G2H2 members are invited to order the Provisional Terms of Reference (“considered as “living document”) of the new working group at the Secretariat.