TWN Info Service on Health Issues (Jan12/02)
Please find below a news report on the need to overhaul rules on WHO-NGO relationship.
Apart from the antiquated rules that govern this relationship....and thus in need of reform...another issue that is most problematic is WHO's scrutiny and censorship of NGO statements. To make statements, the text must be submitted at least 24 hours before delivery. This text will then be scrutinized for its length (max 300 words) and content. The Secretariat may also ask you to change the content or to delete some sections. They may also deny you the right to make the intervention.
None of these practises are seen in other UN bodies, where accredited NGOs are free to speak up without any form of censorship. I understand that the above requirements are not part of the rules that govern WHO-NGO relationship and yet they are practised by the Secretariat.
We hope that this will change as part of the WHO reform and that NGOs will not be subjected to such practices and will have the freedom to speak up.
London, 18 Jan (Sangeeta Shashikant) -- The World Health Organisation's executive body meeting in Geneva this week is expected to take important decisions on the organisation's relationship with non-governmental organizations (NGOs) that may include overhauling the current antiquated principles.
WHO's relationship with NGOs has been a controversial issue for more than a decade. Criticisms include antiquated rules governing WHO-NGO relationship with complicated and onerous procedures to enter into official relations with WHO, which fail to distinguish between public interest NGOs (PINGOs) and business interest NGOs (BINGOs); scrutiny and censorship of NGO statements prior to delivery; inadequate conflicts of interest safeguards; lack of space and opportunity to organize events (e. g. during the annual World Health Assembly); or to interact with the Secretariat and WHO member states.
[In recent years, the WHO Secretariat has suspended NGOs' privilege or made it difficult for NGOs to hold technical briefings during the World Health Assembly.]
There were some attempts to overhaul this relationship following the launch of the "Civil Society Initiative" (CSI) in 2001 by Dr. Gro Harlem Brundtland, then WHO Director-General. However, the Initiative had little success as key recommendations emerging from a thorough review of WHO-NGO relationship (2002 Review report) never made it past WHO member states, and thus remains in a coma, ignored and unimplemented.
The topic has however resurfaced and is now on the agenda of the WHO Executive Board (EB) as part of the WHO reform following a decision of a Special Session of the Executive Board (EBSS) held in November 2010 which requested the Director-General to conduct further analysis of the proposals to promote engagement with other stakeholders.
[This decision of the EBSS was arrived at following numerous objections against the Director General's proposal to convene multi-stakeholder forums such as the World Health Forum as a method of promoting WHO's engagement with stakeholders.]
The lack of suitable guidelines on WHO-NGO relationship is only one part of the problem. Over the years significant concerns have also been raised over the lack of appropriate policies guiding WHO's interaction with the private, for-profit sector as well as not-for-profit philanthropic organizations, particularly the inadequacy of WHO conflicts of interest policy and the need for more oversight of the numerous partnerships with WHO engagement.
Clearly, these are issues that need to be addressed comprehensively if any meaningful outcome is to emerge from the WHO Reform.
The WHO Secretariat in its report (EB130/5 Add. 4) does raise several of these issues and has put forward two proposals for the consideration of member states:
(a) "To review and update the principles governing WHO's relations with non-governmental organizations. The review will consider (i) widening and improving the modalities for the participation of non-governmental organizations at regional and global governing body meetings; (ii) seeking the views of non-governmental organizations in the development of new health policies and strategies; (iii) updating practices and criteria for accreditation. In relation to the last point, the review will consider ways of differentiating between the different types of non-governmental organizations that interact with WHO".
(b) "To develop comprehensive policy frameworks to guide interaction with the private, for-profit as well as not-for-profit philanthropic organizations. The proposed frameworks should, inter-alia, tackle the issue of institutional conflicts of interests."
The Secretariat is also proposing that the EB have greater oversight of partnerships, further adding that the EB could include regularly in its agenda an item on partnerships under which it would establish a dialogue with formal partnerships.
As the WHO appears to be embarking on a major reform, it is indeed an opportune moment to take steps to address the various concerns on WHO's engagement with stakeholders that have been raised for many years by public interest civil society groups, and yet has eluded scrutiny on the part of WHO member states.
However, to fully tackle these valid concerns, the various deficiencies and gaps in the Secretariat proposals need to be addressed.
1987 PRINCIPLES GOVERNING WHO'S RELATIONS WITH NGOS
The first set of working principles governing admission of NGOs in Official Relations was adopted by the World Health Assembly (WHA) in 1948. These were amended and expanded with the current "Principles governing relations between the World Health Organization and Non-governmental Organizations", in place since 1987.
These 1987 principles constitute the current legal basis for all aspects of relations between WHO and NGOs including criteria and procedure for admission of NGOs in official relations with WHO and privileges conferred on NGOs. They also define WHO interactions with NGOs to be formal (official relations) or informal.
To be in official relations, NGOs need to establish a joint programme of work and a 3-year plan with a technical department of WHO, with technical WHO officers appointed as the focal points for such collaboration. A review process of these relations is based on 3-year reports and the drawing up of new work plans.
Admittance into official relations is authorized by a formal decision at the EB. Regional offices use the list of NGOs in official relations to invite participation at regional meetings. NGOs in official relations are accorded the privilege of participating in WHO meetings and the right to make a statement.
As of July 2002, there were 189 NGOs in official relations with WHO while all other relations with NGOs are considered informal, thus not entitled to privileges accorded to the former. The data available as of February 2002 suggests that out of the 482 established relations with WHO, 45% were with NGOs in official relations while 55% of the NGOs were not in official relations.
Thus, while interaction, consultation and cooperation with NGOs is clearly encouraged by the WHO Constitution in Articles 2(h), Art. 33, Art. 71, and Art. 18(h), antiquated principles have created obstacles to effective WHO-NGO relationship and NGO participation in WHO governing bodies.
Attempts to improve WHO-NGO relationship were made in 2001 following the launch of Dr Brundtland's Civil Society Initiative. This led to the establishment of a thorough review of WHO's current policy and practice regarding civil society, ending with a Review Report containing recommendations in 2002.
2002 REVIEW REPORT AND 2003/4 PROPOSED POLICY
The Review process was carried out through a desk review of documents and a process of consultations during the period July 2001-July 2002.
The Review highlighted a number of deficiencies in the 1987 principles as well as WHO practice with regard to NGO relationship. In particular, this includes:
(a) The Principles do not provide guidance to distinguish between public interest NGOs and those linked to commercial interests.
(b) Insufficient safeguards on conflicts of interests. The Review report noted that the closer the involvement of NGOs in the work of WHO and in the setting of policies, norms and standards, the more important it is for WHO to be aware of, make transparent and eliminate all risks of real or perceived conflicts of interests.
(c) The Principles contain lengthy, complicated, onerous, rigid and overly bureaucratic procedures for NGOs to gain the status of "official relations".
(d) Imbalance between participation of organizations from North/West and South/East.
(e) Lack of access to and transparency about WHO processes at the Geneva headquarters, regional and country level. The Review report noted that information needs range from understanding how WHO governance works to gaining updated knowledge on specific technical issues.
(f) The link between NGO in relation and WHO is between 2 individuals i. e. between the WHO and NGO focal points, which can be broken during a turnover of WHO.
(g) The Principles have no formal requirement to analyse and make public the information received on NGOs e. g. knowledge about the sponsors and the interest groups behind individual NGOs.
(h) Lack of participation of NGOs not in official relations.
(i) Existing Principles do not offer the needed managerial and policy guidance for WHO staff interacting with NGOs at headquarters, regional and country level.
The Review concluded that the 1987 Principles were inadequate and less relevant to the realities of WHO and to the needs and aspirations of civil society and called for a new policy that would establish principles to distinguish between different kinds of NGOs and their related interests.
The new policy was also proposed to consist of the following:
(a) An Accreditation Policy: to guide the participation of NGOs in WHO's governing meetings. The Report proposed that unlike the present system, accreditation would not be conditional on working relations with the Secretariat.
(b) A Collaboration Policy: to enhance general interactions between the WHO Secretariat and NGOs including clarity on differentiating between organizations and the role of WHO in supporting Member states' work with civil society.
Following the review a new policy was discussed and presented to the 2003/4 WHA but never made it past WHO member states.
According to sources, the policy had a few good features and quite a few problematic sections. In particular, the policy did not adequately address the key concerns and findings of the CSI review report especially distinguishing between public interest, non-profit entities and those representing commercial interests, as well as sufficient safeguards against conflicts of interests.
MOVING AHEAD WITH SECRETARIAT PROPOSALS
The Secretariat proposal on WHO-NGO relationship does not go far enough. A decision taken on this matter needs to build on the key outcomes that emerged from the 2002 Review report, in particular overhauling the 1987 Principles to develop a policy for accreditation (which is not conditional on NGOs having working relations with WHO) and another for collaboration as well as distinguishing between different kinds of NGOs and their related interests.
There should also be a decision point that eliminates the practice of scrutiny and censorship of NGO statements by the Secretariat prior to delivery. The Director-General should also be requested to make all efforts to ensure that NGOs are afforded sufficient space and opportunity to hold side events, for example, during the WHA.
With regard to private for-profit organizations and not-for-profit philanthropies, the proposal for comprehensive frameworks of interaction with these actors, is indeed timely. However, it is important from the outset to be clear with regard to ongoing interactions as well as envisaged interactions as well as the basic principles that will underpin such frameworks.
It is critical that such frameworks are firmly underpinned by principles of transparency, and avoiding of conflicts of interests.
Such frameworks should also not influence or undermine members' role in decision-making in WHO.
On the matter of transparency, any framework on WHO's interactions with private for-profit organizations and not-for-profit philanthropies should ensure that details of all formal and informal interactions including the inputs provided by such actors are publicly available on WHO's website. This is an important step to safeguarding the independence and constitutional mandate of WHO.
The inadequacy of WHO's conflicts of interests has been noted on a number of occasions.
Most recently, an Expert Review of the International Health Regulations concluded that WHO lacks "a sufficiently robust, systematic and open set of procedures for disclosing, recognising and managing conflicts of interests among expert advisors".
Thus, the ongoing discussions afford a timely opportunity to undertake a thorough review of WHO's current conflicts of interest safeguards with the aim of developing a comprehensive conflicts of interests policy which tackles both individual and institutional conflicts of interest, with adequate measures and mechanisms for its implementation. A comprehensive approach to conflicts of interest is absent from the Secretariat's proposal, which only vaguely touches upon the issue.
On partnerships, while the oversight function is proposed to be handed to the EB, key concerns remain unaddressed.
The Secretariat's proposals should be amended to establish a process to map and analyse all formal and informal partnerships WHO is engaged in, with the aim to conduct a thorough impact assessment of WHO's involvement in such partnerships including the financial implications for WHO, the purpose, strategy, and cost effectiveness of partnerships, as well as their compliance with the WHO Constitution and work plan.