Non-state Actors Seek More Inclusion at WHO
Gaudenz Silberschmidt, WHO Director of Health and Multilateral Partnerships.

The World Health Organization (WHO) is considering changing how it relates to non-state actors (NSAs), but some of these organisations are concerned that the changes envisaged by the global body may weaken their voices.

In 2016, the WHO’s World Health Assembly (WHA) adopted a Framework for Engagement with NSAs – known as FENSA –  to enable closer collaboration with a wide range of organisations to respond to national and global health challenges. An initial evaluation of its implementation was conducted in 2019, and a two-year timeframe was set to fully operationalise the framework.

Over the past weekend, the WHO Executive Board considered a report on progress to implement FENSA , as well as inputs from various NSAs on how their relationships with the global body could be improved.

According to the report, the WHO said it seeks to improve NSAs’ role, voice and contribution in its governance system including by introducing a global constituency for NSAs and grouping NSA statements accordingly. While welcoming the WHO’s intentions, a number of NSAs noted that the proposal could weaken and soften the NSAs’ contributions to WHO’s agenda. 

International humanitarian medical non-governmental organization Médecins Sans Frontières (MSF) expressed concern with the proposal, saying that it fails to acknowledge the value of diversity and expertise inherent in NSA. 

MSF’s Dr Maria Guevara

“The creation of a global constituency and the grouping of NSA statements risk diluting these voices and limiting their meaningful participation in the dialogue and in finding solutions to current health challenges,” MSF’s Dr Maria Guevara argued. 

The International Council of Nurses said that while it supports informal meetings before WHO meeting, it called for more notice and added that the selection of the agenda items must be agreed on between NSAsand WHO member states. 

“After testing [introducing] constituency statements at the 75th WHA, we strongly encourage consultation with NSAs before making a final decision on their implementation,” said the ICN, adding that constituency statements should not prevent individual statements.

In its submission, the European Society for Medical Oncology (ESMO) also called for the WHO to allow non-state actors to still be able to make individual statements on issues that are in line with their core areas of expertise. To accommodate the contribution of more non-state actors, the society called for the WHO to publish each non-state actor’s statement on its website and for these to be included in meetings’ official minutes.

“Non-state actors can submit individual statements on the WHO website and in a way that they are translated and reported in the official minutes of WHO meetings, allowing non-state actors for each agenda item,” ESMO’s Gracemarie Bricalli recommended.

Meanwhile, the Save the Children Fund called on WHO Member States to also prioritize interactions with NSAs, especially the civil society, by actively participating in informal sessions and systematically sharing draft documents and resolutions for civil society organizations to engage in policy making.

It also slammed the WHO Secretariat over lack of time and support provided to NSAs regarding new processes, including constituency statements. It said the process lacked transparency and open dialogue among the different actors.

“We welcome all opportunities to engage with member states and the Secretariat to ensure the meaningful engagement of NSAs including when it comes to the development of a civil society engagement strategy.”

IPPF’s Estelle Wagner

The International Planned Parenthood Federation (IPPF) urged Member States to compel the Secretariat to constitute a diverse working group of member states and civil society organizations to review and develop proposals and report back at the 152nd executive board meeting next year on more robust recommendations to involve NSAs at the WHO beyond making general statements on agenda items.

“More than ever, the pandemic has shown the essential role of NSAs in the work of the WHO and we look forward to a constructive and transparent process to define mechanisms for truly meaningful engagement with WHO governing bodies beyond generalized statements at the end of agenda items,” the federation’s Estelle Wagner stated. 

Canada, USA and UK side with NSAs

Canada’s Elizabeth King

The government of Canada noted that the positions of NSAs on topical issues need to be taken more seriously, adding member states need to hear from NSAs before positions are finalized. It pledged its continuous support for meeting with NSAs prior to the WHA in May, adding that sufficient notice should be provided.

Canada also supported that NSAs should continue to have the option to deliver individual statements on all agenda items to ensure that member states benefit from the diversity of NSAs’ views. 

“This could be combined with a reasonable limit to the number of individual statements an NSA can deliver,” Canada stated.

Canada and the United Kingdom also agreed that the WHO Secretariat should work with NSAs to identify the agenda items where constituency statements would be more valuable, rather than identifying them independently.

“We’d like to reaffirm that hearing and understanding the voices of non state actors in all of our efforts to more meaningfully engage will increase our chances of success,” Canada’s Elizabeth King concluded. 

The US said the priority should be on ensuring WHO’s engagements and involvement of NSAs in its agenda are more meaningful and routine.

It noted that NSAs were critical to the development of vaccines, therapeutics and other medical medical countermeasures, as well as their distribution and delivery to individuals across the globe. By working together with NSAs, the United States said the WHO and the global health community can become more effective, efficient and avoid duplication or miscommunications that could undermine joint aims and efforts. 

A concluding remark from Gaudenz Silberschmidt, Director of Health and Multilateral Partnerships at the WHO said the global health body is committed to making the engagements and interactions between NSAs, member states and the WHO Secretariat to be more meaningful.

The challenge, according to him, is that the increased number of agenda items and interest have put pressure on the time for interventions for NSAs and delegates. He announced plans to organize a meeting with NSAs in February 2022 to consult both on the planning of the informal pre-meeting and on the constituency statements.

“We propose to include a session on those engagement modalities in the informal pre-meeting of the World Health Assembly,” he added.

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