An alliance of conservative World Health Organization (WHO) member states and right-wing US organisations has halted the process of granting a reproductive health organisation “official relations” with the global body.

Meanwhile, a similar member state grouping objected to the use of “WHO LGBTQI+ community” in a routine human resources report that the Director-General tabled at the WHO executive board (EB) meeting on Saturday.

These actions have compromised the WHO secretariat’s “technical, science-based approach to health” and independence, according to other member states at the EB, as the “culture wars” once again polarised and paralysed the global health body.

‘Routine’ discussion erupts

Discussion at last week’s EB on an apparently routine agenda item – relations with non-state actors (NSAs) – was initially deferred amid rumours that Russia objected to the WHO secretariat’s proposal to grant official relations to the Center for Reproductive Rights (CRR).

The EB can grant “official relations” to groups with “sustained and systematic engagement in the interest of the WHO,” according to a report to the EB by the Director General.

Official relations are based on a collaboration plan between the WHO and the NSA that is “structured in accordance with the General Programme of Work and Programme budget and is consistent with the Framework of Engagement with Non-State Actors (FENSA)”.

However, an intense discussion finally erupted at the EB on Friday night over the WHO secretariat’s proposal that the CRR be granted official relations. 

Threatening letter from US right-wingers

By that stage, a letter from leading US right-wing groups, fronted by the Center for Family and Human Rights (C-Fam), had also been sent to EB members objecting to relations with the CRR – and bizarrely using misinformation to press their point.

 Extract from Pro-Life Letter on CRR WHO Status

“Giving special status to the Center for Reproductive Rights will further fuel the culture wars undermining the WHO’s mission to tackle health issues. It confirms fears that WHO’s new accord on pandemic preparedness will be used to undermine national laws related to abortion,” they claimed.

This is precisely the argument being used by global conspiracy theorists, many with links to anti-vaccine groups, that are trying to undermine the WHO as it seeks to better equip the world to address the next pandemic.

The US group, which includes organisations with zero connection to health such as the Center for Military Readiness and iRapture, also threatened that CRR recognition would “expose WHO to loss of funding under future pro-life US presidential administrations”.

C-Fam has also led a campaign to prevent the renewal of the US President’s Emergency Plan for AIDS Relief (PEPFAR), endangering the lives of thousands of people, particularly in Africa, who are dependent on PEPFAR for their antiretroviral medication.

‘Incompatible’ rights

The CRR works in the US, Africa, Asia and Latin America to advance women’s and girls’ access to reproductive health services, including abortion in countries where that is permitted.

The WHO, which has already worked with CRR, envisioned that the CRR would support its work on “promoting and disseminating WHO guidance, statements, tools and strategies on sexual and reproductive health and human rights, as and when appropriate, at global, regional and national levels”. 

Objections to WHO relations with CRR were voiced first by Yemen, speaking on behalf of the East Mediterranean Region (EMRO). 

It claimed that the “efforts” of non-state actors in relations with WHO must “be in line with national laws”, and that the CRR “has principles that run counter to our regional principles”.

Russia concurred, speaking on behalf of several conservative member states where women’s rights and access to reproductive health are restricted – namely  Algeria, Bangladesh, Egypt, Indonesia, Iran, Iraq, Nigeria, Pakistan, Palestine, Saudi Arabia and Sudan.

“States are responsible to their citizens for the activities taken at the side of WHO,” said Russia.

“Taking into account that the Center for Reproductive Health and Rights (sic) is promoting the sexual rights of girls which do not exist on an international level, are fundamentally incompatible with universal recognised human rights and are legally unacceptable in at least half of the WHO member states and are illegal in a number of countries, we are expecting a further sharp reaction from the citizens and organisations of these countries,” added Russia, apparently alluding to the US letter.

“WHO mandate does not provide ground for work promoting sexual rights,” it added.

Meanwhile, Cameroon on behalf of the 47 African member states, expressed “concern about entry into official relations of non-state actors that do not respect the culture and the values of the member states. We would like therefore, to delay the admission process in order to better understand the implications of this decision.”

‘Undermining the secretariat’

However, a wide range of member states including the US, Canada, Brazil and the European Union, supported the CRR’s application.

Furthermore, Mexico on behalf of 25 member states – largely European and Latin American – warned that the WHO secretariat’s “neutrality and authority to fulfil its functions, as requested by member states through FENSA, is being undermined”, accusing the member states who were objecting of “politicising routine decisions that we should trust the secretariat to make in the framework of its mandate”.

“The strength of WHO lies in its technical, normative and science-based work. We call on all member states, and in particular EB members, to safeguard WHO’s technical, normative and independent role,” Mexico added.

The decision has since been deferred to the EB’s Programme, Budget and Administration Committee (PBAC) meeting in May – but it is hard to predict how the WHO will decide on this polarising issue.

LGBTIQ+ ‘unrecognised concept’

Meanwhile, on Saturday afternoon another controversy emerged over what would normally have been a mundane report – the Director General’s report of the International Civil Service Commission that covers issues related to staff relations, pay scales and benefits. This mentioned the “WHO LGBTIQ+ community” in a section on “diversity, equity and inclusion”.

“We have the use of terminology which spreads concepts which are not recognised by everyone and which are in contradiction with the values and religious beliefs of quite a large number of countries,” said Russia.

Meanwhile, Syria not only asked for the sentence to be removed but urged the WHO “to refrain from including references of this nature and future reports and official documents”.

Conversely, nearly three dozen other countries, including the US, Canada, Europe and a number of Latin America countries,  expressed support for the Director General’s commitment to diversity equity and inclusion, and gender equality in the workforce. 

“We support the efforts of the secretariat to promote a decent working environment for all staff regardless of the community to which they belong, including those belonging to the LGBTIQ+  community,”  said Denmark, on behalf of the 32 nations. 

Ultimately, the EB agreed with the chair’s proposal to “note” the report along with the “divergence of views that exist on the board as a whole”.

Additional reporting by Elaine Fletcher.