In one of its last decisions before concluding, the World Health Assembly Tuesday asked WHO’s Director General to continue developing a draft roadmap for WHO’s new  Global Health and Peace initiative – but stopped short of adopting the proposed plan after some member states balked over elements of the strategy. Instead the Assembly agreed to “take note” of the roadmap and ask WHO’s Director General to report back next year on “progress made on strengthening the roadmap as a living document” through consultations with member states and other stakeholders.  

The Global Health and Peace Initiative was launched jointly by Oman and Switzerland in 2019 and primarily aims to use health as an entry point to build peace, following on from a proposal by Director General Dr Tedros Adhanom Ghebreyesus, who saw it as a centrepiece of his leadership.  

The initiative’s objective is to “strengthen the role of WHO and the health sector as contributors to improving the prospects for peace.” It also aims to strengthen resilience to the impact of armed conflict or violence, while empowering communities. 

However, the language of the draft has proven to be contentious with many countries reacting to what some delegates fear might be too much WHO encroachment into the humanitarian sector, and what others saw as potential interference into the business of states waging war in, or supporting, dozens of regional conflicts around the globe. 

Brazil, South Africa and India express reservations 

“Although its main focus is health and health workers, it borders on the most delicate subject: peace and security, peace, nation and state sovereignty,” said Brazil which made a joint statement on behalf of South Africa, India as well. 

“The seriousness is such that we should not rush into taking decisions unless everyone is truly comfortable with the roadmap,” Brazil’s delegate added in a session on Tuesday, WHA’s closing day. After huddling in a closed door session for nearly an nour, member states finally agreed to “take note” of the roadmap draft and ask for its continued development – without endorsing it per se.  

Two-pronged objective for WHO

The published version of the draft roadmap, etches a two-pronged objective for WHO:

• “Ensure that health programs are “peace and conflict sensitive”. This means they are designed and implemented in a way that proactively seeks to mitigate the risks of inadvertently exacerbating social tensions, contributing to conflict, or undermining factors of social cohesion in a given society or community (also known as ‘do no harm’ principle). 
• Where the context, capacities and risks allow, design and implement health programs that are “peace responsive” – meaning, that seek to improve the prospects for peace by, for example, strengthening social cohesion, equity, inclusivity, dialogue, or community resilience to the impact of armed conflict or all forms of violence.    

The roadmap also spells out the possible contribution that WHO can make alongside other UN agencies. It also refers to the role of non-State actors in conflict settings – although it does not spell that out in detail. 

While some may fear WHO’s encroachment in the business of states or other international actors, the initiative notes that: “The Global Health and Peace Initiative is grounded in WHO’s foundational documents. 

“The WHO Constitution recognizes that “the health of all peoples is fundamental to the attainment of peace and security and is dependent upon the fullest cooperation of individuals and States,” while resolution WHA 34.38 (1981) highlights the health sector’s role in promoting “peace as the most significant factor for the attainment of health for all.”

Regional conflicts and instability, together with climate change, have put more people on the move around the world than ever before – leading to increased WHO interest in supporting fragile states – before a crisis peaks.  

WHO estimates that roughly 80% of its humanitarian caseload, as well as 70% of disease outbreaks to which it responds occur in fragile, conflict-affected and vulnerable settings.

The current session of WHA also saw multiple geopolitical eruptions between member states, including over a resolution against Russia on its invasion of Ukraine; Chinese objections to Taiwan’s participation as an observer; the health status of Palestinians in Israeli occupied territories; and on Tuesday, at the closing plenary, between Azerbaijan and Armenia. 

• Correction: an earlier version of this text reported that the health and peace roadmap had been “adopted”. In fact the decision adopted by the WHA was to continue developing the roadmap, with a report from the director-general  due to be made at the WHA in 2024 on progress made. 

Image Credits: WHO/L.Mackenzie, WHO.