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In a couple of weeks, the World Health Organization will be holding its annual January Executive Board meeting. Delegates will consider the edited version of the draft 13th WHO general programme of work for 2019-2023, published on 5 January. Following comments to the first version of the programme in November, the secretariat produced a more fleshed-out document, emphasizing the WHO’s normative role, in particular evidence-based. The necessity of access to medicines and vaccines has been extended to other products, such as devices and blood products, and mention is made of the WHO Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property.

The Revised Draft 13th general programme of work 2019-2023 (GPW13) opens with a quote by WHO Director General Tedros Adhanom Ghebreyesus (who goes by Dr Tedros) on the universality of health care, declaring, “Health is a human right. No one should get sick or die just because they are poor, or because they cannot access the services they need.”

During an extraordinary session of the WHO Executive Board (EB) in November, delegates voiced concerns about the lack of detailed explanations on the financing needed to achieve the promises of the draft general programme (IPW, WHO, 22 November 2018).

Some countries also called for caution and asked that the WHO stay focused on its core functions, while some stressed the importance of access to health services and medicines, underlining high prices, and others advocated for local production of medical products in developing countries.

The draft 13th general programme of work 2019-2023 will be submitted for consideration by the 142nd WTO Executive Board taking place from 22-27 January, and considered by the 71th World Health Assembly, in May.

Strategic Priorities, Shifts

The draft programme is still organised around three strategic priorities: ensure healthy lives and well being for all at all ages; advancing universal health coverage; addressing health emergencies and promoting healthier populations. Those priorities will be supported by three strategic shifts: stepping up leadership; driving impact in every country; and focusing global public goods on impact, according to the document.

Some changes are notable between the two versions, one of them is the shift from the focus on impact to measuring impact.

The sub-section previously titled “major shifts” is now “What is new in GPW13,” and contains more explanation on each new orientation. For example, in the first action, which relates to the importance of the United Nations Sustainable Development Goals (SDGs) in GPW13, the document says that each country will determine its own path to achieving the SDGs.

A new item in the list is concerns the prioritisation in WHO. The paragraph says that WHO will focus on reducing health inequity across populations, both within countries and between countries.

Normative Work, Evidence-Based

The paragraph on WHO strengthening its normative work has been expanded to explain that WHO through the World Health Assembly, “has the authority to adopt conventions or agreements with respect to any matter within the competence of the Organisation” as well as regulations and recommendations. The paragraph further indicates that the “WHO Secretariat will reinforce its science-and evidence-based normative work, anticipate and assess the impact of research and discovery on public health and focus on supporting countries in the implementation of WHO norms, standards and agreements.”

Evidence-based approaches are also underlined in the paragraph describing WHO stepping up leadership at all levels. “Major changes in health come from taking WHO’s science-and evidence-based normative guidance and public health approaches of health promotion and prevention and combining them with advocacy for high-level political support. This will require strong political support from, and engagement with, Member States and civil society,” it said.

Seemingly answering concerns by countries concerned about WHO going beyond its role, in particular in emergency settings, and possibly competing with other UN agencies, or duplicating work, the GPW13 says the WHO “must act in concert with partners, including civil society, research institutions and the private sector, and in close alignment with the United Nations system, in order to avoid duplication, using its Framework of Engagement with Non-State actors.”

WHO is committed to supporting the UN Secretary General’s proposal to work as “one UN,” the document says. Also responding to suggestions by member states that the WHO GPW be aligned with the wider UN planning cycle, the GPW13, “subject to satisfactory progress” could be extended to 2025 so that the WHO general programme of work can be aligned with the wider UN family planning cycle.

Access to Medicines

Several subtitles have been added to the description of the WHO strategic priorities. For example, under the universal health coverage priority, a new paragraph on access to medicines, vaccines and health products has been added with some modifications compared to the previous version.

For example, the new document says universal health coverage includes access to affordable and quality-assured medicines, vaccines and health products, and adds that it should include diagnostics and devices, as well as blood and blood products. The paragraph also mentions that WHO will help to mobilise political will to ensure that policies are put in place to promote access to health products, in line with the WHO Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property.

Also new in this paragraph is the mention of traditional medicines, and the indication that WHO will work with partners and stakeholders to support local production of health products and encourage technology transfer through regulatory support and regional development initiatives.

The document says that there will be no structural implications for the programme budget 2018-2019, which was approved by the 70th World Health Assembly. “However, the Secretariat will reallocate funds within the Director-General’s authority in order to initiate a gradual realignment with the new priorities in GPW13.”

Budget Requirements Coming Later, Need Assessed Contributions

It seems that delegates who had requested information about how the GPW13 would be financed will have to wait a little bit more. According to the latest draft GPW13, the WHO secretariat will provide information about the budgetary requirements in a related document. According to a WHO spokesperson, there is no known date of release for this budget document, and the matter should be discussed during the upcoming Executive Board meeting.

“Given the integrated nature of the work that is required to implement GPW13, more flexible financing will be critical,” the document said. “The quality of funds is almost as important as their quantity. The Director-General has asked Member States to unearmark their contributions. This is a sign of trust and enables management to deliver. Increasing assessed contributions would also give WHO greater independence.”