The World Health Assembly (WHA) continues to be the world’s best kept health secret. What should be page-one security, health security and financial news, if covered at all, is most often buried in lifestyles, fitness and ministerial trip reporting. Think about this. The World Health Organization (WHO) is the only organisation in the world that can declare a global public health emergency that can send stock markets and economies tumbling. Why aren’t we talking more about it? This has got to change, especially this year when Health Ministers, from over a 195 countries, are meeting to pick the world’s top public health diplomat, negotiator, and when necessary, fire-fighter.
That last qualification will be the opening salvo to fiercely test the ethical and political savvy of the chosen one, whether it is Pakistan’s Dr. Sania Nishtar, United Kingdom’s (UK) Dr. David Nabarro or Ethiopia’s Tedros Adhanom who will be the next Director General (DG) of the World Health Organisation (WHO). Why?
Challenges and demands on WHO grow. The world’s only health policy and standards-setter is running out of money and countries, especially movers and shakers, are not in a giving or forgiving mood. The WHA meets even as an Ebola outbreak is in the process of being contained in Congo, civil society members are unhappy with the WHO for either being too close or not close enough to the food industry and pharmaceutical industry and countries are rattling chains to understand what access to medicines means to half the world which has too much and the other half which has too little. And these are just a few issues that will land on the next DG’s plate from day one in addition to the growing health and economic burden of non-communicable diseases (NCDs) which have over-taken communicable diseases in several middle-income countries in transition. These NCDs are a top priority of most states in Africa, Asia and Latin America but a much lower priority for the WHO’s big donors.
Earlier this month, 29 NGOs and 33 health professionals, activists and economists – including Nobel Prize laureate Joseph Stiglitz – asked countries to support a feasibility study on the progressive delinkage of costs of research and development from the price of cancer medicines. Their letter asked the delegates to be “open to alternative R&D models that do not rely on unaffordable medicine prices as the predominant way to fund cancer drug innovation…” Laudable as this may sound, many worry that it undercuts the model that has brought such remarkable recent advances in the treatment of some cancers. Other think it is high time for a change. Read here.
In another move, over 60 NGOs have written an open letter to the three candidates asking that policy and priority setting be kept apart from all commercial influences. In May 2016, the WHA adopted the Framework of Engagement with Non-State Actors (FENSA), a policy which is due to go into operation in May 2018. While FENSA envisages that the WHO will “exercise particular caution…when engaging with private sector entities, civil society groups say the “rhetoric and direction of WHO’s reform process as well as WHO’s chronic funding challenges have left us deeply concerned rather than reassured”. They fear FENSA will shrink WHO’s role to that of a bystander. However, the trend of much of the global community is towards tightly integrated public / private partnerships. If WHO rejects this, it really could be left watching as a new generation of development initiatives comes of age and risks losing the moral compass WHO can exert.
Of course the first two official days of the WHA will be focussed entirely on who the next DG will be. It is a secret ballot and sources tell WHM it will be impossible to call out the election before the last vote is in. The grapevine has it that the race will narrow down to one between Ethiopia and UK – one recent projection on Twitter has Nabarro winning comfortably on the third round and even taking a few African votes. But it’s the first time there has ever been a secret ballot.
This World Health Minute aims to inform the debates with frontline news stories on agenda items and “inside intelligence” reflections such as these on what people are saying and thinking in the Palais. Join us in this journey. Check out the WHM www.worldhealthminute.com and become users and subscribers. We are good for health.