A Resolve to Reform - A look at the Director-General's Opening Address at EB138

We welcome you to this new edition of People’s Health Movement’s (PHM) initiative WHO Watch (more on WHO Watch here). The Watchers will be following the 138th Meeting of the Executive Board (EB138) of the World Health Organisation (WHO) that will be taking place from 25 to 30 January 2016, in Geneva.


This year’s watchers team include activists of various background joining under the banner of PHM and Medicus Mundi International (MMI) to hold government representatives to account and voice PHM’s perspective and demands. Our team on the ground will be watching closely, taking notes and names and actively talking to delegates and working along with other civil society organisations to get PHM’s positions across (PHM’s full commentary can be found here).


“I want you to sing for the world - it’ll go viral!” 


This was perhaps an unfortunate choice of words by Dr David Navarro to open the session on Ebola Virus Disease at the EB138. Directed at Precious Matsoso, the South African Chair of the meeting who decided to sing in order to keep interventions up to the prescribed time, it could also be seen as a plea for attention from an institution in danger of becoming irrelevant, unless it is allowed to implement some desperately needed reforms.


The EB138 puts a host of issues on the table, such as reviews of the WHO’s governance, finance and emergency structure. The growing storm around the Framework of Engagement with Non-State Actors (FENSA), the controversial clarification of the WHO’s relations with non-state actors, is one to watch, with the current draft looking likely to unleash a cavalry of trojan horses from big business and vested interest if it manages to limp its way to conclusion in its current form.

All of this, and more, was covered in the opening remarks of WHO Director-General Margaret Chan, as she opened the morning session of the Executive Board. The topics touched on ranged widely from Ebola to Road Safety, with a particularly telling emphasis on Universal Health Coverage in her final paragraph - could there be a resolution on SDGs in the pipeline?


The illegal US bombing of the MSF-run hospital in Kunduz was conspicuously absent from the Director-General’s statement “deploring the attacks on healthcare workers and facilities that are becoming almost routine in the Middle East”. Whether this was due to the presence of the US delegate, sitting just feet from her, is debatable, but as ever the US dominance over the ostensibly democratic affairs of the WHO is palpable.


A pointed reference to the “explosive spread of Zika virus in new geographical areas”, was a conscious effort to highlight the potential threats of infectious disease beyond Ebola, and the much needed reform of the WHO’s emergency structures. A multitude of expert panels have made much the same recommended actions for change, but it remains to be seen if the fundamental issue of WHO’s dependence over donors earmarked funding will be meaningfully addressed.


An effusive endorsement of Universal Healthcare Coverage, “the most efficient way to respond to the rise of non-communicable diseases” is shocking considering that this proposal has shifted the focus from how services should be provided to how services should be financed, and in the process, private sector providers and private insurance are assumed to be part of the solution. There is enough evidence that private sector participation can lead to health-defeating market failures. This was of course not touched upon in her comments.


Her acceptance of some policy recommendations on child obesity which “pick a fight with powerful economic interests” are welcome, but WHO must go beyond rhetoric and implement large-scale change in the organisation’s relationship with big business. The first step on this path is the outright rejection of FENSA which, if passed, will only build the influence of entities that do not promote health for all, but profit for a few.


Stay tuned for more - let’s hope what we get from the rest of the week isn’t just a song and a dance, but a substantial stab at tangible reform of an organisation the world so desperately needs. Enjoy the watch!


More about the EB138 Watching here.