WORLD HEALTH ORGANIZATION EXECUTIVE BOARD 105th Session Provisional agenda item 7.3 EB105/21 24 November 1999
Research strategy and mechanisms for cooperation (follow up) Report by the Secretariat
1. Following the review of WHO’s research strategy and mechanisms for cooperation, a report was submitted to the Executive Board at its 104th session.1 It recommended inter alia that the Organization should strengthen the network of WHO collaborating centres and other national institutions of high scientific and technical standing. It also laid emphasis on WHO’s role in generating and validating scientific advice at global level on critical health issues. It stressed the need to be able to rely on a transparent and efficient process for the selection of members of expert committees, who are currently drawn from WHO expert advisory panels. Following up the Board’s discussions, the present report sets out a number of proposals on specific issues.
A.
WHO COLLABORATING CENTRES
2. On the basis of resolution WHA50.2 and taking into account discussions at the 101st and 104th sessions of the Executive Board, the procedures governing the selection of WHO collaborating centres and the management of WHO’s joint activities with these centres was reviewed. The review built on previous studies and assessments by the Organization and the centres themselves of recent experience at national, regional and global levels. In 1998 collaborating centres numbered 1300. Their functions and working environments are quite diverse and this aspect was taken into account when formulating recommendations on procedures and collaboration 3. After preparatory work in WHO regions and technical programmes at headquarters, an interregional meeting was held on 28 and 29 May 1999 to reach a consensus on the main issues involved and the changes to be proposed. Proposals were reviewed in July 1999 by the DirectorGeneral and Regional Directors before being finalized for submission to the Executive Board. 4. WHO collaborating centres are an essential and cost-effective cooperation mechanism, which enables the Organization in particular to fulfil its mandated activities and to harness resources far exceeding its own. It gives WHO access to centres of excellence worldwide and the institutional capacity to ensure the scientific validity of global health work. Through this global and interdisciplinary network, which also includes national institutions recognized by WHO, the Organization is able to exercise leadership in shaping the international health agenda. Conversely, designation as a WHO collaborating centre provides institutions with enhanced visibility and 1
Document EB104/2.
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recognition by national authorities, calling public attention to the health issues on which they work. It opens up improved opportunities for them to exchange information and develop technical cooperation with other institutions, in particular at international level, and to mobilize additional and sometimes important resources from funding partners. 5. Careful analysis, however, also reveals a number of problems and shortcomings, which include: • lack of a clear and commonly agreed vision of the strategic role of WHO collaborating centres; • lack of unity and consistency in the implementation, in different parts of the Organization, of criteria for selecting centres and managing and monitoring collaboration with them; • absence of an integrated policy at global level to encourage the development of collaborating centres in countries and regions of greatest need; • weakness of the links, in some instances, between the activities of the centres and the objectives of the Organization as described in the programme budget; • lack of systematic evaluation of the impact and relevance of collaboration in the light of WHO’s evolving needs and policies, which is reflected in the extension of official collaboration with a number of inactive centres; • absence of a global information strategy to support the work of the centres; • inability to take full advantage of the centres and national institutions recognized by WHO, for lack of a concerted and deliberate effort to achieve synergy through networking; • lack of resources (staff and funds) available to WHO for collaboration with the centres.
Recommendations General principles 6. WHO collaborating centres must be able, in close coordination with the WHO technical programmes concerned, to provide strategic support to the Organization to meet two main needs: • implementing WHO’s mandated work and programme objectives; • developing and strengthening institutional capacity in countries and regions. 7. The designation of a collaborating centre must be time limited (four years) and needs driven. This requires strategic choices, based on technical considerations which include geographical and subject balance. The selection process must be open, collective and transparent. Designation could be renewed on the basis of stringent review of performance and future work plans. Evaluation should be seen as a constructive exercise, aimed at strengthening the capacity of all partners involved. Whenever appropriate, the networking of collaborating centres and national institutions recognized by WHO should be encouraged and supported.
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8. National institutions designated by governments and recognized by WHO represent a valuable and flexible mechanism for technical cooperation and the Organization should make fuller use of them. No hierarchical distinction should be made between collaborating centres and national institutions recognized by WHO, as they represent different modalities of collaboration used to meet different needs in areas and within time frames that may vary considerably.
Criteria for the selection of WHO collaborating centres 9. WHO collaborating centres should be selected in fields that are relevant to WHO’s programme activities. Other criteria for selection should include the scientific and technical standing of the institution, its actual level of commitment at the national, regional and international levels, and its ability to strengthen national and regional capacity for health development. The institution should have successfully collaborated with WHO for at least two years in carrying out jointly planned activities. 10. Collaborating centres should have the capacity, and institutional stability, to develop relations with other institutions, including through networking. They should be willing and prepared to use their own resources to implement the collaborative activities proposed in their work plans.
Designation procedure 11. The designation procedure is the same for all parts of the Organization. It must be adhered to, in order to ensure that the process is as objective and transparent as possible. Emphasis should be laid on developing a collective evaluation process, involving all staff concerned, including WHO Representatives. Final authority to designate a WHO collaborating centre rests with the DirectorGeneral. 12. The main steps proposed in the revised procedure are listed below:1 • nomination initiative, which may come from outside WHO (from institutions or governments), or from within WHO; • assessment of the relevance of the institution’s work vis-à-vis WHO’s programme objective; • initial site visit by the WHO Representative; preliminary evaluation – at regional level – of the institution and informal consultation with the government; • evaluation of previous collaboration with the institution; • definition of the formal terms of reference and joint development of the future four-year work plan; • evaluation of the proposal by a regional screening committee or any similar mechanism; • evaluation by a global screening committee; • referral to the Regional Director for final recommendation;
See review of WHO collaborating centres: summary report and proposed guidelines (Document RPC/WHOCC/99/1).
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• request for government’s formal approval; • final decision and designation by the Director-General; • official correspondence, including the formal designation letter and information on the privileges and obligations of WHO collaborating centres.
Management of collaboration 13. The management of collaboration with a centre should be the responsibility primarily of the technical programme that initiated the designation process. Interaction between technical units in regions and headquarters is essential to ensure that the centre’s collaboration is available to the whole Organization. Focal points should be designated in each regional office, as at headquarters, to manage and coordinate statutory information and procedures on collaborating centres. More generally, overall guidelines and schedules for the management and monitoring of collaboration with the centres should be common to all regions and programmes (standard tools were developed for this purpose during the review process).1 14. The links between the work of the centres and that of WHO programmes should be tightened. More attention should be paid to the joint preparation of the centre’s work plans. This should involve the institution, the regional office and, if situated in a different geographical area, the technical unit that initiated the designation process. The work plans should comprise clearly defined objectives, targets and expected results, which should be explicitly related to the activities and objectives set out in WHO’s programme budget. WHO should be ready to dedicate its own staff time and other resources, although not necessarily direct financial support, to ensure that collaboration can develop in a useful manner. 15. Monitoring should take place on a continuing basis and an annual report should be provided on the implementation of activities. A final evaluation should take place at the end of the four-year designation period. It should include an assessment of WHO’s support for, and actual use of, collaboration with the centre. There should be no decision on redesignation until completion of a thorough evaluation of the centre’s past performance, and rigorous assessment of the continued relevance of the collaboration in view of WHO’s evolving needs and policy. 16. To facilitate management, cooperation and networking, a global information system on all WHO collaborating centres should be developed and made accessible worldwide to WHO staff, collaborating centres, Member States, and the public health community at large. Exchange of experience and collaboration between centres should be supported by regular meetings at country and regional levels and on specific topics. 17. Most of the changes proposed can be implemented under the Director-General’s executive and administrative authority, and the Director-General intends to do so. Some, however, would entail amendments to the Regulations for Study and Scientific Groups, Collaborating Institutions and other Mechanisms of Collaboration adopted by the Executive Board at its sixty-ninth session, provided that
1 Idem, Annexes 1 to 5: Preliminary evaluation checklist; Recommended format for evaluation profile; time frame for the designation process; Recommended format for annual reports; Checklist to be used by WHO screening committees and technical programmes to assess relevance and efficiency of collaboration.
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they are approved by the Executive Board.1 The proposed amendments, shown in Annex 1, are submitted to the Executive Board for approval.
B.
EXPERT COMMITTEES AND OTHER GENERATING SCIENTIFIC ADVICE
WHO
MECHANISMS
FOR
18. The report submitted to the Executive Board at its 104th session stressed the need to reconsider the process by which members of WHO expert committees are designated, and to establish a new process that would ensure transparency while allowing for greater flexibility in securing the world’s best expertise.2 Although changes were to be suggested to the Executive Board at its 105th session, it has been found that the complexity of the issue and its implications warrant further study before a new mechanism can be proposed. 19. Changes to current regulations could however be made in two important aspects without having to wait until this in-depth analysis is completed. The first is the desirability of achieving gender balance in the selection of experts; the second is assurance of the independence of scientific advice provided to the Organization, by requiring disclosure by experts of circumstances that could give rise to potential conflicts of interest as a result of their membership in an expert committee or other scientific consultations. 20. Such changes could be implemented under the Director-General’s executive and administrative authority, without having to amend the Regulations for Expert Advisory Panels and Committees.3 It is felt appropriate, however, that these elements should become a formal part of the Regulations. To this end, the amendments contained in Annex 2 are submitted to the Executive Board for its consideration and transmittal to the Fifty-third World Health Assembly for approval. Adoption of these amendments could also be used by the Health Assembly as an opportunity to endorse the Board’s action, if it so agrees, to amend the Regulations for Study and Scientific Groups, Collaborating Institutions and other Mechanisms of Collaboration, as recommended in the first part of this report.4
ACTION BY THE EXECUTIVE BOARD 21. The Executive Board may wish to consider adoption of the following draft resolutions. The Executive Board, Having considered the report of the Secretariat;5
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Resolution EB69.R21, subsequently endorsed by the Health Assembly in resolution WHA35.10. Document EB104/2.
Text adopted by the Health Assembly in resolution WHA35.10, as amended by decision WHA45(10) and resolution WHA49.29. 4 5
Such endorsement would mirror the action taken with respect to the original Regulations (see footnote 1 above). Document EB105/21.
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Recalling resolution EB99.R14 which requested the Director-General to undertake a situation analysis of the existing network of WHO collaborating centres, and discussions of the Executive Board on the centres at its 101st and 104th sessions; Reaffirming the essential role played by WHO collaborating centres in enabling the Organization to implement its mandate and programme objectives, to ensure the scientific validity of global health work, and to strengthen national and regional capacity for health development; Recognizing the need to update the policy and procedures on WHO collaborating centres, so that optimum use can be made of this essential resource; Having considered the draft amendments to the Regulations for Study and Scientific Groups, Collaborating Institutions and other Mechanisms of Collaboration contained in the report of the Secretariat,1 1. URGES Member States: (1) to identify and strengthen national institutions of high scientific and technical standing; (2) to inform WHO of the existence of these centres of expertise;
(3) to make full use of WHO collaborating centres as sources of information, services and expertise, and to strengthen their own national capacity for training, research and collaboration for health development; 2. WELCOMES the Director-General’s intention to take the action required to give effect to the conclusions and recommendations of the review of collaborating centres, including those regarding the use of “national institutions recognized by WHO”; 3. ENCOURAGES collaborating centres to develop working relations with other centres and national institutions recognized by WHO, in particular by setting up or joining collaborative networks with WHO’s support; 4. APPROVES for immediate application the amendments to the Regulations for Study and Scientific Groups, Collaborating Institutions and other Mechanisms of Collaboration. The Executive Board, Having considered the draft amendments to the Regulations for Expert Advisory Panels and Committees contained in a report of the Secretariat;2 RECOMMENDS to the Fifty-third World Health Assembly the adoption of the following resolution:
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Document EB105/21, Annex 1. Document EB105/21.
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The Fifty-third World Health Assembly; Having considered the draft amendments to the Regulations for Expert Advisory Panels and Committees contained in a report of the Secretariat, 1. APPROVES the amendments to the Regulations for Expert Advisory Panels and Committees adopted by the Health Assembly in resolution WHA35.10, as amended in decision WHA45(10) and resolution WHA49.29; 2. ENDORSES resolution EB105.R.. concerning the Regulations for Study and Scientific Groups, Collaborating Institutions and other Mechanisms of Collaboration.
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ANNEX 1 DRAFT CHANGES TO THE REGULATIONS FOR STUDY AND SCIENTIFIC GROUPS, COLLABORATING INSTITUTIONS AND OTHER MECHANISMS OF COLLABORATION
Proposed amendments to regulations for WHO collaborating centres
PRESENT REGULATIONS
AMENDED TEXT (with deletions in square brackets and additions underlined) Designation 3.5 ..................................................................
Designation 3.5 ..................................................................
(f) the institution’s ability, capacity and readiness to contribute to WHO programme activities, whether in support of country programmes or by participating in international cooperative activities.
(f) the institution’s ability, capacity and readiness to contribute, individually and within networks, to WHO programme activities, whether in support of country programmes or by participating in international cooperative activities; (g) the technical and geographical relevance of the institution and its activities to WHO’s programme priorities; (h) the successful completion by the institution of at least two years of collaboration with WHO in carrying out jointly planned activities.
............................................................................ Management 3.11 Regional Directors shall be responsible for the management of the Organization’s collaboration with the centres. Collaborating centres of global compass, however, shall maintain their technical links with the part of the Organization having overall responsibility for the relevant programme
............................................................................ Management 3.11 [Regional Directors shall be responsible for the management of the Organization’s] Collaboration with the centres [.] shall be managed by relevant programme officers in that part of the Organization which initiated the designation process, whether at headquarters or in a region. Collaborating centres [of global compass], however, shall maintain their technical links with [the part] all parts of the Organization [having overall responsibility for the relevant programme] relevant to their agreed programme of work.
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ANNEX 2 DRAFT CHANGES TO THE REGULATIONS FOR EXPERT ADVISORY PANELS AND COMMITTEES
Proposed amendments to regulations for expert committees - membership and procedures
PRESENT REGULATIONS
AMENDED TEXT (with deletions in square brackets and additions underlined) 4.2 The Director-General shall select from one or more expert advisory panels the members of an expert committee, taking into consideration the need for adequate representation of different trends of thought, approaches and practical experience in various parts of the world, as well as for an appropriate interdisciplinary balance. In making this selection, the Director-General shall also take into account the desirability of achieving gender balance. The membership of expert committees shall not be restricted by consideration of language, within the range of the official languages of the Organization. ............................................................................ 4.6 In the exercise of their functions, the members of expert advisory panels and committees shall act as international experts serving the Organization exclusively; in that capacity they may not request or receive instructions from any government or authority external to the Organization. Furthermore, they shall disclose all circumstances that could give rise to a potential conflict of interest as a result of their membership of an expert committee, in accordance with the mechanisms established by the Director-General for that purpose.
4.2 The Director-General shall select from one or more expert advisory panels the members of an expert committee, taking into consideration the need for adequate representation of different trends of thought, approaches and practical experience in various parts of the world, as well as for an appropriate interdisciplinary balance. The membership of expert committees shall not be restricted by consideration of language, within the range of the official languages of the Organization.
............................................................................ 4.6 In the exercise of their functions, the members of expert advisory panels and committees shall act as international experts serving the Organization exclusively; in that capacity they may not request or receive instructions from any government or authority external to the Organization.
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