EXECUTIVE BOARD Special session on WHO reform Provisional agenda item 3.1
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WHO reform The Director-General has the honour to transmit to the Executive Board the report provided on behalf of the Regional Committee for Africa, in line with operative paragraph 4 of decision EB129(8). The report is provided in the annex.
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ANNEX SUMMARY OF SIXTY FIRST REGIONAL COMMITTEE MEETIING OF AFR HEALTH MINISTERS DISCUSSION ON WHO REFORM In line with the WHA 64.4 document and Executive Board 129 (8) decision on WHO Reform, the Sixty-First Session of the Regional Committee meeting for Ministers of Health of the African Region held in-depth discussions on the following documents: AFR/RC61/5 WHO Reform for a Health and the concept papers: AFR/RC61/CP/1 on governance of the WHO, AFR/RC61/CP/2 on independent formative evaluation of WHO and AFR/RC61/CP/3 on the World Health Forum.
Prior to this discussion the WHO Africa Regional Director Dr Louis Gomes Sambo presented to the delegates an overview of the above documents highlighting the following: justification for reforming WHO; the modalities to be used in the reform process; the proposed WHO core business; reforming the financing and management of WHO; transforming WHO governance; the possible role of the World Health Forum; the expected outcomes of the reforms and WHOs expectation from the RC61 discussion.
In supplementing Dr Sambo’s presentation, the Director General Dr Margaret Chan highlighted the role being played by the diplomatic missions in Geneva in the reform process and encouraged Member States to use their diplomatic missions in Geneva to ensure that their contributions are reflected in a common African position. She urged Member States without representation in Geneva to use the web-based consultation in making their contributions. She reassured Member States that the views and comments of all the Regions would be taken into consideration and the reforms will truly be Member State driven. In addition the Director General informed the Delegates that the World Health Forum would not replace the World Health Assembly as the ultimate decision-making body on all WHO matters. The section below summaries the discussion of the Delegates on the concepts documents:
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Annex
AFR/RC61/CP1 Governance of WHO Regarding the governance of WHO, the delegates welcomed the concept paper as the basis of discussion. They however expressed concern over the following issues regarding the concept paper on governance of WHO: the inadequate information on coordination and alignment between the work of WHO and partners and the priorities of Member States; lack of clear mechanisms to monitor the implementation of the various decisions and resolutions adopted by the Governing Bodies and lack of clarity on the roles and responsibilities of the different levels of the Organization. It was also observed that the composition of the Executive Board was not representative enough of the Member States to take final decisions on WHO matters as was being proposed in the concept note.
AFR/RC61/CP2/ Independent Formative Evaluation While recognizing the need for an independent evaluation of WHO, the delegates expressed concern about the lack of clarity on the rationale for, the timing and the intended use of the results of the independent evaluation, the limited involvement of Member States; the lack of consensus on the areas to be covered; and the use of a consortium rather than the established WHO mechanisms and institutions to carry out the evaluation.
AFR/RC61/CP3 World Health Forum Concerning the World Health Forum, the delegates were not convinced of the exact added value of such a Forum. Concerns were raised specifically on the timing, relevance, the exact agenda of the WHF, the possible risk of conflict of interest and how WHO could overcome this, the potential risk of the Forum undermining the sovereignty of Member State through the weakening of the WHO and its governing bodies, the criteria for selection of participants to the WHF, mechanism of ensuring that the “small and voiceless countries” would be heard; financial implications for Member States of holding such a forum and the lack of clarity on how the outcomes of the Forum will influence global health.
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Recommendations of RC61 on WHO Reform Process At the end of the discussion on the documents presented the following recommendations for action were made:
Member States: 1. To organize further consultations at national level to build consensus as well as to provide inputs on the process of Reform; 2. To continue to use the web-based consultation to provide inputs to the Reform process; 3. To continue to involve their diplomatic missions in Geneva in order to ensure coordination of the contributions of Member States in the Region to the Reform process. 4. To ensure that the reform strengthens WHO’s leadership role in defining global health priorities and for WHA to remain the ultimate decision making body of the Organization
WHO: 1. To define clearly the scope of the independent evaluation and share this information with Member States to guide consensus; 2. To ensure that the evaluation is driven by Member States by involving countries at all stages; 3. To use the independent evaluation as an opportunity to help guide the Reform process The discussion on WHO Reforms concluded with member states reaffirming their support to the reform process and thanking the Regional Director and Director General for having included this topic on the RC61 agenda.
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