What is WHO Watch?
See the video from Geneva with Alice Fabbri (PHM's watcher) who explains why PHM watches the WHO. The film maker is Sebastien Sauges.
PHM follows closely the work of WHO, both through the World Health Assembly, the Executive Board and the regional committees. A team of PHM volunteers attends WHO bodies' meetings - following the debate, talking with delegates and making statements to the EB.
The PHM's commentaries covers most of the agenda items of the WHO bodies' meetings and includes a note on the key issues in focus at the meeting, a brief background and critical commentary. Reports on key issues are also prepared.
PHM is part of a wider network of organizations committed to democratizing global health governance and working through the WHO-Watch project.
Global Health Governance
The power relations around global decisions which shape population health can be changed through new alliances and information flows. The Democratising Global Health Governance Initiative, of which WHO Watch is a project, is designed to contribute to improved population health (and health equity) through new alliances and information flows.
The structures and dynamics of Global Health Governance (GHG) are dominated by the big powers (in particular, USA and Europe) and by large transnational pharmaceutical corporations. The big players operate through the UN system, the Bretton Woods system and a plethora of global public private partnerships. They also operate directly through bilateral and regional trade agreements; through the operations of bilateral health-related assistance; and through direct advice and pressure. The operating paradigm of this regime is strongly influenced by the ideology of neoliberalism which is promoted through a much wider range of channels including the commercial media and various corporate peak bodies (such as at the World Economic Forum).
In many respects the regulatory, financing and policy outcomes of this system reflect the interests of the rich world. This bias is reflected in:
- Continuing unimpeded brain drain, in part because the rich countries do not train enough of their own professionals (it is much cheaper to import professionals trained in the developing countries);
- an intellectual property rights regime which is largely focused on maintaining the profits of transnational pharmaceutical companies and discounts the urgent need of millions of people in developing countries for affordable medicines;
- trade policies which sanction the dumping of agricultural produce on developing country markets (which jeopardises the livelihoods of small farmers);
- trade policies which pressure developing countries to cut tariff protection and export duties without regard to the consequent unemployment and loss of government revenues (and public services);
- health system policy models which are oriented to stratified health care delivery with private care for the rich, social insurance for the middle and safety nets for the poor;
- resistance to the kinds of sectoral policies suggested by the WHO Commission on the Social Determinants of Health which could greatly improve population health.
Low and middle income countries are largely excluded from the corridors and forums in which the decisions and policies of the prevailing regime of GHG are formed. Even outside the corridors and forums the voices of most low and middle income countries are muted and dispersed. There are important exceptions; a small number of L&MICs have invested significantly in their intersectoral work (eg between health and trade) and in global health policy advocacy. There are also resources within civil society globally which are well informed and supported by high level analysis and which are sympathetic to the perspectives of L&MICs. Civil society networks which link North and South constituencies also provide an avenue through which the health needs of L&MICs can be brought to Northern consciousness.
There is a strong case for new alliances; for policy research and capacity building with a view to changing in some degree the perspectives which inform GHG and the balance of forces which shape such decision-making.
WHO Watch is a resource for advocacy and mobilisation and an intervention in global health governance.
As a resource for advocacy and mobilisation WHO Watch provides a current account of global policy dynamics in relation to a wide and growing range of health issues. While the focus is on issues being considered through the WHO the background documentation provides a more broadly based account of these issues.
We aim to strengthen various streams in the Health for All movement (IP and access, trade and health, health systems, PHC, quality use of medicines, etc etc) by ensuring that activists whose concerns arise from their grass roots involvements can learn about the global dimensions of the problems they are facing and reshape their advocacy and mobilising accordingly.
WHO Watch is also an intervention in global health governance.
Partly this is about defending WHO which has been subject to very bad stresses for several decades. WHO is the paramount health authority at the global level and needs to be strengthened and reformed and properly funded to play this role. WHO Watch seeks to generate support for a reformed WHO restored to its proper place in global health governance.
WHO Watch also aims to democratise the decision making within WHO, in particular supporting delegations from smaller countries who are seeking to know more about particular issues or are looking for resources regarding issues that they are concerned about. Many delegates from small countries are over-stretched trying to cover a very wide range of issues. We aim to have a resource here which delegates to WHO governing bodies might turn to for ideas and resources. Our objective in resourcing this constituency is largely about better decision making in WHO.
Finally, WHO Watch aims to support wider knowledge of, and participation in, the various engagements across the broader field of GHG. We are aiming to change the balance of power framing global decisions which impact on health. WHO Watch is the first phase of broader ambition, the Democratising of Global Health Governance.
Components of WHO Watch
There are several components of WHO Watch;
- Watching (includes documentation, analysis and advocacy as appropriate) at the governing bodies meetings in Geneva;
- Watching (documentation, analysis and advocacy as appropriate) at the regional committee meetings;
- Watching (monitoring, liaison, collaboration, advocacy) with WHO country representatives;
- Liaison with national representatives before their participation at the WHA, EB and regional committee meetings;
- Maintenance and development of WHO Watch website providing accessible, high value policy analysis and a portal to other relevant resources;
- Collaboration with other CSOs who are involved in health-relevant watching in relation to WHO and other international organisations;
EB Watch and WHA Watch involve mobilising young health activists (including IPHU alumni) from around the world (particularly from LMICs) to come to Geneva in January and May to monitor, document, analyse and advocate around the issues being discussed at the Executive Board and the WHA. The Watching includes an orientation workshop before the commencement of the meeting to review the wider GHG picture, the contemporary standing of WHO (and relevant background) and to explore in depth the agenda items. The watching includes documenting the discussion, nightly analyses, statements from the floor, and liaison with the many other CSOs attendng. Watchers are encouraged to liaise directly with official delegates. In a final workshop watchers put together the implications for the various issues in the form of an advocacy resource for PHM at all levels.
Watching the regional committee meetings involves applying the same principles and protocols at the regional level. It is complicated by the variations in protocols for CS recognition and attendance between different regional offices of WHO.
Watching at the country level varies widely according to the different situations within countries and local regions. Ideally it involves building collaborative relations between CS and WRs to promote HSS and action on the SDH. In some cases it involves more of a monitoring and advocacy approach.
The WHO Watch website aims to document current movements in global health policy in terms of events, topics and at the regional offices. One of the objectives of the website is to provide a resource for delegates from countries which have limited policy resources in their own MOHs.
Critical to the work of WHO Watch are the links between the watching processes and the various struggles for health in various districts, states and provinces and at the national level. These links enable local activists to keep in touch with the global policy movements which shape the context for such local struggles. These links also help to ensure that policy analysis and policy advocacy at the regional and global levels is informed by the reality of grass roots activism, both in health systems and around the conditions which shape health.
WHO Watch acknowledges the dedicated work of the growing body of volunteer watchers and policy analysts and is grateful for the support of a range of funding partners.