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The WHO and the Public-Private Partnerships Debate

This post was written by Elizabeth Montgomery Collins, MD, MPH, DTM, Global Health Council individual member and delegate to the 142nd WHO Executive Board meeting. In January, Global Health Council (GHC) hosted a delegation to the 142nd Session of the World Health Organization (WHO)’s Executive Board (EB) Session. View complete WHO EB updates.

142nd WHO EB Meeting in session. Photo credit: Danielle Heiberg, Global Health Council

A recurring theme at the World Health Organization (WHO) 142nd Executive Board meeting (EB142) in Geneva was the extent to which the WHO should engage in public-private collaborations to achieve policy objectives such as universal access to medicines and vaccines.  Most agenda items prompted two to three minutes of commentary from most of the 34 countries currently serving on the Executive Board, as well as additional comments from countries with observer status that could speak but not vote.  This summary is intended to provide an overview of those comments and a sense of the WHO debate over public-private partnerships.

Agenda Item 3.3 Public health preparedness and response (and affiliated items EB142/8, EB142/9, and EB142/10)

Representing the United States, Garrett Grigsby, Director of the Office of Global Affairs at the U.S. Department of Health and Human Services, articulated the U.S. position that the WHO would be better served by investing in prevention now rather than responding to emergencies later.  He moreover argued that achieving universal access to healthcare in many countries will require the kind of resources only available through private sector investment and that the WHO should, therefore, utilize private sector partnerships to drive healthcare access availability down to the individual level.

Conversely, the People’s Health Movement, a global network of health activists, expressed concern with “the rise of private-public partnerships for global health security such as GAVI and CEPI,” concluding that such collaborations can “potentially undermine WHO’s leadership and confer undue influence to the private sector.”

Agenda Item 3.6 Addressing the global shortage of and access to medicines and vaccines

Director Grigsby reported that in 2017 the U.S. Food and Drug Administration (FDA) set an all-time record for approvals (763) granted for generic medications.  This increase in approvals reflects the growing understanding that generic medications will play an essential role in expanding global access to medicines and vaccines.  Director Grigsby further suggested that the private sector companies who develop and manufacture such medicines would make a logical (and perhaps indispensable) partner in the WHO’s efforts to overcome access barriers (such as scarcity and price) to medicines and vaccines.  The U.S. also emphasized the importance of innovation, which typically originates in the private and academic sectors.

The representative from Portugal, however, cautioned that private sector partnerships fail to advance the three keys to global access:  transparency, fair pricing, and joint public procurement.  The representative specifically pointed out that a “lack of transparency regarding costs of production, research and development, and prices paid by other Member States and procurement agencies results in a lack of power to negotiate and a reliance on mechanisms for comparison such as international reference pricing, which is likewise opaque.” In addition, the “lack of transparency stimulates corruption, bad governance and allows for abuses such as the very high prices that are currently being imposed for some innovative medicines, namely for cancer, Hepatitis C or some new gene therapies.”

A number of non-state actors also offered comments on Agenda Item 3.6.  Dr. Mychelle Farmer of the Global Health Council delegation, in a statement supported by the American Academy of Pediatrics (AAP), which represents 66,000 pediatricians, and NCD Child, a global coalition for prevention and treatment of non-communicable diseases (NCDs), stated that the WHO should consider pursuing Product Development Partnerships to target specific diseases, including non-communicable diseases.

Agenda Item 3.8 Preparation for the third High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases

Regarding the prevention and control of NCDs, the U.S. delegation highlighted the critical need for “collaboration and partnerships across sectors.”

Likewise, Canada, speaking on behalf of Canada, the Caribbean, Central and South America, and Mexico, said, “To effectively address the growing epidemic of NCDs and manage their shared risk factors we believe a whole-of-government and a whole-of-society approach should be promoted. Strong political will, investments and cooperation are necessary to tackle the social, economic, political and capacity challenges underpinning NCDs and to encourage action across sectors as well as multi-stakeholder engagement and partnership.”

The Global Health Council, supported by NCD Child, the AAP, and the International Federation of Psoriasis Associations, echoed this sentiment and indicated that the WHO must create linkages between non-state actors and non-health sectors to effect lasting change.

Commentary on Twitter, however, suggests that the European Union statement, while welcoming global efforts to combat NCDs, opposes corporate involvement in the effort, referencing the UN model policy on preventing tobacco industry interference.

Agenda Item number 3.9 Preparation for a high-level meeting of the General Assembly on ending tuberculosis (TB)

The U.S., which claimed to be the largest funder of TB prevention, treatment, and research worldwide, stated that the U.S. is committed to domestic TB elimination and believes that with effective collaboration, and increased multi-sector engagement, the WHO can end TB worldwide.

Agenda Item 4.2 Physical activity for health

The NCD Alliance noted that the inadequacy of existing resources to achieve the WHO’s physical activity targets may require “cross-sectoral collaboration, co-investments and accountability” but that any such collaborations should be “informed by WHO recommendations on restrictions of marketing of unhealthy foods and non-alcoholic beverages, and the Commission on Ending Childhood Obesity” and other “potentially incompatible partnerships e.g. those with the alcohol, gambling and fossil fuels industries, whose products and services drive modifiable NCD risk factors and contradict sustainable development principles.”

Ilona Kickbusch, Director of the Global Health Centre of The Graduate Institute of International and Development Studies in Geneva, similarly tweeted that “the food and drinks industry are complicit to the NCDs epidemic and must change”.

Meanwhile, the Infectious Diseases Society of America (IDSA) suggested that the WHO must strengthen its own research and vaccine development, and that it would be counterproductive to exclude private sector contributions when addressing the health of all people everywhere.

Conclusion

Although the debate continues, the WHO has acknowledged the potential benefits of public-private collaborations.  In a January 19, 2018 article in The Wire entitled “WHO Gets to Work: 2018 a Litmus Test for New Team”, for example, the WHO reportedly has indicated a willingness to engage with a range of non-state actors, including private entities, because “outreach to such actors is critical for WHO’s work.”  The WHO likewise acknowledges in its revised Global Plan for Work GPW13 that “Non-State actors and, in particular, the private sector can also contribute to [universal healthcare] UHC in service delivery, innovation, investment, and as employers.”  At the same time, the WHO continues to reaffirm that it will always “speak up against practices from any sector, including industry, that, based on evidence, are harmful to health.”

  • View Global Health Council’s 2017 World Health Assembly statement for Agenda Item 23.3: Engagement with non-state actors.
142nd WHO Executive Board (EB) Session Updates

Global Health Council (GHC) is hosting a delegation to the 142nd Session of the World Health Organization (WHO)’s Executive Board (EB) Session. The WHO EB Session is currently in progress in Geneva, Switzerland and will conclude on January 27The following updates were provided by Danielle Heiberg, Senior Advocacy Manager, Global Health Council.

142nd WHO EB Meeting in session. Photo credit: Danielle Heiberg

MORE INFORMATION ON THE WHO EB SESSION

VIEW JOINT EB STATEMENTS FROM GHC & MEMBERS

Reflections on WHO’s Thirteenth Global Programme of Work (GPW13) – Women in Global Health

Make sure to follow @GlobalHealthOrg on Twitter to stay informed of live updates from our delegates and partners attending the Session.

Day 3: Midway Through

The EB covered several topics today: Public Health Preparedness and Response (NSA statements); Polio Transition; Health, environment and climate change; and Addressing the global shortage and access to medicines and vaccines.

Matt Robinson with GHTC provided a short write up on the last issue:

The afternoon session on access to medicines produced far less controversy than expected. Though the topic remains contentious overall, the late introduction of a resolution asking WHO to spend the next year developing a “roadmap” for its work on access to medicines appeared to defuse any simmering tension by providing the opportunity for more dialogue behind closed doors. The session reached such consensus that New Zealand actually proposed closing debate without hearing statements from non-EB members, unless there were any objections. As a result of the resolution, expect this debate to continue over the coming year.

GHC members presented statements on preparedness and responsepolio transition and access to medicines.

The GHC delegation met with members of the U.S. delegation at the WHO EB Session.

In addition, GHC’s delegation met with Garrett Grigsby and Jenifer Healy from the Office of Global Affairs at the U.S. Department of Health and Human Services.

Tomorrow, (Thursday, January 25), the debate will begin with the Global strategy and action plan on public health, innovation, and intellectual property, followed by the agenda items on the high-level meetings on NCDs and TB. The EB will be in session during the day, as well as the evening in order to get through a number of agenda items.

 

 



Day 2: Public Health Preparedness and Response

Today the Executive wrapped up agenda item 3.1 on the draft Global Programme of Work. GHC read a statement that included a few areas of concern specifically on health workforce, WASH and polio transition.

The EB also considered WHO reform, as well as agenda item 3.3. on Public Health Preparedness and Response. The session ended later so that all Member States could provide their interventions. Tomorrow morning (Wednesday, January 24) the session will open with statements from NSAs. PATH will read a statement on behalf of GHC, AAP, PATH, GHTC, and IDSA.

Philippe Guinot, PATH, reads the EB statement on Agenda 3.3 Public Health Preparedness and Response on behalf of GHC, AAP, PATH, GHTC, and IDSA.

The U.S. government, led by Garrett Grigsby from the Office of Global Affairs at the Department of Health and Human Services, delivered a statement on preparedness and response that touched on several ideas (special thanks to Annie Toro for the summary):

1) Highlighted the importance for the Joint External Evaluations (JEEs) to drive preparedness and HSS
2) Enforced standard operating procedures to ensure consistency across regions
3) For health emergencies, a dashboard should be shared with member states
4) R&D – work with all partners in emergency contexts
5) Full IHR implementation is key and an obligation of WHO
6) Consider the important role of sectors outside of health for security purposes
7) Consider issues regarding biosafety as well as national and financial issues for biosecurity

To find out what is next on the agenda, follow the daily journals (published every morning, Geneva time) here: http://apps.who.int/gb/e/e_eb142.html.

 



Day 1: Tedros’ Dialogue with Member States

The WHO Executive Board (EB) session kicked off with a dialogue between Director-General Dr. Tedros Adhanom Ghebreyesus and Member States. Dr. Tedros’ speech focused on three key elements: Universal Health Coverage (UHC), Global Health Security (GHS), and what the WHO of the future looks like.

A few highlights:

1) Dr. Tedros will send letters to the heads of all Member States challenging them to commitment to three concrete steps to achieve universal health coverage. He will ask Member States to make their commitments at the upcoming World Health Assembly (WHA) in May.
2) Since the start of his tenure, Dr. Tedros has been working to strengthen foundations of organization; developing a plan to transform that includes a “rethink” of resource mobilization for the agency; and building strong leadership including achieving gender parity in top ranks and geographical diversity.
3) Dr. Tedros put out a call to Member States to commit in-kind supply donations and personnel to a “Global Health Reserve Army” that could be ready to respond to an outbreak within 72 hours.
4) In regards to funding for WHO, Dr. Tedros spoke several times about the need for “unearmarked” funds to allow the agency greater flexibility in addressing priorities.

Dr. Tedros’ comments should be available here.

Before adjourning for the day, the EB began member statements on agenda item 3.1 the Global Program of Work. On the second day, the remaining 15 Member States will give their statements followed by non-state actors.

We expect several statements to be read by our delegation today on the Global Program of Work, Public Health Preparedness and Response, and possibly, Polio Transition Planning.

 

 

142nd WHO Executive Board Session Begins in Geneva: GHC Delegation to Read Statements on Multiple Agenda Items

Broken Chair at the Place Des Nations, Geneva, Switzerland.

This year, Global Health Council (GHC) is hosting a delegation to the 142nd Session of the World Health Organization (WHO)’s Executive Board (EB) Session. The EB Session is currently in progress in Geneva, Switzerland and will conclude on January 27.  The full agenda, associated documents, along with the live-webcast link can be accessed at GHC’s events calendar.

Discussion and debate of WHO’s Draft Thirteenth General Programme of Work (GPW) will emphasize three priorities: 1 billion more people with health coverage; 1 billion more people made safer from health emergencies, and 1 billion more people enjoying better health and well-being. WHO, under the leadership of Dr. Tedros Adhanom Ghebreyesus, the Director General of the organization, plans to reshape its operations, and place greater importance on accountability and impact. The organization intends to use the Sustainable Development Goals (SDGs) as a foundation for its global health priorities.

As we speak, the following speakers from the GHC delegation are preparing to read their statements at the WHO EB Session. Each of the statements corresponds to specific agenda items featured in the Provisional Agenda (EB 142/1) and are submitted by GHC member organizations.

1) 3.1: Draft 13th General Programme of Work 2019-2023  – The joint statement from GHC supported by ACTION and Frontline Health Workers Coalition will be read by Danielle Heiberg, Global Health Council.

2) 3.3: Public Health Preparedness and Response – This joint statement from GHC supported by PATH, Global Health Technologies Coalition (GHTC), American Academy of Pediatrics (AAP), and Infectious Diseases Society of America (IDSA) will be read by Philippe Guinot, PATH.

3) 3.4 Polio Transition PlanningThis joint statement from GHC supported by PATH, ACTION, RESULTS UK, and AAP will be read by Philippe Guinot, PATH.

4) 3.6 Addressing the Global Shortage of, and Access to, Medicines and Vaccines – This joint statement from GHC supported by PATH, AAP, and NCD Child will be read by Mychelle Yvette Farmer, NCD Child.

5) 3.7 Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property – This joint statement from GHC, supported by IDSA, will be read by Rabita Aziz, IDSA.

6) 3.8 Preparation for the Third High-level Meeting of the General Assembly on the Prevention and Control of Non-Communicable Diseases (NCDs), to be held in 2018 – This joint statement from Global Health Council, supported by NCD Child, AAP, and IFPA, will be ready by Mychelle Yvette Farmer, NCD Child.

7) 3.9 Preparation for the High-Level Meeting of the General Assembly on Ending Tuberculosis  – This joint statement from GHC, supported by IDSA, will be read by Rabita Aziz, IDSA.

8) 4.2 Physical Activity for Health – This joint statement by GHC supported by AAP and NCD Child will be read by  Mychelle Yvette Farmer, NCD Child.

9) 4.3 Global Strategy for Women’s, Children’s and Adolescents’ Health (2016-2030): Early Childhood Development – This joint statement by GHC supported by AAP and NCD Child will be read by Mychelle Yvette Farmer, NCD Child.

10) 4.4 mHealth – This joint statement from GHC supported by Living Goods will be read by Annie Toro, United States Pharmacopeia.

11) 4.6.1 Comprehensive Implementation Plan on Maternal, Infant and Young Child Nutrition: Biennial Report – This joint statement from GHC supported by AAP and NCD Child will be read by Mychelle Yvette Farmer, NCD Child.

Make sure to follow @GlobalHealthOrg on Twitter to stay informed of live updates from our delegates and partners attending the Session.

142nd World Health Organization (WHO) Executive Board (EB) Session

Organized by World Health Organization (WHO)

January 22 – 27
Geneva, Switzerland

MORE INFORMATION ON THE EXECUTIVE BOARD

ACCESS THE EB SESSION DOCUMENTATION

WATCH THE LIVE WEBCAST

GHC will be sending a delegation of its members to the meeting. Be sure to follow GHC on Twitter (@GlobalHealthOrg) for the latest updates from the delegation, including forthcoming statements.

The Executive Board is composed of 34 technically qualified members elected for three-year terms. The annual Board meeting is held in January when the members agree upon the agenda for the World Health Assembly and the resolutions to be considered by the Health Assembly.

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142nd WHO Executive Board Session Briefing

Organized by

142nd WHO Executive Board Session Briefing
January 17
1:30 PM – 2:30 PM EST
Webinar

REGISTRATION

SUBMIT YOUR QUESTIONS FOR THE Q/A SESSION

(Deadline for submission is January 16)

Join GHC for a webinar briefing to gather insights regarding the 142nd WHO Executive Board (EB) session, which opens in Geneva on January 22. The webinar will feature remarks from GHC members and partners and will address critical EB discussions on WHO’s leadership priorities, including the draft thirteenth general programme of work 2019–2023, TB, and NCDs. U.S. government staff have been invited to attend the briefing. Remarks will be followed by a Q&A/Discussion with participants. GHC is now accepting questions from participants ahead of the webinar for the Q&A session. Please complete this form by no later than January 16.

Special guests include:

1) Garret Grigsby, Director of the Office of Global Affairs, U.S. Department of Health & Human Services

2) Jenifer Healy, Chief of Staff, Office of Global Affairs, U.S. Department of Health & Human Services

 

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