Posted by: davidjolson | 05/28/2010

WHA is challenging but critical venue for global health

GENEVA, Switzerland — Last week I participated in my first World Health Assembly (WHA) and I’ve been thinking about the difference it made, how the Global Health Council fits in and whether the ends justify the considerable effort.

The WHA, the world’s highest health policy-setting body, is the mechanism through which the World Health Organization (WHO) is governed by its 193 member states. The main tasks of the WHA are to approve the WHO program and budget for the next two years, and to decide major health policy issues.

On that basis alone, the Council almost has to be involved. After all, one of our major responsibilities is to advocate for global health wherever important decisions are made. No one can deny that happens at the WHA, although the decisions often take a circuitous and torturous route.  

I came away skeptical of the ability of any of the civil society groups active at the WHA to influence the dialogue that takes place here. But I also came away convinced that it is possible, and that it is incumbent on us — leaders of civil society on global health — to try on behalf of our members, very few of whom can come to Geneva themselves. It is a very useful and appropriate role for a membership organization like the Global Health Council to play. Every year, we invite all of our members to join the GHC delegation that we lead to the WHA: This year, we had 50 registered representatives in our delegation representing 20-some member organizations.

One of the most energetic members of our delegation was Dr. Amy Hagopian of the University of Washington, who was indefatigable in her lobbying for a new global code of practice for the international recruitment of health personnel. Against all odds, she was successful, and the code passed on Friday, May 21, the last day of the WHA. I attribute her success to her single-minded focus on this one issue, her non-stop advocacy with the civil society delegates and, possibly, her equally energetic blogging here at Blog4GlobalHealth (you can read all of her posts below). She also co-authored an op-ed in the Seattle Times.

Another example of where we had the opportunity to influence the dialogue was when our President and CEO Jeffrey L. Sturchio addressed the plenary, one of only a handful of civil society representatives allowed to do so. In his short speech, he stated GHC’s support for 1) a draft resolution on HIV/AIDS proposed by Brazil, 2) the role of research and development in reaching the health-related Millennium Development Goals (MDGs), 3) a common framework around health systems strengthening and 4) clear road maps and timelines for achieving MDGs 4, 5 and 6.

How could we target our communications better than to have three minutes to speak directly to the assembled health leadership of the developed and developing worlds?

I was appalled at how civil society was marginalized (or even ignored) in many of the plenary sessions, where we were confined to an inadequate space where we could not hear anything even if we had had the rare working set of headphones, which most of us did not.

On the other hand, I was delighted that in other “special meetings” and “side events,” a member of civil society might be sitting next to, say, the health minister of Cambodia or Tanzania, and have just as good a chance of them as being called upon by the moderator to ask a question or make a point as government officials.

So it is a good thing that civil society organizations like the Global Health Council go to the WHA and make their best effort to influence the agenda in favor of the underserved and marginalized populations in developing countries that we represent. And it is vital that we reflect on how we interacted and what worked and what didn’t, so we can become progressively more effective in this venue.


  1. Why should NGOs necessarily have a place next to the government representatives of the WHA? Do the NGOs pay dues to the WHA? I think your comment on having NGOs sit next to country members is a bit over the top. It is presumptive and arrogant to think that NGOs necessarily have an important role to play, although they can play an important role and in this particular case, they did. If we accept NGOs, perhaps we should also accept pharmaceutical companies, too. Anyway, my point is NGOs are not members and it is not obvious that they therefore should be given benefits of equal attendance as countries. Even a little island called Taiwan – perhaps you’ve heard of it – is given visitor or viewer status.

    Anyway, I’m tired of people simply assuming that civil society is somehow an assumed good thing. In many countries, it’s as rife with corruption as any other thing. On top of it, there’s no automatic mechanism for accountability (as there is the bottom line in the market or in democracy). In fact, you could easily argue that their status makes it easier to hide behind. In the US, this is certainly the case where, although there are a number of high quality NGOs, a large (if not larger) percentage is of para-political organizations (think Rush Limbaugh) or religious groups or (gasp) terrorists in our own country?

    Please don’t take my message as critical. Just want an open dialogue. That’s all!


  2. Indeed the WHA is one of the most important venues for global health policy, yet after attending three assemblies, twice as a delegate with GHC and most recently with the World Federation of Public Health Associations, I agree it is important to think how to best intervene in this process. I offer these points at this time:

    1. If the GHC is global then in some sense it is the civil society voice for all of the delegations. There does not seem to be opportunity to interact with the delegations prior to or during the assembly when debates were underway. This may be a function of the system at assembly but it seems to me there may be ways to submit papers under the rules. This of course will demand effort prior to and during the process. But as I have watched, there is change that occurs during assembly in the various positions. I think this is a role for GHC. Perhaps GHC should consider a Geneva-based representative. As expensive as that may be, perhaps it is time.

    2. IF GHC is perceived as a “U.S.” civil society organization then there could be ways to increase its interaction with the US delegation while it prepares its positions. While the interagency process is the means of developing US positions, I doubt the US delegation truly allows for CSO input as it is developing its statements. This is an important step in my view because if the GHC cannot have its voice heard in US policy how can it model such behavior for other countries? And since US policy is highly influential, it is most important that it truly reflects the views of US citizens. I am not convinced it does. This raises the issue for me whether GHC as a US based NGO is thus a US corporate citizen. If not then what is it?

    3. I wish the GHC would formally request better conditions for the NGO seating area.

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