WHO: NGOs raise concerns on denial of effective participation at governing body meetings

Geneva, 6 February (K M Gopakumar) – Several non-governmental organisations (NGOs) which include civil society organisations (CSO) have raised concerns on the denial of effective participation at the World Health Organization’s governing body meetings.

Since around the COVID-19 outbreak Non-State actors (NSAs) are given only one minute to make their individual statements during the meeting of the Executive Board (EB) or World Health Assembly (WHA). Instead of individual statements, NGOs are forced to make collective statements called constituency statements.

The WHO EB document (EB152/38) titled “Involvement of non-state actors in WHO governing bodies” mentions “providing incentives for non-State actors to deliver a limited number of grouped statements in governing bodies”. The incentive to provide constituency statements is by limiting the duration of individual statements to one minute.

Though there is a possibility to upload 300 words for each NSA statement it ls learnt that the WHO Secretariat is instead actively discouraging NSAs to upload statements of this length.

In the name of providing participation the Secretariat is organising  informal pre-meetings to provide inputs to various agenda items. However, so far the presence of Member States in such sessions is very minimal. Thus the agenda under the disguise of involvement of NSAs in governing body meetings is systematically pushing NSAs to the margins.

The ongoing 152^nd EB session (30 January to 7 February 2023) is to take a decision to institutionalise the constituency statements in governing body meetings. The draft decision states: “Decided that the constituency statements will continue to be implemented during all WHO governing body meetings, in accordance with the modalities outlined in paragraphs 15 to 17 of document EB152/38”.

Paragraphs 16 and 17 set the following conditions to make constituency statements:

“It is proposed that the Secretariat should select a limited number of agenda items for constituency statements based on an assessment of which items are likely to attract the most interest for statements by non-State actors. Non-State actors will make a maximum of five constituency statements on those items earlier in the debates at the invitation of the Chair of the meeting. Only non-State actors in official relations may join the constituencies for a statement.

Non-State actors can join more than one constituency statement, but those joining constituency statements cannot make an additional individual statement on the same agenda item. However, for items where constituency statements are made, there will be flexibility in respect of non-State actors that have not joined the constituency statement. Such non-State actors should be allowed to make an individual statement at the Chair’s discretion. It is expected that the number of individual statements will decrease as more non-State actors find joining a constituency statement made earlier in the debates to be more impactful. This should increase the meaningful engagement of non-State actors in governing body
debates while maintaining or even reducing the time needed for their statements.”

Thus the decision provides a free hand for the Secretariat to decide on the number of agenda items open for constituency statements. This arrangement undermines the diverse voices among the NGOs especially CSOs.

Since COVID-19 the physical participation of NSAs in various WHO meetings is denied. During the 152^nd EB session NSAs are allowed to include only 4 members as part of their delegation.

The statement posted by NGOs under agenda item 23.3 raises concern on the systematic marginalisation during the governing body meetings.

The International Council of Nurses (ICN) stated: “Ignoring the direct voice of 28 million nurses worldwide through non-state actors like the ICN would omit critical information needed to address global health and well-being. ICN supports listening to the direct voices of non-state actors for advancing global health and well-being. Consultation with NSAs is needed before making the final decision on constituency statements. Constituency statements should not prevent individual statements, and the selection of agenda items must involve NSAs.”

The International Federation of Medical Students’ Association (IFMSA) said: “Over the last few years, with the WHO high level meetings recovering from the impacts of the pandemic, there have been shrinking spaces for NSAs to engage in a meaningful way due to limited seats and speaking opportunities”.

Médecins Sans Frontières International (MSF) expressed their “… ongoing concerns about the proposals under consideration that could limit NSAs role, voice and contribution in WHO’s governing system. These proposals fail to acknowledge the true added value of diversity and the expertise inherent in the varied nature of NSAs. They risk diluting NSAs voice, limiting their meaningful participation in the dialogues and in finding solutions to current health challenges”.

Save the Children stated that it is “disappointed that the proposed way forward does not guarantee that consultations will take place regarding the informal pre-meetings and constituency statements. Last year, we appreciated the consultation process to prepare the informal pre-meetings. We would welcome continued engagement from all actors, including Member States, in these sessions this year. With regard to the constituency statements, we regret the lack of transparent and open dialogue on the selection of agenda items as well as the lack of time we had this time again to properly prepare”.

Medicines Mundi International (MMI) remarked: “In the name of enhancing CSO participation, the Secretariat has systematically marginalised their voice in the governing body meetings. While other UN agencies give CSOs sufficient time to speak, WHO gives individual CSOs 1 minute. This undermines democratisation of global health”. Further the MMI statement calls upon the EB to request the Director-General “to carry out an in-depth discussion or consultation with CSOs and Member States on enhancing participation of NSAs in the governing body meetings”.+