TWN Info Service on Health, Finance and Sustainable Development
29 May 2023
Third World Network
www.twn.my

Health: CSOs warn of dangers from private sector investments in WHO
Published in SUNS #9791 dated 29 May 2023

Geneva, 26 May (D. Ravi Kanth) — Global civil society organizations (CSOs) and several health experts on 24 May inveighed against attempts being made at privatizing major health initiatives/policies of the World Health Organization under the so-called “sustainable financing” framework.

As countries are slowly recovering from the COVID-19 pandemic that has claimed millions of lives while enabling Big Pharma to make bumper profits worth billions of dollars through the provision of COVID-19 vaccines, over the past three years, it seems somewhat alarming that the WHO is attempting to embark on attracting private sector investments to overcome its funding crunch.

The WHO Director-General, Dr Tedros Adhanom Ghebreyesus, has repeatedly ridiculed the “me-first” vaccination policies adopted by the United States and several other Northern countries that placed profits before saving lives.

Yet, the WHO appears to be working on overdrive to bring private sector investments into the global health sector, which is bound to cause more asymmetries in access to affordable medicines across countries, according to several studies.

CONTEXT

It is well-known that the WHO has been facing a persistent funding crunch along with insufficient sourcing of its funds over the past several years.

Consequently, the weak financial situation has adversely affected its core activities.

To address the grim situation arising from the persistent funding crunch, a Working Group on Sustainable Financing was established two years ago to examine the factors responsible for the continued funding crunch as well as for making appropriate recommendations to resolve it.

The Working Group, according to the CSOs and health experts, correctly came to the conclusion that WHO is suffering from a structural lack of flexible funding which, in turn, is affecting its work and priorities.

While the new funding methods aim to increase assessed contributions, up to 50% by 2028, at present, only 20% of the current base segment of the budget comes from assessed contributions.

The gaps that emerge in the prevailing funding structure are filled by the financing mechanism, which is also known as the replenishment mechanism, comprising voluntary (earmarked) contributions.

It is an open secret that voluntary contributions come with strings attached as they depend on the contributor’s priorities.

In short, the so-called earmark system is bound to keep the WHO dependent on voluntary contributions and thereby, undermine its decision-making process in which members ought to play a major role.

Privately, several members suggested that the WHO has already been “hijacked” by donors and philanthropic bodies like the Bill and Melinda Gates Foundation.

Ultimately, such voluntary funds could form a barrier for the WHO to fulfill its normative mandate of “health for all”.

Last year, at the 75th World Health Assembly (WHA), WHO members adopted the recommendations of the Working Group and asked the Secretariat to develop a replenishment mechanism to broaden the financial base.

However, in a surprising move, the decision on the replacement mechanism calls for earmarked funding alongside unearmarked funding.

DRAFT WHA DECISION

At the ongoing 76th WHA in Geneva that began on 21 May, the WHO members are set to decide on a draft decision concerning the issue of accepting voluntary contributions from donors representing the non-state private actors and rich philanthropic bodies.

In effect, the draft decision appears to open the floodgates for bringing huge investible funds from the private sector that has hitherto used public funds for furthering its profit-oriented motives in the health sector.

The proposal being debated at the WHA is contained in the draft WHA A76/32 decision, which is based on a report submitted by the WHO DG.

It urges members and other donors “to ensure the full financing of the base budget segment of the Fourteenth General Programme of Work, and to continue to strive to provide WHO with unearmarked voluntary contributions consistent with the recommendations of the Working Group on Sustainable Financing adopted by the Seventy-fifth World Health Assembly.”

The draft decision adds, “to continue for WHO to accept, alongside unearmarked voluntary contributions, voluntary contributions that are earmarked and/or single-year contributions from Member States and other donors and further increase transparency of reporting on voluntary earmarked contributions and on their impact and allocation across the three levels of the Organization.”

Further, it requests the WHO Director-General, in consultation with Member States, to proceed “with the planning of a WHO investment round for the last quarter of 2024 to facilitate the financing of the Fourteenth General Programme of Work …”

The DG is to also present a report with a full plan that includes “modalities and anticipated costs and efficiencies (including staffing adjustments)” for undertaking this exercise.

In a footnote attached to the draft decision, it is proposed that “when engaging with donors representing non-state actors, the Secretariat will apply relevant policies and rules including the WHO Framework of Engagement with Non-State Actors (FENSA).”

The draft decision calls for developing a target funding envelope for the WHO investment round, based on the base segment of the financing envelope.

CSOs EXPRESS SHARP CONCERNS

Against this backdrop, at a press conference on 24 May, the CSOs raised sharp concerns, particularly on the issue of WHO funding and pathways being created for private sector investments.

“The draft decision goes against the very objective of the recommendation of the Working Group,” said Lauren Paremoer of Peoples’ Health Movement (PHM).

According to Ms Paremoer, “as per the approved budget of USD 6834.1 million for the 2024-25 biennium, USD 5685.8 million is to be funded through Voluntary Contributions (VCs).”

Clearly, such a large magnitude of funds to be drawn through voluntary contributions would be tantamount to “the institutionalization of earmarked funding (that) would further stabilize donor-driven priorities and compromise the credibility, independence, and integrity of WHO,” she argued.

Mr Baba Aye from Public Services International (PSI) severely criticized what he reckoned as the “philanthro- capitalist influence” on the WHO, saying that “it cannot be the destiny of the WHO.”

Sadly, he said, “it has come to be accepted as the normal state of affairs but has to be resisted in every way possible.”

He called on WHO members “to ensure sufficient and predictable assessed funds to safeguard the leading role of WHO in international health.”

The CSOs noted that the draft decision provides the mandate to the WHO Secretariat to organise the investment round, and that as per the draft decision to support the investment round, a WHO Investors’ Forum would be established.

In this context, Nicoletta Dentico of the Society for International Development (SID), said: “Health is surely not an expenditure but the most important political investment in and for society, yet the current WHO investment approach towards public health is highly problematic, as it inherently reproduces the extractive logic of the banking and financial system, not the long-term mentality that health policies require.”

The only way to address the WHO’s funding crunch is through enhanced public funding, she said.

“We of course need to increase public funding, but the devil is hidden in the multilateral development community’s fixation with leveraging the private sector in healthcare using public money to de-risk investments,” she persuasively argued.

According to Ms Dentico, “the creation of an Investors’ Forum at the WHO looks now [like a] new attempt to advance health financialization at the very core of the agency’s governance.”

UNDERMINING MEMBERS’ ROLE IN WHO GOVERNANCE

In a sharp critique of the WHO’s proposed Investors’ Forum that could undermine members’ role in the governance of the body, Mr K M Gopakumar of the Third World Network (TWN) said that the very idea of a WHO’s Investors’ Forum is a recipe for seriously undermining the role of the vast majority of members in WHO’s overall governance.

“The Forum’s participants consisting of a rather impenetrable network of philanthropic foundations and the private sector would de facto control WHO’s priorities,” the TWN representative argued.

Worse still, “it also legitimizes the whitewashing of money and images of the private sector through WHO Foundation,” Mr Gopakumar warned.

The time has come to stop the WHO’s “descent into the abyss” of neo-liberal health policies and financing routes that wreaked havoc during the pandemic.

Such policies have exposed the dangers of privatization of the health sector over the last 30 years.

Ultimately, health is a public good that can only be sustained through public funding. For some inexplicable reason, the WHO DG seems to be determined to bring the private sector into the organization in a big way to the detriment of his major health priorities, said people, who asked not to be quoted. +