Without a comprehensive press release and a scattered array of sources for final resolutions and other outcomes, the World Health Assembly (WHA) concluded its 68th session with the adoption of at least 15 resolutions setting policy and guidance for the World Health Organization. A series of press releases does provide information on the main results, available here. We are hosting a webinar on Wednesday, 4 June 2015 from 2:30 pm to 3:30 pm CET to provide an opportunity for updates on the outcomes. The related PowerPoint presentation will also be available on request. Here we provide our insights on two of the resolutions of interest to CMMD – one on linking the WHO on air pollution and health to the forthcoming Paris Climate Change Summit in December 2015, and the other on the state of play regarding a proposed new framework for engagement with non-State actors at the WHO.
- Health and Air Pollution
Many NGOs are calling the WHA resolution on health and air pollution to be a “landmark resolution” or the “most high level health action on air pollution to date”. These remarks come from the Health and Environment Alliance (HEAL) and the Climate and Clean Air Coalition (CCAC). The United Nations Environment Programme adds that this resolution is a “pivotal decision” of the WHA. The United Nations Framework Convention on Climate Change repeats this same press release from UNEP on its website here. Meanwhile, the WHO itself incorporated its passage into the final press release for the 68th WHA, announcing several “landmark resolutions and decisions” but describing only the air pollution resolution and a resolution on strengthening care for epilepsy – plus the resolution that simply extends the timeline for developing consensus on a new framework of engagement with non-state actors. One would hope for (a) a comprehensive press release assessing everything that was accomplished during the WHA; and (b) special attention given to this particular “landmark” or “pivotal” decision on air pollution and health. The latter seems to be receiving more widespread attention in environmental circles than in health circles.
The resolution on air pollution, WHA68.8, 26 May 2015, calls for 13 specific actions, including the development of a “road map” to present to the 69th session of the WHA in May 2016. More formally called the resolution on Health and environment: addressing the health impact of air pollution, WHA68.8 was triggered by evidence from a WHO report that air pollution is the greatest health risk of the 21st century, with both indoor and outdoor air pollution contributing to over 7 million premature deaths per year. The resolution recognizes the two largest culprits of outdoor air pollution to be coal-fired power stations and diesel from transport. On this front, the resolution calls for air quality monitoring systems and health registries to improve surveillance from all illnesses related to air pollution. Of course, indoor air pollution has different sources, related to cooking with solid fuels on open fires or traditional stoves. The resolution calls for developing new technologies for clean cooking, but also heating and lighting technologies. The WHO is called upon to facilitate the international transfer of expertise, technologies and scientific data.
The resolution was co-sponsored by several member-States, but the lead sponsor was Norway. This government was joined by Chile, Colombia, France, Ukraine, USA and Zambia. A drafting group was established when the issue was first raised in a WHA committee, and its work product was only presented on the final day of the WHA, suggesting that there were several member-states, mostly from developing countries, who resisted the broadening of the WHO mandate in this area. The resolution, however, does mandate active health sector engagement in the international climate change negotiations leading to the Paris Summit. It also calls for the establishment of air quality monitoring systems and health registries to improve surveillance for all illnesses. The resolution passed with only a few developing countries expressing a lower level of enthusiasm than the sponsors, but it was nonetheless approved by a consensus. See the final resolution here.
- The Proposed Framework of Engagement for Non-State Actors
The proposed framework of engagement for non-state actors was also tied up in a drafting group until the last day of the WHA. In this particular case, the resolution adopted by the WHA provides for continued negotiations because there was still no final agreed terminology that could be negotiated by the disparate parties before the end of the WHA. The resolution provides for another open-ended intergovernmental meeting to be convened before 15 October 2015 to resolve all remaining issues so that a final draft text can go to the WHO Executive Board in January 2016 and then to the 69th session of the WHA in May 2016. It also provides for the development of a “register” of all non-governmental organizations to be presented to the 2016 WHA, even though the proposed framework of engagement is still to be negotiated.
WHO Director-General Margaret Chan has been promoting a comprehensive reform process for the WHO, encompassing programmes and priorities, governance reform and managerial reform. See the special webpage on the reform process here. The issue of how the WHO should reform its policies on engaging with non-state actors has continued to be the one item of the overall reform process that has yet to be completed. The sticking point is reform related to the role of the private sector. On the whole, it seems that there are activist governments on both sides of the issue, but the public statements of governments tend to be cautiously optimistic about working out the differences. All public statements by governments regarding the state of negotiations were supportive of the progress made under the Argentine chair of the drafting group, and it is expected that Argentina will continue to chair the process. Several of the non-governmental organizations (NGOs) in formal relations with the WHO, on the other hand, are more vocal on either side.
Seven statements were officially presented by NGOs on this issue at the 2015 WHA. Four statements emphasized the importance of subjecting all non-state actors to the same standards of transparency and conflict of interest. These include the Global Health Council, which submitted a statement in cooperation with the Global Social Observatory. Others represented patient groups, the health professions, and the pharmaceutical industry. Three statements came from NGOs that are suspicious of “undue corporate influence” or even the “improper influence of transnational corporations”, citing examples where private sector interests have organized efforts to advance their views on intellectual property rights or on consumption guidelines. See the seven statements here.
In an Annex to the resolution on non-state actors approved by the WHA one finds the text for further negotiations. The governments did not highlight their concerns in their statements of support for continued negotiations, but the Annex is fairly indicative of where the main sticking points can be found. The text highlighted in green is text that has been agreed, while text in yellow is still disputed, and text in grey is the Chair’s proposed compromise language. Although there does appear to be a consensus on proceeding with four distinct categories of non-state actors – NGOs, the private sector, philanthropic foundations and academia – the definitions for these categories remain in dispute, especially regarding the distinction between NGOs and the private sector. But the main issue is the extent to which the private sector is to be singled out for additional restrictions. These include unresolved text regarding acceptable resources for engagement with the WHO and whether there should be a ceiling on financial resources from non-state actors. And they also include text regarding whether certain other industries besides tobacco and arms should be excluded from engagement for “affecting human health” or being “affected by the WHO’s norms and standards”. The scope of transparency requirements and the scope of an oversight mechanism are also unresolved, which makes it odd that the resolution supports the implementation of a “register” of non-state actors without these issues being resolved.
From the CMMD Geneva Observer 1 June 2015